Dementia Flashcards
What are the most common causes of dementia? (5)
Alzheimer's (50%) Vascular (25%) Mix of the above (15%) Lewy Body (5%) Others (5%)
What is the mean onset age of alzheimers?
70 Years Old
What are the symptoms of temporo-parietal dementia? (3)
- Early memory disturbance
- Language and visuospatial problems
- Personality is preserved until later
What are the symptoms of Lewy Body Dementia? (5)
- Dementia
- 2 of 3 of the lewy triad
- Suggestive symtpoms
- Falls
- Unlikely to be dementia with stroke / other neurological conditions.
What are the lewy triad symptoms of dementia?
Two symptoms = Probable
One symptom = Possible
1) Fluctuation of state [important]
2) Visual Hallucination
3) Parkinsonisms
What are Parkinsonisms? (4)
Bradykinesia
Tremor
Rigidity
Postural Instability
What are suggestive symptoms of dementia?
- REM Sleep Disorder
- Severe antipsychotics sensitivity
- Abnormal DaT scan
Why do we not give antipsychotics to people with parkinsons?
Blocking of dopaminergic D2 receptors can induce extrapyramidal symptoms and dyskinesia.
What are the symptoms of Frontotemporal Dementia? (8)
- Early change in personality / behavious
- Change in eating habits
- Early dysphasia
- Memory relatively preserved
- Speech disorder
- Frontal dysexecutive syndrome
- Abnormal frontotemporal lobes (in imaging)
- Neurological signs absent
What is frontal dysexecutive syndrome described as?
“Having a library without a librarian”
(lack of frontal function like planning and socialising)
Memory, praxis and visuospatial function preserved
What are some symptoms of speech disorder associated with dementia? (5)
1) Altered output (Aphasia)
2) Stereotypy (repitition)
3) Echolalia (parrot behaviour)
4) Perseveration (repetition)
5) Mutism
What is the ABCD of Dementia?
A - Activities of Daily Living (ADL)
B - Behavioural and Psychiatric Symptoms of Dementia (BPSD)
C - Cognitive impairment and low mood
D - Decline
What are the COGNITIVE features of Dementia? (7)
Poor memory AND one (or more) of the following:
- Dysphasia
- Dyspraxia
- Dysgnosia
- Dysexecutive Functioninf
- Functional Decline (ADLs)
What is dysphasia?
Inability to appropriately communicate.
can be BOTH expressive or receptive
What is Dyspraxia?
Reduced motor skills
What is dysgnosia?
Inability to recognise objects
What is ADL?
Activity of Daily Living
What cognitive testing can we conduct on a patient suspected of having dementia? (2)
MMSE
MOCA
What do we give to treat mild to moderate Senile Dementia of Alzheimer’s Type (SDAT)?
Acetylcholinesterase Inhibitors
AChEi
What drug do we use to treat Lewy Body dementia?
Rivastigmine
What type of dementia is treated with MEMANTINE?
ALZHEIMER’S type senile dementia (SDAT)
How do AChEi drugs help dementia?
Only help non-cognitive symptoms, it does NOT stop disease progression.
What are non-cognitive symptoms of dementia? (4)
Bradycardia
Syncope
Gastric Ulcer
Respiratory Problems
What are the side-effects of Acetylcholinesterase Inhibitors? (5)
- N & V
- Diarrhoea
- Fatigue
- Muscle cramps
- Headaches
- Dizziness
List 3 antipsychotics:
Risperidone
Quetiapine
Amisulpride
List 3 common antidepressants:
Venlafaxine (SNRI)
Sertraline (SSRI)
Bupropion (NDRI)
List a common Anxiolytic:
Lorazepam
List 3 hypnotics:
Zolpidem
Zopliclone
Clonazepam
List 2 Anticonvulstants:
Valproate
Carbamazepine
What are neuroleptics?
Anti-psychotics
What are some side-effects of antipsychotics?
Stroke
Death
(that’s why we start slow, go slow and review and stop)
What happens to driving capabilities if diagnosed with dementia? (3)
- Notify DVLA of diagnosis
- If caught early, licence may be on yearly renewal cycle
- lack of insight, memory loss and disorientation = NO DRIVING
What is AMCUR? (think capacity)
Can the dementia patient:
1) Act
2) Make
3) Communicate
4) Understand
5) Retention memory
