Dementia

Question 1

Dementia

Answer 1

syndrome due to disease of the brain - disturbance of multiple higher cortical functions - global cognitive decline- memory problems along with behavioural changes, mood disturbances, personality changes, psychosis

Question 2

Alzheimers

Answer 2

Amyloid plaques and neurofibrillary tangles

Question 3

Pharmacological treatment of alzheimers

Answer 3

cholinesterase inhibitors- donepezil

Memantine- moderate to severe alzheimers- blocks NDMA type glutamate receptors

Question 4

Vascular dementia

Answer 4

HIS- score of 4 or less Alzheimers, 7 or more for vascular dementia
stepwise decline
CT/MRI- severe small vessel disease or multiple lacunar infarcts

Question 5

Lewy body dementia and dementia in Parkinson’s disease

Answer 5

Lewy body dementia- cognitive impairment occurs before or around the same time as the movement disorder
Dementia of Parkinson’s- movement disorder present for at least a year before onset of cognitive impairment

Question 6

Cognitive testing

Answer 6

4AT- rapid assessment of delirium
Adenbrooks (ACE III)
Montreal cognitive assessment (MOCA)
MMSE
Frontal assessment battery
Detailed neuropsychological testing
collateral history

Question 7

Alzheimers

Answer 7

memory loss, particularly short term
dysphasia, dyspraxia, agnosia
temporal lobe atrophy

Question 8

frontotemporal dementia

Answer 8

behavioural variant- executive dysfunction, impulsivity, inhibition, loss of social skills, apathy, obsessions, chancges in diet, primary progressive aphasia, semantic dementia

Question 9

semantic dementia

Answer 9

impaired understanding of meaning of words, fluent but empty speech, difficulty retrieving names

Question 10

CT/MRI frontotemporal dementia

Answer 10

fronto temporal atrophy