Dementia Flashcards
1
Q
What is dementia characterized by?
A
- memory impairment
- at least one other neuropsychological impairment
- cognitive impairment causes significant deficits in daily functioning
2
Q
Dementia facts
A
- before age 65, 1.5% prevalence
- after 65, prevalence doubles every 4 years
- females are more likely to have it then men, because women tend to live longer
3
Q
What is Alzheimer’s Disease characterized by?
A
- insidious onset
- slow, continuous progression
- 50% of cases of dementia
- 6th leading cause of death in US
4
Q
Theories of why people get AD
A
- Genetic- if one twin gets it, 40% chance other will too
- Mutation- chromosome 21
- Accumulation of beta amyloid protein (plaque developing inside neurons)
- abnormal TAU protiens forming neurofibrillary tangles
5
Q
How to diagnose AD
A
- CONDITIONAL diagnosis, can only be confirmed at death (autopsy)
- 6 months to 1 year of check ups to typically diagnose
- behaviourally diagnosed
- first thing to go : incidental memory
6
Q
Neuropsych tests for AD
A
- mini mental status exam, will see continuous drop in scores
- delayed memory
- executive functioning
- orientation
- dementia rating scales, longer version of mini mental status
- calinfornia verbal learning test
7
Q
AD impairments
A
- loss in memory consolidation
- orientation
- familiar names and faces become hard to recall
- visuomotor and visuospatial abilities decline
- delusions and hallucinations
- wandering behavior
- confusion
- behavioral outbursts
8
Q
Treatment of AD
A
- cholinergic drugs lengthen period of mild to moderate cognitive deficits, but doesn’t extend life or in regaining functioning
- therapy to add memory aids, cognitiv remediation to slow loss of cognitive functioning
- psychotherapy for acceptance, life planning
9
Q
AD prognosis
A
- age is a negative prognostic indicatory, before 65= very bad prognosis
- lose speech production, then comprehension
- motor cortex failure will cause lack of movement
- death is usually respitory failure, cardiac arrest, or infection
10
Q
Lewy Body Dementia
A
- second most common type of dementia (20%)
- characterized by the presence of lewy bodies which are clumps of protiens that are not properly digested by cells
- faster onset
- fluctuating course
- get worse in evening/afternoon
- frank visual hallucinations
- parkinsonian motor features
11
Q
Diagnosis of DLB
A
- can only be truly diagnosis with discovery of lewy bodies during autopsy
- behavioral observation
- show parkinsonian symptoms at same time as dementia symptoms
12
Q
DLB treatment
A
- treatment involves combo of cholinergics and dopaminergics
- associated with psychotic symptoms so dopamine needs to be monitored
13
Q
What characterizes vascular dementia?
A
- 3rd most common type (15%)
- typified in the brain as lunar infarcts
- fast onset
- quick small degeneration in performance followed by little to no progression over time
- association with cva
14
Q
Diagnosis of VaD
A
- can often be seen on CT scan with associated lunar infarcts
- may be too small to see with multiple TIAs
- prognostic indicators of CVA are same for VaD
15
Q
Treatment of VaD
A
- Vad can be stopped!
- antihypertensives
- anticholesterol drugs
- diet change and exercise
- however, cannot be diagnosed until significant damage is done
