dementia Flashcards
dementia
memory - repetitive temporal gradient amnesia
- difficult to learn new things
functionla ability
- easily muddled
personality alter, empathetic, lack of emotion, disinhibited, change in food preference
language - rememebering names
visuosaptial - lost in familiar spaces
pscyh features - depression
how fast are there declining
tests for dementia
MMC
ACE - addenbrooks cognitive examination
primitive reflexes
limb paraxis - cant they copy ypur hand movements
blow out candle
blood tests for dementia
blood test - FBC, U&Es, CRP, glucose, TFTs, calcium, LFTs, vit B12
imaging on dementia
CT/MRI
radionucleide
LP
EEG
neuropshcy
gold standard for alzheimers
LP - CSF examination - reduced amyloid beta 42, raised tau protein
MRI
shrunking of temporal
fronto-temporal dementia another name Picks
frontal
temporal - lack of coherent speech
CJD sporadic
chorea - myoclonic
dementia treatment
reversible causes hydrocephalus, frontal meningiomas
medication for dementia
donepezil, galantamine - acetylocholinesterase inhibitors - mild to moderate alzheimer
Salivation Lacrimation Urination Diarrhoea GI Emesis
2nd line memantine - NMDA receptor antagonist as in alzheimer make loads of glutamate
deal with psych issues
inform DVLA
power of attorney
what to do before giving medication for dementia
ECG
Diagnostic criteria for dementia
impairment at least two cognitive domains - memory, language, behaviour, visuospatial, executive function
path features of alzheimer
amyloid plaques
neurofibrillary tangles
atrophy of cerebral cortex
what do you have dementia
mild cognitive impairment
what is MCI
WHY early diagnosis
Optimising medical management Relief gained Maximising decision making autonomy Access to care and services Risk reduction Clinical and cost effectiveness A human right?
types of cognitive assessment screen
6-item Cognitive Impairment Test (6-CIT)* Mini-Cog* 10-CS* GPCOG MMSE
basic ADLS include
Ambulating: The extent of an individual’s ability to move from one position to another and walk independently.
Feeding: The ability of a person to feed oneself.
Dressing: The ability to select appropriate clothes and to put the clothes on.
Personal hygiene: The ability to bathe and groom oneself and to maintaining dental hygiene, nail and hair care.
Continence: The ability to control bladder and bowel function
Toileting: The ability to get to and from the toilet, using it appropriately, and cleaning oneself.
instrumental ADLs
Transportation and shopping: Ability to procure groceries, attend events Managing transportation, either via driving or by organizing other means of transport.
Managing finances: This includes the ability to pay bills and managing financial assets.
Shopping and meal preparation. ie everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
Housecleaning and home maintenance. Cleaning kitchens after eating, maintaining living areas reasonably clean and tidy, and keeping up with home maintenance.
Managing communication with others: The ability to manage telephone and mail.
Managing medications: Ability to obtain medications and taking them as directed.
