Dementia Flashcards
Describe 6 changes to the brain with normal ageing
Weight + volume decreases.
Ventricle size increases.
Decreased grey matter
Nerve cell loss in the cortex, hippocampus, cerebellum + fewer cell connections
New deposits: protein tangles, plaques (amyloid), lewy bodies (intracellular inclusions)
What is dementia?
Chronic + progressive deterioration of cognitive function due to organic brain disease.
Irreversible
Consciousness is not impaired.
What 6 higher cortical functions are disrupted in dementia?
Memory Thinking/ Judgement Orientation Calculation Learning/ Comprehension Language
What 5 psychiatric/ behavioural changes are seen in dementia?
Changes in personality, emotional control, + social behaviour Depression Agitation Hallucinations Delusions
What are the 4 main types of dementia?
Alzheimer’s disease (50%)
Vascular Dementia (25%)
Lewy Body Dementia (15%)
Frontotemporal Dementia
What is the pathophysiology of Alzheimers? How does this present?
degeneration of cerebral cortex, with cortical atrophy, amyloid plaque formation + reduction in ACh production
insidious onset
What is the pathophysiology of Vascular Dementia? How does this present?
brain damage due to several incidents of cerebrovascular disease (e.g. strokes/TIAs)
step-wise decline
What is the pathophysiology of Lewy Body Dementia? How does this present?
Deposition of abnormal proteins (Lewy bodies) within the brain stem + neocortex
Fluctuating levels of consciousness, hallucinations, falls + Parkinsonian symptoms
What is the pathophysiology of Frontotemporal Dementia? How does this present?
specific degeneration of frontal + temporal lobes
behavioural + intellectual changes
What is dementia diagnosis is based on?
HISTORY
AMTS
MMSE
Full cognitive assessment
What other causes must you exclude when suspecting dementia?
Treatable causes: Hypothyroidism Vitamin B12/folate deficiency Space-occupying lesion Normal pressure hydrocephalus
