Dementia

Question 1

Commonest cause of dementia?

Answer 1

Alzheimer’s disease

Question 2

Dementia is characterised by?

Answer 2

progressive cognitive, social and functional impairment

Question 3

List potential causes of dementia.

Answer 3

depression, alcohol related brain damage, hypothyroidism, Cushing’s, Addison’s, benign tumours, hydrocephalus, infections, Huntingdon’s

Question 4

Describe the change in cognitive function in those with dementia over several years.

Answer 4

generally decreasing, at a faster rate than normal aging

Question 5

Why is it difficult to diagnose dementia in the clinic?

Answer 5

disease follows heterogenous course, in old age present w/ multiple comorbidities, younger patients more typical

Question 6

What’s on the checklist to interview patients with potential dementia?

Answer 6

memory, language, numerical skill, executive skill, visuospatial skill, neglect phenomena, visual perception, route finding, landmark identification, personality/social conduct, sexual behaviour, eating, mood, motivation/apathy, anxiety/agitation, delusions/hallucinations, activities of daily living

Question 7

What is dementia?

Answer 7

severe loss of memory and other cognitive abilities which leads to impaired daily function (regardless of underlying cause)

Question 8

What investigations could you perform when testing for dementia?

Answer 8

neuropsychology
bloods
MRI
PET

Question 9

What are you looking for in bloods when testing for dementia?

Answer 9

full blood count, inflammatory markers, thyroid fx, biochem/renal fx, glucose, B12 + folate, clotting, syphilis serology, HIV, caeruloplasmin

Question 10

What does a brain MRI look like in a person with dementia vs a normal scan?

Answer 10

narrowed gyri
widened sulci
ventricles dilated + enlarged
temporal volume loss
hippocampal volume loss
space replaced with CSF

Question 11

List types of dementia.

Answer 11

alzheimer’s
vascular
lewy body
frontotemporal

Question 12

What proteins are involved in the development of dementia?

Answer 12

beta amyloid

tau

Question 13

Management of dementia?

Answer 13

acetylcholinesterase inhibitors
watch and wait
treating behavioural/psychological symptoms
occupational therapy/social services

Question 14

What other common conditions should you rule out when making a diagnosis of dementia?

Answer 14

delirium

depression

Question 15

Vascular dementia is characterised by?

Answer 15

cerebrovascular disease with classical step wise deterioration with multiple infarcts

Question 16

Lewy body dementia is characterised by?

Answer 16

cognitive impairment before/within 1 year of Parkinsonian symptoms, visual hallucinations and fluctuating cognition

Question 17

Frontotemporal dementia is characterised by?

Answer 17

behaviour variant FTD, semantic dementia, progressive non-fluent aphasia