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BDS3 BAMS Special Care Dentistry > Dementia > Flashcards

Dementia Flashcards

1
Q

What are tasks that older people can struggle with

A

mobility
dexterity
communication

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2
Q

What are the medical diseases that are common in elderly

A 
musculoskeletal
diabetes, hormonal dysfunction
cognitive impairment
visual conditions
hearing conditions
CV conditions
GI conditions
malignancy
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3
Q

What do older people value

A

company and relationships
time
a desire to contribute to society
someone listening

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4
Q

What is dementia

A

a syndrome
usually of a chronic or progressive nature
results in deterioration in cognitive function beyond what might be expected from normal age

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5
Q

What does dementia effect

A 
memory
thinking
orietnation
comprehension
calculation
learning capacity
language
judgement
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6
Q

What is dementia defined as

A

an acquired progressive loss of cognitive functions, intellectual and social abilities
severe enough to interfere with daily functioning

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7
Q

What is dementia characterized by

A

amnesia
inability to concentrate
disorientation in time, place or person
intellectual impairment

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8
Q

What are issues that those with dementia may have

A 
day to day memory 
concentrating, planning or organizing 
language
visuospatial skills
orientation
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9
Q

How is day to day memory effected

A

there is difficulty recalling events that happened recently

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10
Q

How is concentrating, planning or organizing effected

A

difficulties making decisions, solving problems or carrying out a sequence of tasks

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11
Q

What is language effected

A

difficulties following a conversation or finding the right word for something

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12
Q

How is visuospatial skills effected

A

problems judging distances e.g on stairs and seeing objects in 3D

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13
Q

How is orientation effected

A

losing track of the day or date, or becoming confused about where they are

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14
Q

What is the impairment in cognitive function commonly accompanied or preceded by

A

deterioration in

emotional control, social behavior, motivation

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15
Q

What is alzheimer’s

A

most common type of dementia

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16
Q

What is alzheimer caused by

A

reduction size of the cortex, severe in the hippocampus

caused by plaque and tangle

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17
Q

Describe the plaques seen in Alzeihmers

A

protein called beta amyloid build up in the spaces between nerve cells

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18
Q

Describe the tangles seen in Alzeihmers

A

twisted fibers of tau protein build up inside cells

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19
Q

What are distinctive features of alzeihmers

A 
STML
aphasia
communication difficulties
muddled over everyday activities
mood swings
withdrawn
loss of confidence
20
Q

What are associated factors with Alzeihmers

A 
age
gender (women>men)
head injury
lifestyle 
genetic
21
Q

What lifestyle factors increase risk of Alzeihmers

A

smoking, hypertension, low folate, and high blood cholesterol

22
Q

What lifestyle factors reduce risk of alzeihmers

A

physical, mental and social activities

23
Q

What is the genetic factor that contributes to risk of alhzeihmers

A

abnormalities on chromosome 1, 14, 21

24
Q

What is vascular dementia

A

caused by reduced flow to the brain which damages and eventually kills the brain cells

25
Q

What can vascular dementia develop as a result of

A

small vessel disease

a single large stroke

lots of mini strokes

linked to underlying health conditions such as high blood pressure and diabetes as well as other lifestyle factors

26
Q

What are distinctive features of vascular dementia

A

memory problem of sudden onset, visuospatial difficulties, anxiety, delusions, seizures

27
Q

What is dementia with lewy bodies due to

A

deposits of an abnormal protein called Lewy bodies inside the brian cells

these deposits which are also found in people with Parkinson’s disease, build up in areas of the brain responsible for things such as memory and muscle movement

28
Q

What are distinctive features of Lewy body dementia

A 
STML 
cognitive abilityfluctuates 
visuospatial difficulties
attentional difficulties
overlapping motor disorders
speech and swallowing problems
sleep disorders
delusions
29
Q

What is frontotemporal dementia

A

effects frontal lobes of the brain

ubiqitin associated clumps of protein

TDP-43

30
Q

What is the age of onset of frontotemporal

A

younger

31
Q

What are distinctive features of frontotemporal dementia

A 
STML 
not always present
uncontrollable repetition of wards 
mutism
repetition of words of other people
personality change
decline in personal and social conduct
32
Q

What are the rarer forms

A 
HIV - related genitive impairment
Parkinson's disease
corticobasal degeneration
MS
niemann-pick disease
creutzfeldt-jakob disease
33
Q

What are dementia risk factors

A 
age
gender
genetic background
medical histroy
lifestyle
34
Q

What are early stage symptoms often misattributed to

A

stress, bereavement or normal aging

35
Q

What are the early onset symptom

A

loss of short term memory

confusion, poor judgement, unwilling to make decisions

anxiety, agitation or distress over perceived changes

inability to manage every tasks

communication problems - a decline in ability or interest in talking, reading and writing

36
Q

What are the middle stage symptoms

A

more support required, including reminders to eat, wash, dress and use the toilet

increasing forgetful and may not recognize people

mood changes (aggression)

risk of wandering

may behave inappropriately

may experience hallucinations or throw back memories

37
Q

What are late stage symptoms

A

inability to recognize familiar objects, surroundings or people - but there may be some flashes of recognition

increasing physical frailty, may start to shuffle or walk unsteadily, eventually becoming bed/wheelchair confined

difficulty eating and sometimes swallowing, weight loss

incontinence and gradual loss of speech

symptoms are progressive and reversible

38
Q

What is the diagnosis and measurement of dementia tests

A

dementia screen to eliminate treatable causes

glucose, serum B12, folate and calcium, C-reactive protein and urinalysis

if indicates - syphillis serology, autoantibody screen, serum cholesterol and CT

neurological examination and detailed cognitive testing

39
Q

What does the cognitive testing consist of

A

mini-mental state examination

blessed dementia scale

the montreal cognitive assessment (MoCA)

single neuropsychological tests

clock draws, delayed word recall, category fluency

combined single tests

40
Q

What are the pros of the mini mental state exam (folstein)

A

well known
easy to administer
samples range of cognitive function
test - retest and inter rater availability

41
Q

What are the cons of the mini mental state exam (Folstein)

A

only 3 words to be remembered on recall
not sensitive to mild impairment

old

non standardized time between registration and recall

not sensitive in testing frontal lobe

42
Q

What is the treatment of dementia

A

no pharmocological, surgical or behavioral cure

consoling may delay residential care by up to a year

aspirin and reducing cardiac risks may halt deterioration of vascular types

NSAIDs may slow progression

vitamin E and ginkgo biloba may slow progression

43
Q

What is the drug treatments

A

anticholinesterases

44
Q

What is a dementia friendly care home

A

walls, floor coverings, skirting boards and doors are all in different colors providing good visual contrast to aid way finding

fix labels and images to drawers to help let people find what they need without assistance

bedroom WC should be visible from bed and when lying down

position personal pictures

radiators should be low temp

futrnite and traditional domestic

45
Q

What are dementia friendly healthcare environments

A

reception desk visible from the entrance door

ceilings, floors and floor coverings should be acoustically absorbent to support audible communication

colors and tone of walls should be distinctive from the flooring

color and tone of furniture should be distinctive from the flooring

avoid non essential signs

any signage should be at eye level with simple clear use of text and color. use of pictorial elements

ensure good levels of natural light to minimize artificial light

any staff or locked rooms should be colored the same as the walls to avoid attention

BDS3 BAMS Special Care Dentistry (14 decks)

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