Dementia Flashcards
what is the commonest cause of dememtia?
alzheimer’s disease
what is dementia?
- fatal, neurogenerative disorder characterised by progressive cognitive, social and functional impairment
what is the current treatment for dementia?
- no current cure
- acetylcholinesterase inhibitors have modest symptomatic benefit at early stages
what is the age group for switch from young onset and late onset dementia?
- age cut of at 65 between young onset and late onset dementia
- most prevalent >65 is Alzheimer’s
what is the continuum of dementia?
the diesase follows heterogenous course
in old age presentation is multiple co-morbidities
what are the causes of dementia?
- fAD- familial autosomal dominant
- AD- Alzheimer’s disease
- VaD- vascular dementia
- DLB/PD- parkinsons/ dementia with Lewy bodies
- FTD- frontotemporal dementia
- Alcohol or other
how can dementia be identified in elderly?
- As progresses lack insight so much ask family/carers – History most important in identifying dementia
what is the brain pathology of dementia?
- High Beta-amyloid antibody presence identified in immunochemistry post-mortem or PET scans in-vivo correspond with high liklihood of Alzheimer’s disease
what happens to the brain on dementia progression?
- As disease progresses get narrow gyri, widened sulci and ventricles dilated and enlarged, mediotemporal volume loss bilaterally, hippocampal volume loss and replaced with CSF
what can be used to assess a patient for dementia?
- MMSE (mini mental state exsamination)
- Head turning sign- when ask patient direct question, turn head to partner as either don’t know answer or cant be sure, need verification
- ACE (addenbrooks cognitive assessment)
- Episodic memory usually affected (profound impairment, particularly in relatin to recently learned material)
- Episodic memory= memory for particular episodes in life
- Dependant of medial temporal lobes inc hippocampus
what is the management for demetia?
- Acetylcholinesterase inhibitors
- Watch and wait (deterioration over 6months)
- Treating behavioural/ psychological symptoms
- Specialist therapy/ occupational therapy/ social services
how is Alzheimer’s diagnosed?
- subtle, insidious amnesic/ non amnesic presentation
- presence amyloid + tau + neurodegeneration for diagnosis Alzheimers
- can measure amyloid via PET or CSF, Tau via CSF
- CSF amyloid alzheimers = lower than normal
- CSF Tau alzheimers= higher than normal
what are the features of vascular dementia?
- reletated to cerebrovascular disease with classival step-wise deterioration + multiple infarcts
what are the features of dementia with lewy bodies?
cognitive impairment before/ within 1 year of parkinsonian symptoms, visual hallucinations and fluctuating cognition
- May be aware of recent events with no evidence of altered behaviour
- Memory not specifically an issue
- REM sleep disorder
- fluctuating cognition
- visual hallucinations can be improved with cholinesterase inhibitor (rivastigmine)
- high risk falls
what are the variants of frontotemporal dementia?
- variants: behavioural variant FTD, sematic dementia, progressive non-fluent aphasia
how are lewy bodies formed?
