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OTH 618 Adult Physical Rehab II > Dementia and Alzheimer’s > Flashcards

Dementia and Alzheimer’s Flashcards

1
Q

At age 65 what is the frequency of Alzheimer’s in women?

A

1 in 10

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2
Q

At age 65 what is the frequency of Alzheimer’s in men?

A

1 in 20

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3
Q

Dementia

A

A group of symptoms or syndrome that manifests and creates challenges related to memory, communication, and problem solving

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4
Q

What is mixed dimentia

A

There are multiple types and it is common for patients to have multiple or mixed dimentia

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5
Q

Some people have dementia like symptoms but no brain changes what are the causes?

A

Depression, alcohol abuse and vitamin deficiences

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6
Q

Alzheimer’s diesease

A

A condition in which neurons have been damaged or destroyed affecting mobility and bodily functions and is ultimately fatal.

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7
Q

What are the 3 stages of alzheimers

A
  1. Dementia
  2. Mild cognitive impairment
  3. Preclinical dementia (no symptoms)
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8
Q

Dementia due to Alzheimer’s disease

A

First stage of Alzheimer’s. Bio markers are present as well as changes in behavior, memory and thinking that impact occupational functioning

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9
Q

What is mild cognitive impairments due to Alzheimer’s disease?

A

Second stage of alzheimers. Bio marker present in addition to challenges with cognition that is more than what is considered normal given their age

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10
Q

Pre-clinical Alzheimer’s disease

A

3 stage. Evidence of brain changes yet no noted challenges with memory. Can occur up to 20 year prior to symptom onset.

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11
Q

What is early onset alzheimers?

A

When the disease effects people age 30-mid 60’s

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12
Q

How likely is it that relatives of someone with early onset dementia will get it?

A

50/50

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13
Q

Vascular dementia

A

2nd most common form of dementia. Later in life

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14
Q

What is the main type of dementia

A

Frontotemporal dementia. Has a strong family history.

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15
Q

What increases the risk of dementia with lewy bodies?

A

Parkinson’s disease

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16
Q

What is the most common form of dementia ?

A

Alzheimer’s disease

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17
Q

symptoms of vascular dementia

A

executive function impairments, decision making and organization

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18
Q

lewy body dementia symptoms

A

difficulty sleeping early on then hallucinations and mobility impairments with parkinson like symptoms.

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19
Q

frontal temporal lobe degeneration symptom

A

mostly in changes of behavior and personality. often with aphasia and memory issues

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20
Q

What are some of the biomarkers of dementia

A

as beta-amyloid and tau levels in cerebrospinal fluid, and brain changes noted through imaging via magnetic resonance imaging (MRI) or computed tomography (CT),

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21
Q

Delirium is a

A

sudden and acute change in mental status, frequently presenting with psychomotor activity impairment, difficulty main- taining a stream of thought, and poor reasoning skills.

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22
Q

what is the cardinal sign of metabolic encepha- lopathy,

A

Diffuse brain dysfunction

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23
Q

metabolic encephalopathy

A

chemical changes in the brain that affect cognitive function.

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24
Q

Behaviors associated with sundowning include

A

increased agitation, psychosis, confusion, or mood swings.

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25
Q

Explicit memory is the recall of

A

facts, concepts, and events.

26
Q

Implicit memory places more emphasis on

A

motor engrams (memories stored physiologically i.e., kinesthetic memory), learned and emotional responses, and procedural recall.

27
Q

Your client presents with moderate cognitive decline and has challenges with short-term memory and basic arithmetic. Which stage of the Global Deterioration Scale is their impairment?

A

stage 4

28
Q

Which of the following are reversible causes of dementia according to your reading? (Select 3)
vascular dementia
depression
anemia
vitamin deficiency

A

depression
anemia
vitamin deficiency

29
Q

four main causes of altered mental status

A

dementia
delirium - medially based - usually short lived
metabolic encephalopathy - systemic virus
depression

30
Q

cause of dementia

A

damage to braincells. Hippocampus are the first to be damaged. effects learning and memory

31
Q

risk factors for dementia

A

age, family history, race/ethnicity, physical activity, smoking, education, staying socially and metally active, blood pressure, diet

32
Q

what are the genetic chromosome markers for early onset ?

A

1, 14, 21

33
Q

circulation can affect the risk of dementia why is this important

A

to do that other health issues can contribute

34
Q

alcoholism can lead to

A

dementia

35
Q

Signs of Alzheimer’s dementia

A
  • memory loss that disrupts daily activity
  • challenges in planning or problem solving
  • difficulty completing familiar tasks
  • confusion with time or place
  • trouble understanding visual images and spatial relationship
  • new problems with words in speaking or writing
  • difficulty following conversation
  • misplacing things and not able to replace steps
  • decreased or poor judgement
  • paying less attention to grooming or hygiene
  • withdrawal from work or social
  • changes in mood or personality
  • confused, suspicious
36
Q

features associated with dementia

A

agitation, aggression, sleep disturbances, apathy, depression or anxiety, personality changes, behavioral disinhibition, impaired insight, hallucinations, delusions

37
Q

for a dementia diagnosis they need to have memory loss and one of the following

A
  • aphasia, apraxia, agnosia or impaired executive functioning
  • Deficits cause significant impairment
    in social or occupational functioning
38
Q

potentially reversable forms of dementia

A

Drug Toxicity
Metabolic Disturbance
Hydrocephalus
Mass Lesion (Tumor, Chronic Subdural)
Infectious Process (Meningitis, Syphilis)
Endocrine Disorder (Thyroid, Parathyroid)
Nutritional Disease (B12,thiamine,folate)
Other (COPD, CHF, Liver Dz, Apnea)

39
Q

what is the percentage of reversable dementia

A

13%

40
Q

Aphasia

A

able to speak but hard time comprehending. they may talk around what they are trying to say.

impaired comprehension

41
Q

Apraxia

A

inability to carry out motor activities despite having motor function.

42
Q

Agnosia

A

inability to recognize or identify objects despite knowing it

43
Q

impaired executive functioning

A

difficulty with planning. higher level thinking

44
Q

what does executive function create difficulty in

A

IADLs

45
Q

Mild cognitive impairment

A
  • early stage of memory loss/other cognitive ability loss (such as language or visual/spatial perception)
  • maintain the ability to independently perform most ADLs
  • noticed by the person affected and by family members and friends
  • can develop for multiple reasons
  • may or may not later develop dementia
46
Q

Early onset:

A

before the age of 60
Less than 5% of all cases of AD
Strong genetic link
Tends to progress more rapidly

47
Q

late onset:

A

after age 60
Represents the majority of cases

48
Q

dementia is an umbrella term. what are the types?

A

alxheimer’s
vascular
lewy body
frontotemporal
other - huntingtons
mixed dementia

49
Q

amigdala is effected later what does this cause

A

emotional disturbances later on in the diagnoses.

50
Q

prefrontotemporal dementia

A

progressive, abnormal amounts of proteiens in brains. deals with repetitive movements, lip smacking - go back and look this up.

51
Q

vascular dementia

A

microscopic bleeding and vessel blockage in the brain. changes in white matter. most common symptom is impaired judgement and decision making.

52
Q

Lewy body dementia

A

more physical side effects. decline in thinking, tremors, slow movement - look up.

53
Q

alzheimer’s disease does what to the brain.

A

accumulation of the protein beta-amyloid (plaques) outside neurons and twisted strands of the protein tau (tangles) inside neurons in the brain
death of neurons and damage to brain tissue

54
Q

dementia 3 stage model

A

Early, middle, late stages
goes along with mini mental

55
Q

dementia seven stage model

A

Global Deterioration Scale

56
Q

early stage of demetia

A

Usually the first 2-3 years after diagnosis
Primarily memory and visual-spatial deficits
Mild difficulty with ADLs
can function rather independently and requires little care assistance

57
Q

middle stage or moderate level of dementia

A

3-6 years following diagnosis
Longest stage
Aphasia and apraxia become more pronounced
Loss of IADLS and increased assistance with ADLs
Initially prompts/cues and eventual hands-on assist
Harder to complete multistep tasks
Requires constant supervision
Beginning to exhibit some neuropsychology symptoms particularly paranoia
May have difficulty recognizing loved ones

58
Q

late stage or severe

A
  • Usually 6-10 years following diagnosis
  • Severe language disturbances: mutism, echolalia, repetitive vocalizations
  • Pronounced neuropsychology manifestations including agitation, aggression
  • Very late in the course can see muscle rigidity, gait disturbances, incontinence, dysphagia
  • Require around-the-clock assistance with daily personal care
    ​- Lose awareness of recent experiences as well as of their surroundings
  • Have difficulty communicating
  • Become vulnerable to infections, especially pneumonia
59
Q

prognosis of dementia

A

Insidious onset and progressive course

a person with Alzheimer’s lives 4-8 years after diagnosis, but can live as long as 20 years, depending on other factors (Alzheimer’s Association)

Dementia with Lewy Bodies life expectancy:
8 years after dx

60
Q

assessments for dementia

A

Montreal Cognitive Assessment (MOCA)
Mini mental state exam
Clock Drawing Test (CDT)
Mini-Cog
Time and Change
7-Minute Screen

61
Q

OT evaluation

A

In addition to typical evaluation of ADL, motor, sensory, cognitive:
Determine AE or DME needs considering the learning abilities of the pt.
Routines/Hobbies/Likes/Dislikes
Environment:
appropriate lighting? Noise levels? Good roommate match? Visual stimulation?
Safety:
Ability to use call button, lock wheelchair breaks, express wants/needs

62
Q
A

OTH 618 Adult Physical Rehab II (20 decks)

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