Dementia and Alzheimer’s

Question 1

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

Answer 1

1 in 10

Question 2

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

Answer 2

1 in 20

Question 3

Dementia

Answer 3

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

Question 4

What is mixed dimentia

Answer 4

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

Question 5

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

Answer 5

Depression, alcohol abuse and vitamin deficiences

Question 6

Alzheimer’s diesease

Answer 6

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

Question 7

What are the 3 stages of alzheimers

Answer 7

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

Question 8

Dementia due to Alzheimer’s disease

Answer 8

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

Question 9

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

Answer 9

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

Question 10

Pre-clinical Alzheimer’s disease

Answer 10

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

Question 11

What is early onset alzheimers?

Answer 11

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

Question 12

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

Answer 12

50/50

Question 13

Vascular dementia

Answer 13

2nd most common form of dementia. Later in life

Question 14

What is the main type of dementia

Answer 14

Frontotemporal dementia. Has a strong family history.

Question 15

What increases the risk of dementia with lewy bodies?

Answer 15

Parkinson’s disease

Question 16

What is the most common form of dementia ?

Answer 16

Alzheimer’s disease

Question 17

symptoms of vascular dementia

Answer 17

executive function impairments, decision making and organization

Question 18

lewy body dementia symptoms

Answer 18

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

Question 19

frontal temporal lobe degeneration symptom

Answer 19

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

Question 20

What are some of the biomarkers of dementia

Answer 20

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

Question 21

Delirium is a

Answer 21

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

Question 22

what is the cardinal sign of metabolic encepha- lopathy,

Answer 22

Diffuse brain dysfunction

Question 23

metabolic encephalopathy

Answer 23

chemical changes in the brain that affect cognitive function.

Question 24

Behaviors associated with sundowning include

Answer 24

increased agitation, psychosis, confusion, or mood swings.

Question 25

Explicit memory is the recall of

Answer 25

facts, concepts, and events.

Question 26

Implicit memory places more emphasis on

Answer 26

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

Question 27

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?

Answer 27

stage 4

Question 28

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

Answer 28

depression anemia vitamin deficiency

Question 29

four main causes of altered mental status

Answer 29

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

Question 30

cause of dementia

Answer 30

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

Question 31

risk factors for dementia

Answer 31

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

Question 32

what are the genetic chromosome markers for early onset ?

Answer 32

1, 14, 21

Question 33

circulation can affect the risk of dementia why is this important

Answer 33

to do that other health issues can contribute

Question 34

alcoholism can lead to

Answer 34

dementia

Question 35

Signs of Alzheimer's dementia

Answer 35

- 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

Question 36

features associated with dementia

Answer 36

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

Question 37

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

Answer 37

- aphasia, apraxia, agnosia or impaired executive functioning - Deficits cause significant impairment in social or occupational functioning

Question 38

potentially reversable forms of dementia

Answer 38

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)

Question 39

what is the percentage of reversable dementia

Answer 39

13%

Question 40

Aphasia

Answer 40

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

Question 41

Apraxia

Answer 41

inability to carry out motor activities despite having motor function.

Question 42

Agnosia

Answer 42

inability to recognize or identify objects despite knowing it

Question 43

impaired executive functioning

Answer 43

difficulty with planning. higher level thinking

Question 44

what does executive function create difficulty in

Answer 44

IADLs

Question 45

Mild cognitive impairment

Answer 45

- 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

Question 46

Early onset:

Answer 46

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

Question 47

late onset:

Answer 47

after age 60 Represents the majority of cases

Question 48

dementia is an umbrella term. what are the types?

Answer 48

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

Question 49

amigdala is effected later what does this cause

Answer 49

emotional disturbances later on in the diagnoses.

Question 50

prefrontotemporal dementia

Answer 50

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

Question 51

vascular dementia

Answer 51

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

Question 52

Lewy body dementia

Answer 52

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

Question 53

alzheimer's disease does what to the brain.

Answer 53

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

Question 54

dementia 3 stage model

Answer 54

Early, middle, late stages goes along with mini mental

Question 55

dementia seven stage model

Answer 55

Global Deterioration Scale

Question 56

early stage of demetia

Answer 56

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

Question 57

middle stage or moderate level of dementia

Answer 57

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

Question 58

late stage or severe

Answer 58

- 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

Question 59

prognosis of dementia

Answer 59

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

Question 60

assessments for dementia

Answer 60

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

Question 61

OT evaluation

Answer 61

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