Dementia and Alzheimer’s Flashcards
At age 65 what is the frequency of Alzheimer’s in women?
1 in 10
At age 65 what is the frequency of Alzheimer’s in men?
1 in 20
Dementia
A group of symptoms or syndrome that manifests and creates challenges related to memory, communication, and problem solving
What is mixed dimentia
There are multiple types and it is common for patients to have multiple or mixed dimentia
Some people have dementia like symptoms but no brain changes what are the causes?
Depression, alcohol abuse and vitamin deficiences
Alzheimer’s diesease
A condition in which neurons have been damaged or destroyed affecting mobility and bodily functions and is ultimately fatal.
What are the 3 stages of alzheimers
- Dementia
- Mild cognitive impairment
- Preclinical dementia (no symptoms)
Dementia due to Alzheimer’s disease
First stage of Alzheimer’s. Bio markers are present as well as changes in behavior, memory and thinking that impact occupational functioning
What is mild cognitive impairments due to Alzheimer’s disease?
Second stage of alzheimers. Bio marker present in addition to challenges with cognition that is more than what is considered normal given their age
Pre-clinical Alzheimer’s disease
3 stage. Evidence of brain changes yet no noted challenges with memory. Can occur up to 20 year prior to symptom onset.
What is early onset alzheimers?
When the disease effects people age 30-mid 60’s
How likely is it that relatives of someone with early onset dementia will get it?
50/50
Vascular dementia
2nd most common form of dementia. Later in life
What is the main type of dementia
Frontotemporal dementia. Has a strong family history.
What increases the risk of dementia with lewy bodies?
Parkinson’s disease
What is the most common form of dementia ?
Alzheimer’s disease
symptoms of vascular dementia
executive function impairments, decision making and organization
lewy body dementia symptoms
difficulty sleeping early on then hallucinations and mobility impairments with parkinson like symptoms.
frontal temporal lobe degeneration symptom
mostly in changes of behavior and personality. often with aphasia and memory issues
What are some of the biomarkers of dementia
as beta-amyloid and tau levels in cerebrospinal fluid, and brain changes noted through imaging via magnetic resonance imaging (MRI) or computed tomography (CT),
Delirium is 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.
what is the cardinal sign of metabolic encepha- lopathy,
Diffuse brain dysfunction
metabolic encephalopathy
chemical changes in the brain that affect cognitive function.
Behaviors associated with sundowning include
increased agitation, psychosis, confusion, or mood swings.
Explicit memory is the recall of
facts, concepts, and events.
Implicit memory places more emphasis on
motor engrams (memories stored physiologically i.e., kinesthetic memory), learned and emotional responses, and procedural recall.
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?
stage 4
Which of the following are reversible causes of dementia according to your reading? (Select 3)
vascular dementia
depression
anemia
vitamin deficiency
depression
anemia
vitamin deficiency
four main causes of altered mental status
dementia
delirium - medially based - usually short lived
metabolic encephalopathy - systemic virus
depression
cause of dementia
damage to braincells. Hippocampus are the first to be damaged. effects learning and memory
risk factors for dementia
age, family history, race/ethnicity, physical activity, smoking, education, staying socially and metally active, blood pressure, diet
what are the genetic chromosome markers for early onset ?
1, 14, 21
circulation can affect the risk of dementia why is this important
to do that other health issues can contribute
alcoholism can lead to
dementia
Signs of Alzheimer’s dementia
- 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
features associated with dementia
agitation, aggression, sleep disturbances, apathy, depression or anxiety, personality changes, behavioral disinhibition, impaired insight, hallucinations, delusions
for a dementia diagnosis they need to have memory loss and one of the following
- aphasia, apraxia, agnosia or impaired executive functioning
- Deficits cause significant impairment
in social or occupational functioning
potentially reversable forms of dementia
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)
what is the percentage of reversable dementia
13%
Aphasia
able to speak but hard time comprehending. they may talk around what they are trying to say.
impaired comprehension
Apraxia
inability to carry out motor activities despite having motor function.
Agnosia
inability to recognize or identify objects despite knowing it
impaired executive functioning
difficulty with planning. higher level thinking
what does executive function create difficulty in
IADLs
Mild cognitive impairment
- 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
Early onset:
before the age of 60
Less than 5% of all cases of AD
Strong genetic link
Tends to progress more rapidly
late onset:
after age 60
Represents the majority of cases
dementia is an umbrella term. what are the types?
alxheimer’s
vascular
lewy body
frontotemporal
other - huntingtons
mixed dementia
amigdala is effected later what does this cause
emotional disturbances later on in the diagnoses.
prefrontotemporal dementia
progressive, abnormal amounts of proteiens in brains. deals with repetitive movements, lip smacking - go back and look this up.
vascular dementia
microscopic bleeding and vessel blockage in the brain. changes in white matter. most common symptom is impaired judgement and decision making.
Lewy body dementia
more physical side effects. decline in thinking, tremors, slow movement - look up.
alzheimer’s disease does what to the brain.
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
dementia 3 stage model
Early, middle, late stages
goes along with mini mental
dementia seven stage model
Global Deterioration Scale
early stage of demetia
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
middle stage or moderate level of dementia
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
late stage or severe
- 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
prognosis of dementia
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
assessments for dementia
Montreal Cognitive Assessment (MOCA)
Mini mental state exam
Clock Drawing Test (CDT)
Mini-Cog
Time and Change
7-Minute Screen
OT evaluation
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
