Dementia and Delirium Flashcards
what is dementia
a decline in memory and other cognitive functions that affect daily life
is dementia a acquired syndrome
yes
are the cog issues seen with dementia seen with delrium and other psych disorders
nope
how do decide if someone has dementia
patient history
refer to another person who has knowledge of performance
what are the cog domain that are involved in the neuro-cog evaluation
impaired memory and learning
visuospatial and orientation to dressing
finding object
language - word finding, spelling,
personality or behavioral chnage
what are the three types of dementia that she mentions
alheimer’s disease
vascular dem
lewy body dem
what do we see with lewy body dem
~20% have hallucinations
what does normal pressure hydrocephalus lead to
dem - rapid progression
gait problems
UI
hard time writting
what is the prison disease
the jakob disease
what is the most common type of dem
alzheimer’s
2/3 of all dem
how does alz present
gradual onset
progressive decline in cog
sparing motor and sensory functions
aphasia, apraxia, visuospatial function
alz and planning actions
have a hard time with activities that have multiple steps
dressing, bucking a seat belt, movinng out of the asile
what are some warning signs for alz
memory loss
hard time performing familar tasks
language issues
no Ax2
poor decision making
abstract thinking
misplacing things
chnages in mood and behavior
loss of inciative
what is the difference between dem and delirium
delirium: reversible normally, caused acutely by a disease or drug, affecting your attention and awareness
dementia: progressive longterm condition, effects cog and memory function
what is mild cog impairment
this is a transitional state between normal aging and early dementia
what do we see with MCI
slight impairment with cog function with otherwise intact functional status
normal ADL
memory complaint from close person
score 1.5 below age appropriate norms
do all those who have dem have to pass through the MCI phase
nope
8/10 of those convert into dem in 6 year s
is AD costly
yes
more then heart disease
are chromosomal mutation often a cause of AD
nope only 5% of cases
does a family history of AD increase your risk
slight increase in risk
what are the other risk factors for AD
age
down syndrome
low education - may be related to cog reserve
depression
possible lack of physcial activity
what is the average span of AD
10 years
3-20 year = rnage
when do we see the most chnages in those with AD
in the end
slow changes in the begining
how long does it normally take for one to get diagnosed with AD
1 - 4 years
it is normally dismissed as a result of aging
what is lost first IADLs or ADLs
iadls
what is AD characterized by
hard time with
memory
language
vision/spatial function
praxia
what is kind of memory loss is seen with AD
this is normally the presenting feature
STM impacted first
impairment in learning new infromation
progresses to complete failure of recall
what kind of orientation is normally most impacted
time orientation is most vulnerable
how is language impacted with AD
word finding difficulty
vauge content
use pronoun
automatic phrases and cliches
loss of rythmn of voice
loss to global aphasia
what visual impairment do we see with AD
agnosia: impaired recognition of objects
what EF do people with AD have
judgement
problem solving
plan abstract thinking
what self awareness problem do people with AD have
rec of impairment
what are the three thing that are normally seen with pre -AD
memory changes - new info
lang - generating lang
behavioral - personality, irritable, anxiety/depression
what are the chara seen with middle stage AD
poor judgement
visuospatial function
delusion, agression, hallucinations
what is seen with late stage AD
disorientation
neglect self care, eating, bathing, grooming
wandering
hallucination, delusions
what physical changes do we see to the brain with AD
decrease in the size of the hippo and the cortex
enlargement of the ventricles
what is the patho of AD
amyloid plagues and tangles in the brain
what is the patho of vascular dementia
disease or injury to the blood vessel leading to the brain
what is the patho of frontotemporal dem
deteriation of the frontal and temporal lobes of the brain
what is the patho of lewy body dem
lewy body proteins on nerve cells
what is the difference between hallucintation and delusion
hall: there is a visible and audible stim
delusion: very strong false belief
what are some common causes for confusion in patients
dem
stroke
low blood sugar
MCI
drugs
do other neuro or physiological issues cause dementia
nope
cannot be attributed to complications with meds
what is a hypoglycemic level
<70mg/d
what are some signs and sym of hypoglycemia
sweating
nervous
confusion
rapid onset of sym
tachy
palpitations
how quickly can delirium set in
hours to days
what is included in the cofusion assessment method
acute onset
fluctuating course
inattention
diorganized thinking
is there a drug for delirum
no
what is the treatment for delirium
look for the cause of delirium
optimizing the conditions for the brain
address the distress
consider dementia
rehab during delirium
what are some treatment ideas for those with dem
family member present
community with team and family
mobility
maintain sleep wake cycles - with cues
re-orientation
decrease attention to hall and delusions
oppertunies for cog stimulation
families
what is personal space
6ft to arm length
what is public space
6ft away from me
what is intimate space
6 inches or less
physical contact
what is scuba mask
peri vision is lost
what are the steps to connect with someone with dem
- visually
- verbally
- physically
- emtionally
- personality - individually - spiritualluy
