Dementia, Delirium and Cognitive Decline Flashcards
What is dementia?
A progressive neurological disorder
How many different types of dementia exist and what is the most common?
> 100
Alzheimer’s (70%)
What are the characteristics of Alzheimer’s?
- Gradual onset and progressive decline
- Short then lost term memory
- Decline in cognition and executive functioning
- Difficulties with language and spatial skills
- Mood swings
- Visual and hearing disturbances
- Loss of enthusiasm/ability to initiate
- Decline in physical function
What is Lewy body disease?
Degeneration and death of N cells
What are the characteristics of Lewy body disease?
- Fluctuations in confusion/lucidity within short periods of time
- Parkinsonism - rigidity and balance
- Visual hallucinations
- Visualspatial deficits (falls risk)
- Sleep disturbances
What are people with dementia at increased risk of?
- Falls
- Delirium
- Depression
- Difficult behaviour
- Poor nutrition and hydration
- Elder abuse
What occurs with vascular dementia?
Single stroke or multiple infarcts in cortex
What are the symptoms of vascular dementia?
Symptoms dependent on area of brain affected, but some overlap with Alzheimers:
- Mild memory loss
- Behaviour changes
- Difficulty with speech and swallowing
- Epilepsy
What are the characteristics associated with frontotemporal dementia?
- Fixed mood, selfish behaviour
- Loss of empathy
- Apathy, lack of motivation
- Loss of normal inhibitions
- Difficulty with reasoning and judgement
- Distracted and impulsive
- Changes in eating habits
- Decline in self-care
What aspects of our functioning are affected by frontotemporal dementia?
Frontal lobes:
- Mood
- Social behaviour
- Attention
- Judgement
- Planning
- Self-control
- Processing visual and auditory
What languages difficulties may occur as a result of dementia?
- Nominal aphasia
- Grammar confusion
- Pronunciation difficulty
- Inappropriate word substitution
What memory difficulties may occur as result of dementia?
- Repeating of questions
- Unable to recall events
What factors may increase dementia-related agitation and confusion?
- Confusing structures
- Fatigue
- Change in routine
- Moving wards/beds
- Unmanaged pain
- Carer demands exceeding capacity
How do hospital outcomes differ for patients with dementia compared to those without?
- Two times more likely to experience delirium
- Two times more likely to die in hospital
- Average length of stay twice as long (16.4 days)
How can the impact of dementia by reduced in a hospital setting?
- Have familiar objects
- Memory cues (clocks, calendars)
- Good lighting
- Good signage
- Low noise level
- Limit choices
