Dementia / Elderly Psych Flashcards
Most common form of dementia
Alzheimers
Who declines faster with Alzheimer’s ?
What insidious changes might you notice?
Younger <65
Missing appointment, lack of self care, wandering
What are the cognitive features of Alzheimer’s?
4 A’s
Amnesia - memory deterioration
Apraxia - difficulty with motor planning
Agnostic - inability to process sensory information
Aphasia - difficulty with speech
What radiological signs of Alzheimer’s ?
Shrinkage of cerebral cortex and hippocampus
Enlarged ventricles
Natural Hx of vascular dementia ?
Acute with steep decline
Signs of vascular dementia /
Focal neurology
Series of minor strokes
Risks for vascular dementia
HTN , cholesterol, diabetes, peripheral vascular disease
What is picks disease also known as? Usual age of onset? Signs?
Fronto-temporal lobe dementia
50-60
Personality change -> apathy, disinhibition, emotional blunting, language changes
Memory loss may occur later
What are the signs of levy body disease? What is it related to?
Visual hallucinations
Parkinson’s
-get frequent falls, R.E.M. Sleep disorders
2 classes of drug for Alzheimer’s and Eg?
NMDA antagonist - memantine
Acetylene cholinesterase inhibitors - donepezil, Rivastigmine, galantamine
Treatment of vascular dementia?
Statins, antihypertensive, aspirin , treat diabetes
What would you look for on examination of older psych
MSE
Physical - CVA -> Neuro Sx, Parkinson’s, anaemia, dehydration, hypothyroidism
What investigations for older psych ?
Addenbrookes cognitive examination (attention, memory, language, visual-spacial, fluency)
Bloods
ECG
CXR
What is BPSD? What are they? What’s the cause?
Behavioural and psychological Sx of dementia
Anxiety, depression, agitation, psychosis, disinhibition
PINCH ME
Pain, infection, nutrition, constipation, hydration, medication, environment
What type of schizophrenia can you get in older people? Severity? What are the risk factors?
Paraphrenia
Less emotional blunting and personality decline
Women / social isolation
