Dementia General

Question 1

What two types of exercise would you recommend for a person concerned about developing dementia?

Answer 1

Any form of exercise
Frequent, vigorous
Higher number of steps
Old answer: aerobic and resistance/balance training

Question 2

8 points of discussion for advanced care planning for patient with dementia

Answer 2

1. Arrange POA and advanced directives
2. Place of care planning: PSW, LTC, etc.
3. Driving cessation discussion/planning
4. Caregiver support
5. Connect with Alzheimer’s Society
6. Blister pack medications
7. Nature of illness (progressive)
8. Treatment options - only symptom modifying

Question 3

8 modifiable risk factors for dementia

Answer 3

Early life (<45))
1. Low education (<grade 12)
Mid life (45-65)
2. Hearing loss
3. TBI
4. HTN
5. Alcohol (>21 U per week)
6. Obesity
Late life (>65)
7. DM
8. Smoking
9. Depression
10. Social isolation
11. Physical inactivity
12. Air pollution

Question 4

What percent of dementia cases are due to preventable/modifiable causes?

Answer 4

40%

Question 5

8 reasons dementia is under recognized in Indigenous people

Answer 5

1. Decreased access to clinic
2. Lack of geriatric specialists
3. Need to travel to specialists
4. Decreased awareness of pathology
5. Cognitive changes thought to be due to normal aging
6. Databases lack Indigenous identification/statistics
7. Mistrust/fear of Western systems
8. Fear of dx/repercussions

Question 6

6 non-medical complications of dementia that require preventative action

Answer 6

1. Home safety: fire, flood, firearms, tools
2. Wandering/exit seeking
3. Falls
4. Malnutrition/dehydration
5. Function: self care, incontinence
6. Capacity/ACP: shelter, medical decision, POA/SDM
   Other
   Psychiatric - hallucinations, delusions
   Social - isolation, depression

Question 7

4 potential causes for weight loss in patient with moderate dementia on CHei

Answer 7

1. GI side effect of CHei - N/V/D, appetite loss
2. Dementia process - loss of appetite, forgetting to eat
3. Poor dentition
4. Dysphagia
   Other
5. Depression/apathy
6. Decreased muscle mass (aging, deconditioning)

Question 8

Based on Rising Tide what is the prevalence of dementia in Canada by the year 2038?

Answer 8

2.8% of the Canadian population
1, 125, 200 people

Question 9

Define apraxia

Answer 9

Inability to perform particular purposive actions

Question 10

Define agnosia

Answer 10

Inability to interpret sensory information (via 5 senses) and hence to recognize things

Question 11

Regarding the Canada National Dementia strategy, name the 3 national objectives

Answer 11

1. Prevention
2. Therapies
3. Improve QOL of people with dementia and their caregivers

Question 12

List 3 diseases of tauopathy

Answer 12

1. PSP
2. CBD
3. FTD - behavioural
4. FTD - language variants (semantic variant PPA, non fluent variant PPA)
5. Alzheimer’s dementia

Question 13

Alzheimer’s dementia pathological proteins

Answer 13

Beta amyloid plaques
Tau protein neurofibrillary tangles

Question 14

Alzheimer’s disease localization

Answer 14

Medial temporal structures (hippocampal atrophy)

Question 15

PCA localization

Answer 15

Occipital atrophy

Question 16

Logopenic PPA localization

Answer 16

Left posterior perisylvian/parietal atrophy

Question 17

FTD pathological proteins

Answer 17

Tau
TDP-43
C9
FUS

Question 18

BVFTD localization

Answer 18

Frontal +/- temporal atrophy on MRI

Question 19

Non fluent PPA localization

Answer 19

L posterior frontoinsular atrophy

Question 20

Semantic PPA localization

Answer 20

Bilateral anterior temporal lobe atrophy, L>R

Question 21

LBD pathological protein

Answer 21

Alpha synucleinopathy

Question 22

LBD localization

Answer 22

Possible global atrophy if severe (on MRI)
Best imaging for location is PET (decreased DA-transporter uptake in basal ganglia)