Dementia in Aging Adults

Question 1

True or False: Loss of synaptic connections (which creates memory impairment which is slowed but intact) is a normal part of aging and not considered pathological.

Answer 1

True

Question 2

True or False: Dementia and death/loss of neurons are normal aspects of aging.

Answer 2

False, these are considered pathological

Question 3

What are the 3 most common types of dementia?

Which is MOST common?

Answer 3

Alzheimer’s (most common)
Vascular Dementia (second most common)
Lewy Body dementia

Question 4

What are the risk factors of Alzheimer’s?

Answer 4

Advancing age
Positive family history
women>men
African american and Hispanic populations are more affected

Question 5

How would a patient who is suffering from Alzheimer’s present in the clinic?

Answer 5

memory impairments
lapse in judgement
personality changes
possible depression
language problems
ADL difficulties
hositlity
loss of motor functions such as swallowing or bowel and bladder

Question 6

What are the risk factors for Vascular Dementia?

Answer 6

Hypertension
smoking
hypercholesteremia
Diabetes
Cardiovascular and cerebrovascular diseases

Question 7

How would a patient with vascular dementia present in the clinic?

Answer 7

Impaired memory
Abstract thinking
Poor judgement
Poor Impulse control
personality changes

characterized more by an abrupt onset, step by step deterioration, fluctuating course, and emotional lability

Question 8

Lewy Body Dementia leads to progressive cognitive decline of what 3 major factors?

Answer 8

• Fluctuations in alertness and attention (may be drowsy or lethargic
• Visual Hallucinations
• Parkinsonian Motor Symptoms

Question 9

How would a patient with Lewy Body Dementia present?

Answer 9

gait and balance issues
visual spatial issues
poor executive functioning
sensitivity to antipsychotics, may be depressed

Question 10

What is Delirium?

What is it usually confused with?

Answer 10

sudden rapid change in mental function which is often confused with dementia

however delirium is usually short term and temporary rather than long term such as dementia

Question 11

Clinically, how might someone with delirium present?

what should treatment be focused on?

Answer 11

may present with shouting and resisting, refusal to cooperate with medical care, potential to be injured falling, combative, and pulling at lines or tubes

treatment should be focused on increasing time out of bed, walking, as well as managing hydration, hypoxia and nutrition

Question 12

How should motor learning practice be for a patient with dementia?

[think in terms of practice (including mental practice), if it should be discovery vs. guided practice, and how we should give feedback]

Answer 12

dementia patients should practice with a massed, constant, or blocked schedule but it should not be random and there can’t be any mental practice

patients must be given guidance with practice, they can’t be left to discover on their own

feedback should be simple and skillfully given

Question 13

Which of these is not a PT strategy to use for patients with dementia?

• Use stimuli for teaching and performing (scent or sound)
• Don’t repeat the practice often
• Positive reinforcement
• be consistent
• Use meaningful distractions to challenge patients senses
• go slow
• avoid tactile cues
• avoid debate or conflict
• find a connection (hobbies, previous employment, etc.)

Answer 13

• Don’t repeat the practice often
• Use meaningful distractions to challenge patients senses
• Avoid tactile cues

Question 14

True or False: Aerobic training helps improve mental cognition

Answer 14

true

Question 15

True or false: PT intervention for dementia patients should be focused to maximize function and prevent slow physical decline

Answer 15

True