Dementia in Parkinson's disease Flashcards
1
Q
Parkinsons disease
A
- result of degeneration of the subcortical structures
- substantia nigra
- putamen and globus palliduss
- it is a subcortical degenerative disease
- 3 Ms: movement, mood and mentation (cognition)
2
Q
Thinking in PD
A
- slowed thinking (bradyphenia)
- likelihood of cognitive symptoms is greater in those with late onset disease (after 70 years of age)
3
Q
Dementia and PD
A
- 10% each year
- over 8 years, 78% became demented in one study
4
Q
Testing
A
- visuospatial tasks
- set shifting
- Wisonsin card sorting
- Stroop test
5
Q
Treatment and hallucinations
A
-levodopa and dopamine agonists cause hallucinations, psychosis, anxiety, mania, impulsive behaviour, delirium
6
Q
Visual hallucinations
A
- preserved insight
- delusions of persecution occur
- treatment focuses on balancing levodopa
- atypical antipsychotics can be used
- clozapine is successful but quetiapine is often used first
7
Q
Risk factors for developing psychosis and hallucination in PD
A
- older age
- longer duration of illness
- cognitive impairment or dementia
- severity of illness
- sleep deprivation
- use of doamine agonists and polypharmacy
8
Q
Difference between LBD and PDD
A
- LBD: motor symptoms and cognitive symptoms develop within 12 months
- PDD- parkinsonian symptoms existed for more than 12 months before the dementia develops
9
Q
SPECT
A
- LBD shows greater caudate involvement
- reduced perfusion of the precuneus and parietal cortex
10
Q
DAT scan
A
- 123I-FP-CIT
- reflects dopamine deficiency
11
Q
Treatment of PDD
A
-Rivastigmine is licensed for treatment of PDD
