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)
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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)

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3
Q

Dementia and PD

A
  • 10% each year

- over 8 years, 78% became demented in one study

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4
Q

Testing

A
  • visuospatial tasks
  • set shifting
  • Wisonsin card sorting
  • Stroop test
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5
Q

Treatment and hallucinations

A

-levodopa and dopamine agonists cause hallucinations, psychosis, anxiety, mania, impulsive behaviour, delirium

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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
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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
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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
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9
Q

SPECT

A
  • LBD shows greater caudate involvement

- reduced perfusion of the precuneus and parietal cortex

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10
Q

DAT scan

A
  • 123I-FP-CIT

- reflects dopamine deficiency

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11
Q

Treatment of PDD

A

-Rivastigmine is licensed for treatment of PDD

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