Dementia- Jason Rucker

Question 1

cognition according to Temple Grandin

Answer 1

cognition is thinking without language

Question 2

temporo-parietal areas of cognition

Answer 2

knowledge aquisition
comprehension
thinking
knowing
remembering

Question 3

frontal areas of cognition

Answer 3

judgement
problem solving
imagination
planning

Question 4

sensory memory

Answer 4

< 1 sec

Question 5

working memory

Answer 5

< 1 min, trying to remember a phone number until u can dial it

Question 6

long term memory

Answer 6

2 types: explicit memory- conscious

implicit memory- unconscious

Question 7

implicit memory breaks down into

Answer 7

procedural memory (skills)

Question 8

explicit memory breaks down into

Answer 8

declaritive memory (facts and events)

Question 9

declaritive memory breaks down into

Answer 9

episodic- autobiographical

semantic- facts, concepts

Question 10

cognition thought process

Answer 10

1) occipital lobe- what is it?
2) temporal lobe- how does it relate to me?
3) limbic system- how do i feel about it
4) frontal lobe- what do i think about it

Question 11

when does brain aging begin?

Answer 11

age 20-30

Question 12

what happens with brain aging?

Answer 12

dec. cap and arteriole density
dec. blood flow
dec. brain weight
inc. ventricular volume
inc. subarachnoid space
inc. reliance on procedural memory
decisions replaced by routine and ritual

Question 13

mild cognitive impairment

Answer 13

impairments in thinking and memory that do not interfere with everyday activities, most of these ppl will eventually convert to dementia

Question 14

amnestic type

Answer 14

memory lost

Question 15

multi-domain

Answer 15

judgement and or language

Question 16

S&S of MCI

Answer 16

forgetting names
losing objects
forgets items on a list
forgets multiple step tasks
unable to recall info after a distraction
score of greater than or equal to 1 SD blow the mean on a memory test

Question 17

diagnosing MCI

Answer 17

reaction time
dual task performance
word fluency
category fluency
delayed verbal recall
narrative recall
name-face pair recall
complex figure copying

Question 18

what is a disturbance of consciousness/change in cognition that is acute and transient (lasts only hours to days)

Answer 18

delirium

Question 19

how do u diagnose delirium?

Answer 19

1. acute onset and fluctuating course
2. altered level of consciousness
3. inattention
4. disorganized thinking
   diagnosis requires presence of both 1 and 2 and either 3 OR 4

Question 20

Define dementia

Answer 20

syndrome of impairment in memory and at least one other cog. ability
-language, visuospatial fxn, executive fxn

Question 21

what is visuospatial fxn?

Answer 21

recognizing objects

Question 22

early signs of dementia

Answer 22

forgetful
confused
wt. loss
 sleep disturbances
gait abnormalities
ADL deficits

Question 23

how does beta amyloid and tau proteins contribute to pathology of AD

Answer 23

beta amyloid proteins acumulate outside the neurons (plaques)
tau proteins accumulation inside neurons (tangles)

Question 24

what is the gene that causes increased risk of AD

Answer 24

ApoE4

Question 25

Cognitive AD symps

Answer 25

``` disorientation loss of reasonig loss of insight poor judgement perceptual problems inability to perform arithmetic inability to learn loss of attention language impairment apathy withdrawl impaired ADLs ```

Question 26

non-cognitive AD symps

Answer 26

``` paranoia delusions sleep disturbance hallucinations agitation aggression wandering sundowning anxiety depression hostility fear jealousy insecurity ```

Question 27

Diagnostic criteria for AD

Answer 27

1) deficit in memory and at least one other cognitive domain 2) decline from previous function that interferes with social or occupational fxn 3) gradual onset and continuous decline >6 mo. 4) symps are proven not to be secondary to systemic disease, CNS, psychiatric or drug induced conditions

Question 28

Vascular cognitive impairment (VCI)

Answer 28

2nd most common cause of demenia behind AD, presents more like a stroke than like dementia

Question 29

Symps of VCI

Answer 29

``` hemiparesis visual probs incontinence pseudobulbar signs probs with exec. fxn psychomotor impairment personality changes hyperreflexia giat deficits ```

Question 30

Types of VCI

Answer 30

multi-infarct dementia binswanger's diesase CADASIL > migraine related

Question 31

Frontotemporal Dementias

Answer 31

orbitofrontal area- monitoring Anterior cingulate- motivation dorsolateral prefrontal areas- exec. fxn

Question 32

Pick's disease

Answer 32

pick bodies (accumulation of tau proteins) in neurons

Question 33

symps of pick's disease

Answer 33

``` >aggressive, inappropriate behavior >early onset of lang. pathology >incontinence >sociopathic, obsessive, stereotyped behaviors, >may occur with parkinsonism ```

Question 34

Semantic demtia

Answer 34

left temporal dysfunction, loss of semantic memory and knowledge initial sparing of episodic memory and other cog. fxns, impairment of language syntax and phonology may progress to FTD in 5-10 years (lady who couldn't identify pen and scissors)

Question 35

PPA (primary progressive aphasia) | a lot like brocas aphasia

Answer 35

>loss of expressive language, can't get words out! >comprehension often spared >progresses to full FTD

Question 36

Lewy-body dementia

Answer 36

accumulation of alpha-synuclein protein inside neural nuclei

Question 37

LBD is closely associated with what disease?

Answer 37

PD

Question 38

symps of LBD

Answer 38

- striking flucuations in cognition - visual hallucinations - bradykinesia - parkinsonian posture and gait - tremor is less common

Question 39

what is a distinguising feature about LBD

Answer 39

visual cortex involvement

Question 40

other types of dementia

Answer 40

- huntingtons chorea - prion diseases- KURU and Creutzfeld-Jacob - normal pressure hydrocephalus - PD (basal ganglia interacts with pre-frontal cortex)

Question 41

ahnodenia

Answer 41

loss of pleasure, enjoyment

Question 42

stage 1 AD

Answer 42

``` >Stage 1: 2-4 years repeats questions anhedonia word finding problems loses items personality changes ```

Question 43

Stage 2 AD

Answer 43

``` >Stage 2: 2-10 years gets lost easily confusion over recent events ADL impirments argumenative pacing axiety/depression delusions ```

Question 44

Stage 3 AD

Answer 44

``` >stage 3, 1-3 years unable to do ADLs impaired speech impaired comprehension unable to recognize loved ones unable to recognize self ```

Question 45

FTD diagnostic criteria

Answer 45

``` 2 of the following: loss of personal awareness strange eating habits perseveration mood change at least 1 of the following: exec. dysfunction impaired speech intact visuospatial fxn ```

Question 46

FTD work group criteria

Answer 46

>cognitive deficits marked by: -early, progressive personality or behavioral changes -early, progressive expressive or semantic language changes >impairment in social or occupational fxn > gradual onset and continual decline >not due to other medical or psychiatric condition >absence of delirium