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exam#2 485 > Dementia (part 1 & 2) > Flashcards

Dementia (part 1 & 2) Flashcards

1
Q

> 85 YOA is fastest growing demographic group. t/f

A

t

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2
Q

What are the “cluster” of symptoms that make up Dementia? (5)

A
  1. forgetfulness (progressive)
  2. difficulty doing familiar tasks
  3. confusion
  4. poor judgment
  5. decline in intellectual functioning
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3
Q

Is dementia a part of “normal” aging?

A

no

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4
Q

Dementia is not just ____ disease. It is used to describe a _______ of diseases/symptoms.

A

one

group

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5
Q

Dementia has ________ syndromes.

A

acquired

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6
Q

Dementia involves short term memory, social and/or occupational impairments, and at least one of the following: (4)

A
  1. aphasia
  2. apraxia
  3. agnosia
  4. abstract thinking/executive function impairments
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7
Q

What is apraxia?

A

motor memory impairment (loss of ability to coordinate learned body movements)

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8
Q

What is aphasia?

A

language impairments (inability to speak or understand)

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9
Q

what is agnosia?

A

sensory memory impairments (inability to recognize what is seen) NOT just a memory problem.

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10
Q

most people with dementia will visit a doctor when what type of problems occur with dementia?

A

social issues, problems on the job, multitasking, spousal complaints

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11
Q

dementia or normal aging?

only mentions memory loss when asked, can’t give examples

A

dementia

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12
Q

dementia or normal aging?

close family members are much more concerned about memory problems than the patient is.

A

dementia

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13
Q

How many levels of dementia are there?

A 
6
questionable
mild
moderate
severe
profound
terminal
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14
Q

how long does the early stage of dementia last?

A

virtually no time to about 5 years

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15
Q

what are common characteristics (minor changes) of the early stage of dementia?

A

Difficulty remembering most recent information
Difficulty performing familiar tasks
Decreased or altered judgment
Language Changes (speech, word-finding, etc.)
Changes in personality, behavior, & mood (worsening)
Disoriented with time and place
Problems with abstract thinking

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16
Q

what is the time frame of the middle stage of dementia?

A

2-12 years

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17
Q

symptoms are usually more obvious for dementia during what stage?

A

middle

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18
Q

what are characteristics of the middle stage of dementia?

A

Remembers less and less (Forgets quicker than in Early Stage)
Increased difficulty or inability to perform familiar tasks
Lack of judgment
Increased changes in behavior, mood, and personality (suspiciousness)
More confused about time and place
Loss of ability to think abstractly
Changes in the five senses
Physical changes (loss of bladder control, less steady while walking, etc.)

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19
Q

what stage of dementia do people usually go for help?

A

middle

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20
Q

what stage of dementia will physical changes happen?

A

middle (loss of bladder control, unsteady walking)

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21
Q

what is the time frame for the late stage of dementia?

A

1-3 years

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22
Q

what are characteristics of late stage dementia?

A 
Little or no short term memory remains
Unable to perform tasks
Lack of judgment
Unable to communicate effectively 
Doesn’t recognize self or family
Puts things in their mouth or touches & grabs things
Five senses have little or no function
Physical activity declines (loss of ability to walk and/or trouble swallowing)
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23
Q

what is when therapy is given to help prolong abilities they do have

A

mild-moderate

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24
Q

what is the Etiology of Dementia�

A

impaired functioning of MULTIPLE brain systems in both cortical and sub-cortical areas
�

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25
what happens to the brain with dementia?
structural brain damage (neurons are breaking down) that is often progressive and relatively irreversible
26
Coritcially and subcortical structures are involved with the impairment; making this a _______ issue
global
27
dementia is a diffuse, progressive damage. t/f
true
28
what are the 2 most common dementia's?
alzheimers | vascular
29
What are some of the "other" categories for dementia?
alcohol related, Pick's disease, HSE (herpes virus gets into spinal fluid)
30
Under the age of 65, _______ dementia is the most common dementia.
frontotemporal
31
under the age of 55, _____ dementia is the most common dementia.
HIV
32
What type of dementia is language specific and may be helped through therapy
frontotemporal
33
What type of dementia reacts to the autoimmune system and deteriorates the brain?
HIV
34
what is the first prominent symptom of Alzheimer's disease?
short term memory loss
35
What are the 3 consistent changes seen in the structure of the brain in Alzheimer's?
1. Amyloid plaques 2. neurofibrillary tangles 3. neuronal degeneration
36
In AD structural changes in the brain happen YEARS before behavioral symptoms. T/F
true
37
tangles affect the ____
nureons
38
What type of scans will show a activity of the brain and help to show if the brain is being affected by tangles and plaques?
PET scans
39
what symptoms are apparent in the mild stage of AD?
``` Cognitive symptoms require assistance with ADL memory loss language problems mood swings personality changes diminished judgment ```
40
what symptoms are apparent in the moderate stage of AD?
behavioral, personality changes unable to learn/recall new info long-term memory affected wandering, agitation, aggression, confusion
41
what symptoms are apparent in the severe stage of AD?
gait incontinence bedridden placement in long-term care
42
Is down syndrome a risk factor for AD?
yes
43
are females more at risk for AD?
yes
44
is ethnicity a risk factor for AD?
yes. Caucasians have the lowest risk due to general health
45
what is APOE?
the gene linked with AD
46
is head trauma a risk factor for AD?
yes
47
what type of dementia has an abrupt onset of symptoms followed by stepwise deterioration?
vascular
48
what age group is vascular dementia more prevalent?
before 75 YOA
49
what age group is AD more prevalent?
75+
50
what are 3 risk factors for vascular dementia?
older age hypertension diabetes
51
what is classified as "other" dementia?
frontotemporal (including progressive aphasia)
52
what are some infectious causes of the "other" dementia's?
neurosyphilis (30% of untreated syphilis pts) Lyme disease Herpes encephalitis dementia viral, parasitic, bacterial infections or brain abscess Human prion (proteins) disease: ‘Mad-cow disease’, Kuru, fatal familial insomnia
53
what is ALWAYS present during Clinical Presentation of Dementia
cognitive disturbances | functional impairment
54
what is often time present during clinical presentations of dementia?
``` visuospatial impairments (reading/conversations) behavioral distrubances ```
55
what are Visuospatial impairments
visual recognition | spatial deficits
56
what is capgras syndrome?
trouble recognizing familiar faces.
57
getting lost in familiar surroundings, 3-D drawing deficits, trouble replicating a drawing, would be what type of deficit?
spatial deficits
58
personality change will happen ______ in dementia
early
59
personality change can be affected in 3 different ways
passivity (apathy, withdrawal) disinhibition (inappropriate sexual behavior/language) self-centered behaviors
60
______ is very common and frequently worsens as the illness progresses.
agitation
61
what are some common behavioral disturbances with dementia?
agitation depression psychosis (delusions, perceptual disturbances) sleep disturbances
62
what are some memory impairments associated with dementia?
forming new memories retrieval deficits episodic (misplacing items)
63
language deficits of dementia include:
anomia fluency less complex sentences semantic paraphasias
64
what stage is this: Uses frequent stereotypical utterances unable to generate a sequence of related ideas. Patient begins to exhibit semantic impairment slightly reduced vocabulary word finding difficulties increased use of automatisms and clichés. Errors are often self-corrected
early
65
during the early stage of dementia what 2 aspects of language are still intact?
syntax | phonology
66
surface dyslexia
errors with irregular words (yacht)
67
during the early stage of dementia reading ____ words and _____ is spared although there are errors with ______ words
regular nonwords irregular
68
during the early stage of dementia many lose the desire to communicate. t/f
t
69
during the early stage of dementia there is speech inhibitions. t/f
t
70
during what stage of dementia is Speech perseverative, non-meaningful
middle
71
during what stage of dementia are language error not self corrected?
middle
72
during what stage of dementia does the patient show further semantic impairments such as: significantly reduced vocabulary errors semantically and visually related. More semantic utterances are usually very concrete �
middle
73
during the middle stage of dementia speech production is _______ in syntactic complexity and ________ skills deteriorate
reduced | repetition
74
reading and writing skills during the middle stage of dementia includes: ____ and ______ impaired. ______ dysgraphia emerges.
nonword irregular surface (yacht-->yot)
75
diminished eye contact begins during what stage of dementia?
middle
76
declining sensitivity to context begins during what stage of dementia?
middle
77
what stage does patient require extensive personal care?
late
78
what stage does this happen? very reduced vocabulary. frequent use of unrelated meanings. Frequent paraphasias / neologistic speech
late
79
At what stage is further syntactic and phonological impairments in speech production noticeable?
late
80
What stage is all reading and writing impaired?
late
81
What stage is there no adherence to conversational rules, poor eye contact, and lack of social awareness?
late
82
Executive function impairments are due to _____ ____ dysfunction.
frontal lobe
83
_________ ________ impairments may include: planning, predicting, correlating, abstract ideas.
executive function
84
Pronounced deficits often seen in FTD's before overt ______ impairment.
memory
85
The lack of taking multiple threads of information and processing it to make a decision is an example of
executive function impairments
86
Functional impairment and performance on cognitive testing may not correlate strongly early in the course of dementia t/f
true
87
Rate and specific pattern of loss will vary by individual and somewhat by diagnosis t/f
t
88
functional impairments will show deficits first in ???
IADL activities of daily living | managing finances, driving, keeping appointments
89
how is dementia different than normal aging?
not aware of their deficits
90
normal aging or dementia: | Frequent word finding difficulties
dementia
91
normal aging or dementia? | Only mentions memory loss when asked, can’t give examples
dementia
92
normal aging or dementia? | Patient is more concerned about forgetfulness than close family are
normal aging
93
what are some causes/predictors of dementia?
``` Age Family history / genetics Down’s syndrome Head Trauma (esp. late in life) Female gender Ethnicity (Caucasians have the lowest risk; general health) Late-onset depression (after age 65) Mild Cognitive Impairment (MCI) ```
94
what are some characteristics of the brains of individuals with dementia, and particularly Alzheimer's?
plaques, tangles, decay
95
how is memory affected by dementia?
1. difficulty forming new memories 2. information retrieval 3. misplacing items 4. implicit memory better than declarative (knowing "what" is more important than knowing "how")
96
how is vascular dementia different than aphasia?
?/
97
what are the language deficits affected by dementia?
anomia fluency less complex sentences semantic paraphasias
98
what language aspect is generally preserved in people with dementia?
auditory comprehension

exam#2 485 (7 decks)

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