Dementia Syndromes Flashcards
Dementia is a ______ of memory and/or other ______ abilities from a previous level of ______. It must be sufficiently ______ to cause impairment in ____ or _______ functioning.
It must have:
- a _____ from a previous level of functioning
- ______ cognitive and behavioural domains affected
- ______ on the person’s activities of daily living (if this is not the case, they could have a mild cognitive impairment)
decline cognitive functioning severe social occupational
change
multiple
impact
What are the SIX cognitive domains dementia can affect?
Memory Language Visuo-perceptual skills Praxis (skills movements, planning and sequences of movements) Attention Executive functions
(these are expanded on in the lecture if you want to have a look)
Because there are so many types of dementia, and various ______ domains it can affect, patients can present with different __________.
cognitive
symptomatologies
What is needed to diagnose dementia?
- clinical history of decline in cognitive function (preferably from multiple sources)
- objective evidence of cognitive and/or behavioural impairment on neuropsychological testing (preferably over different time points)
- evidence of progressive decline
- associated biomarkers - evidence from brain scans, abnormal CSF, brain biopsy, genetic testing
- not explained by another condition (mood disorder, stroke, etc)
Alzheimer’s Disease was first described over 100 years ago, and in the 80s a more formal clinical ______ criteria was released. This led to the disease being included in the _____ and _____.
Criterion A: Multiple ______ deficits, including memory and one or more of: ______, _____, visuo-______ and _______ functioning
Criterion B: significant impairment in _____ and _______ functioning
Criterion C: _____ onset and continuing _______ decline
The DSM-5 re-named dementia to “____ ______ _____”. It also included the clause that a ______ impairment is not necessary for diagnosis if there is evidence of a ______ component.
diagnostic
DSM-IV
DSM-V
cognitive language praxis spatial executive
social
occupational
gradual
cognitive
major neurocognitive disorder
memory
genetic
The TYPICAL presentation of Alzheimer’s Disease is:
- after ___ years
- first presenting complaint is _______ ____. This is BOTH a failure to ______ and ______ this information (delayed recall is poor and cueing doesn’t help)
- as it advances, there is a decline in other ______ areas
- _______ is preserved until the very late stages
Generally, the location of the plaques mirrors the neuronal _______. This is seen in the ______-_____ lobe, ______ lobe and some parts of frontal lobe.
60 memory loss encode store cognitive personality
atrophy
medial-temporal
parietal
Describe the differences seen in the ATYPICAL variant of Alzheimer’s Disease generally
- earlier onset (40s-50s)
- memory NOT compromised in early stages
- brain changes in parietal and occipital lobes, or frontal lobe. Temporal lobe is spared.
In the ATYPICAL “Visual variant Alzheimer’s Disease”, brain changes are mainly seen in the ______ and ______ lobes.
Changes first seen in:
- ____-_____ (judging locations, left/right orientation, can’t judge distances so issues driving and reaching out to items)
- _____ ______ (impaired object recognition)
- ______ (complex actions, sequences, assembling things, dressing, etc)
parietal
occipital
visuo-spatial
visual agnosia
apraxia
In the ATYPICAL “Frontal variant Alzheimer’s Disease”, brain changes are mainly seen in the _____ lobes. Hence, changes are first seen in _______ function (poor planning, organisation, impaired mental flexibility, concrete thinking, etc) AND ________.
(visuo-spatial skills are ok and memory is ok)
frontal
executive
personality
Fronto-temporal dementia is characterised by _____ bodies. It is quite a rare form and has an _____ onset. In general, _______, ______-______ and _______ well preserved.
There are 3 variants:
- ________ variant
- _______ dementia
- ______ ____-______ aphasia
Pick early memory visuo-spatial personality
behavioural
semantic
progressive non-fluent
Describe the changes seen in the BEHAVIOURAL variant of fronto-temporal dementia and the location of atrophy
Frontal lobe atrophy
Main changes seen in personality and behavioural changes (apathy, emotional-blunting, talking inappropriately).
Neuropsychological testing reveals executive dysfunctions - lack of mental flexibility and issues with planning.
Describe the changes seen in the SEMANTIC DEMENTIA variant of fronto-temporal dementia and the location of atrophy
Anterior-lateral temporal lobe atrophy
Leads to progressive loss of semantic knowledge (basic concepts, not recognising objects, etc)
Describe the changes seen in the PROGRESSIVE NON-FLUENT APHASIA variant of fronto-temporal dementia and the location of atrophy
Frontal and temporal lobe atrophy near the language areas.
Hence non-fluent speech and incorrect grammar is observed.
Vascular (multi-infarct) dementia is quite a ____ dementia. It is caused by ________ which leads to multiple strokes. The onset of symptoms are related to cerebro-_____ events. Hence, there is more of a ____-_____ decline (stroke - decline - plateau - stroke again - another decline, etc)
These lesions are usually in the ______ matter, so the _______ of different brain regions is impaired. There is a more _______ neuropsychological picture.
Symptoms include:
- _____ speed of processing
- ________ problems
- ______ problems can present as well (can see weakness, paralysis, issues walking, due to strokes in basal ganglia and internal capsule, etc)
_______ problems are secondary to attention difficulties and difficulties _______ a memory search (as opposed to a loss of stored memories)
rare
hypertension
vascular
step-wise
white
communication
subcortical
slow
attention
motor
memory
initiating
