Dementia Theraputics Flashcards
What are the 10 warning signs of AD?
- memory loss that disruts daily life
- challenges planning or solving problems
- difficulty completing familiar tasks
- confusion with time/place
- trouble with visual image or spatial relationships
- new problems with words when speaking/ writing
- misplacing things and losing ability to retrace steps
- decreased/ poor judgement
- withdrawal from work/socail activities
- change in mood/personality
What are risk factors for AD?
- aging
- 1st degree relative
- APDE-4 gene
- lower levels of education/ cognitive engagement
- African-American and Hispanics
- Women
- moderate-severe brain injury
- current smoking
- midlife obesity
- CV diseases (HTN, heart disease, stroke, diabetes)
How can lifestyle be modified to decrease risk of AD?
- mental/social activity
- mediterranean diet
- DASH/ heart healthy diet
- physical activity
How is AD diagnosed?
differential diagnosis must rule out all other types of dementia, cerebrovascular disease/brain injury
What are other causes of AD symptoms?
- depression
- hypothyroidism
- B12 / folate deficiences
- drug-induced cognitive impairment
- CNS infection
- substance use disorder
What are biomarkers of alzhimers disease?
PET scaning or CSF measured abnormal amount of beta-amyloid
What screening tools can help diagnose AD?
DSM 5- recognizes major and mild neurocognitive impairment
What screening tool can help record cognitive changes over time?
Mini-Mental State Exam (MMSE)
What are disadvantages to the MMSE?
- Biased against people with poor education (language and math)
- Biased against visually impaired
- poor sensitivity for mild/poor dementia
What is the MMSE scoring criteria?
0-17: severe cognitive impairment
18-23: mild cognitive impairment
24-30: no cognitive impairment
What are non pharm therapies for AD?
- group support
- education of pt, fam, and caregivers
- physical and mental activity (aerobic exercise, socialization. cognitive acitvietes)
- avoid inappropriate medications
What role do cholinesterase inhibitors have in AD?
recommended to start early to maximize benefits
What is a disadvntage to using cholinesterase inhibitors?
interuption of therapy for more than a few days requires registration from starting dose
Why are cholinesterase inhibitors a concern in pts with PUD or NSAID use?
increase gastric acid production
Why are cholinesterase inhibitors a concern in pts that take beta blocker?
Syncope, hypotension due to bradycardia from cholinergic effects
