Dementias Flashcards
What is dementia?
An irreversible and progressive decline in memory, cognition, personality, and communication without impaired consciousness.
At what age is early-onset dementia typically diagnosed?
Less than 65 years.
What is mild cognitive impairment?
Deficit in cognition and memory greater than expected with age, but not significant enough for diagnosis of dementia.
What are the key pathologies associated with Alzheimer’s dementia?
- Amyloid plaques
- Neurofibrillary tangles
- Brain atrophy
What are the clinical features of Alzheimer’s dementia?
- Progressive memory loss
- Planning/speech/orientation difficulties
What is vascular dementia?
The second most common type of dementia caused by vascular damage in the brain.
What are the risk factors for vascular dementia?
- Stroke
- Hypertension
- Diabetes
- Smoking
What are the clinical features of vascular dementia?
- Cognitive impairment
- Emotional lability
- Psychosis
- Depression
What characterizes dementia with Lewy bodies?
Rapidly progressing dementia with parkinsonism features.
What are the clinical features of dementia with Lewy bodies?
- Visual hallucinations and delusions
- Parkinsonism
- Fluctuating consciousness
- Sleep disorders
What is frontotemporal dementia and Pick’s disease?
Dementia usually occurring in individuals aged 40-60, may be inherited.
What are the key pathologies associated with frontotemporal dementia?
- Frontal/temporal lobe atrophy
- Tau protein deposits
What are the clinical features of frontotemporal dementia?
- Behavioural changes
- Speech and language abnormalities
Name three conditions that can cause cognitive impairment.
- Medications with anticholinergic effects
- Psychiatric conditions
- Neurological conditions
What are examples of medications with anticholinergic effects?
- Oxybutynin
- Solifenacin
- Tolterodine
- Chlorphenamine
- Promethazine
- Amitriptyline
What neurological conditions can lead to cognitive impairment?
- Brain tumours
- Parkinson’s disease
- Huntington’s disease
- Normal pressure hydrocephalus
What are the clinical features of normal pressure hydrocephalus?
- worsening memory
- personality and behaviour changes
- difficulty walking
- urinary incontinence
What are some endocrine conditions that may cause cognitive impairment?
- Hypothyroidism
- Adrenal insufficiency
- Cushing’s syndrome
- Hyperparathyroidism
What nutritional deficiencies can affect cognition?
- Vitamin B12
- Thiamine (Wernicke-Korsakoff syndrome)
List modifiable risk factors for dementia.
- Exercise
- Mental stimulation
- Maintaining a healthy weight
- Blood pressure control
- Blood glucose control
What are early symptoms of dementia?
- Forgetting events
- Forgetting names
- Difficulty remembering words
- Repeatedly asking the same question
- Impaired decision making
- Reduced flexibility
What are advanced symptoms of dementia?
- Aphasia
- Dysphagia
- Appetite and weight loss
- Incontinence
Name three memory screening tests.
- Six item cognitive impairment test (6CIT)
- Mini-cog
- General practitioner assessment of cognition (GPCOG)
What is the purpose of the Addenbrooke’s Cognitive Examination III (ACE-III)?
Detailed assessment tool for memory impairment.
What score on the ACE-III indicates possible dementia?
Score ≤ 88.
What are some management strategies for dementia?
- Lasting power of attorney
- Advanced directives
- Future care planning
What medications are used for managing Alzheimer’s disease?
- Acetylcholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine)
- Memantine
What does BPSD stand for?
Behavioural and psychological symptoms of dementia.
What are some behavioral and psychological symptoms of dementia (BPSD)?
- Depression
- Anxiety
- Agitation
- Aggression
- Disinhibition
- Hallucinations
- Delusions
- Sleep disturbance
What is a management strategy for BPSD?
Treat any underlying cause, optimize environmental factors, medications (SSRIs, risperidone, benzodiazepines)
