Dementias Flashcards

1
Q
A
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2
Q

What is dementia?

A

An irreversible and progressive decline in memory, cognition, personality, and communication without impaired consciousness.

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3
Q

At what age is early-onset dementia typically diagnosed?

A

Less than 65 years.

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4
Q

What is mild cognitive impairment?

A

Deficit in cognition and memory greater than expected with age, but not significant enough for diagnosis of dementia.

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5
Q

What are the key pathologies associated with Alzheimer’s dementia?

A
  • Amyloid plaques
  • Neurofibrillary tangles
  • Brain atrophy
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6
Q

What are the clinical features of Alzheimer’s dementia?

A
  • Progressive memory loss
  • Planning/speech/orientation difficulties
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7
Q

What is vascular dementia?

A

The second most common type of dementia caused by vascular damage in the brain.

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8
Q

What are the risk factors for vascular dementia?

A
  • Stroke
  • Hypertension
  • Diabetes
  • Smoking
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9
Q

What are the clinical features of vascular dementia?

A
  • Cognitive impairment
  • Emotional lability
  • Psychosis
  • Depression
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10
Q

What characterizes dementia with Lewy bodies?

A

Rapidly progressing dementia with parkinsonism features.

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11
Q

What are the clinical features of dementia with Lewy bodies?

A
  • Visual hallucinations and delusions
  • Parkinsonism
  • Fluctuating consciousness
  • Sleep disorders
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12
Q

What is frontotemporal dementia and Pick’s disease?

A

Dementia usually occurring in individuals aged 40-60, may be inherited.

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13
Q

What are the key pathologies associated with frontotemporal dementia?

A
  • Frontal/temporal lobe atrophy
  • Tau protein deposits
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14
Q

What are the clinical features of frontotemporal dementia?

A
  • Behavioural changes
  • Speech and language abnormalities
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15
Q

Name three conditions that can cause cognitive impairment.

A
  • Medications with anticholinergic effects
  • Psychiatric conditions
  • Neurological conditions
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16
Q

What are examples of medications with anticholinergic effects?

A
  • Oxybutynin
  • Solifenacin
  • Tolterodine
  • Chlorphenamine
  • Promethazine
  • Amitriptyline
17
Q

What neurological conditions can lead to cognitive impairment?

A
  • Brain tumours
  • Parkinson’s disease
  • Huntington’s disease
  • Normal pressure hydrocephalus
18
Q

What are the clinical features of normal pressure hydrocephalus?

A
  • worsening memory
  • personality and behaviour changes
  • difficulty walking
  • urinary incontinence
19
Q

What are some endocrine conditions that may cause cognitive impairment?

A
  • Hypothyroidism
  • Adrenal insufficiency
  • Cushing’s syndrome
  • Hyperparathyroidism
20
Q

What nutritional deficiencies can affect cognition?

A
  • Vitamin B12
  • Thiamine (Wernicke-Korsakoff syndrome)
21
Q

List modifiable risk factors for dementia.

A
  • Exercise
  • Mental stimulation
  • Maintaining a healthy weight
  • Blood pressure control
  • Blood glucose control
22
Q

What are early symptoms of dementia?

A
  • Forgetting events
  • Forgetting names
  • Difficulty remembering words
  • Repeatedly asking the same question
  • Impaired decision making
  • Reduced flexibility
23
Q

What are advanced symptoms of dementia?

A
  • Aphasia
  • Dysphagia
  • Appetite and weight loss
  • Incontinence
24
Q

Name three memory screening tests.

A
  • Six item cognitive impairment test (6CIT)
  • Mini-cog
  • General practitioner assessment of cognition (GPCOG)
25
What is the purpose of the Addenbrooke’s Cognitive Examination III (ACE-III)?
Detailed assessment tool for memory impairment.
26
What score on the ACE-III indicates possible dementia?
Score ≤ 88.
27
What are some management strategies for dementia?
* Lasting power of attorney * Advanced directives * Future care planning
28
What medications are used for managing Alzheimer's disease?
* Acetylcholinesterase inhibitors (Donepezil, Rivastigmine, Galantamine) * Memantine
29
What does BPSD stand for?
Behavioural and psychological symptoms of dementia.
30
What are some behavioral and psychological symptoms of dementia (BPSD)?
* Depression * Anxiety * Agitation * Aggression * Disinhibition * Hallucinations * Delusions * Sleep disturbance
31
What is a management strategy for BPSD?
Treat any underlying cause, optimize environmental factors, medications (SSRIs, risperidone, benzodiazepines)