Dementias Flashcards
what is cognition?
the mind process in which we become aware of objects of thought and perception, including all aspects of perceiving, remembering, reasoning, evaluating, judging, learning and thinking
definition of dementia
an acquired global impairment of intellect, memory and personality but without impairment of consciousness.
the cognitive decline must represent a decline from the previous level of functioning and persist for at least 6 months.
The decline must be significant enough to affect the person’s social and occupational life aspects
what is the most common form of dementia
Alzheimer disease is the most common form of dementia
and may contribute to 60–70% of cases.
b/w men and women who are more affected by dementia
women are more affected by dementia, by either having dementia themselves and/or being the carer of someone with dementia
aetiology of dementia
Significant loss of brain neurons
decreased volume in brain regions devoted to memory and higher mental functioning
Neurofibrillary tangles accumulation (damaged nerve call fibres)
Environmental factors : infection, metals and toxins.
Deficiencies of vitamin B6,B12 and Folate.
Early depression can be a risk factor for Alzheimer’s disease
common risk factors of dementia
High cholesterol levels.
High blood pressure.
Obesity.
name 3 reversible causes of dementia
- Intracranial space occupying lesions.
- Metabolic disorders, hepatic failure, and renal failure.
- Endocrine disorders: myxoedema, Addison’s disease.
- Infection: AIDS, meningitis, encephalitis.
- Intoxication : Alcohol, heavy metals( lead, arsenic), smoking.
- Anoxia, post anaesthesia, chronic respiratory failure.
- Vitamin deficiencies: Thiamine
- Normal pressure hydrocephalus.
- Traumatic: subdural haematoma.
name 3 irreversible causes of dementia
- Alzheimer’s disease.
- Pick’s disease.
- Huntington’s disease.
- Parkinson’s disease.
- Vascular-multi-infarct dementia/vascular dementia
name the two types of dementia and breifly describe them
- Cortical dementia: tend to cause problems with memory, language, thinking and social behaviour.
- Subcortical dementia: tends to cause changes in emotions and movement, in addition to memory problems
3 features of Alzheimer’s disease
gradual progression, short term memory loss, loss of communication and judgement, global impairment.
3 features of vascular disease
step wise progression, multiple cerebrovascular accidents, unsteady gait, depression, behavioural changes, vascular risk factors
3 features of Lewy body dementia
gradual progression, fluctuating cognition,
visual hallucination, parkinsonian features,
neuroleptic sensitivity, autonomic dysfunction, Visuospatial deficits
what is mixed dementia
a micture of Alzheimer’s and vascular
features can be of both of the above types of dementia
3 features of Frontal lobe dementia
gradual progression, younger onset,
change in social conduct, speech reduction, early loss of insight, emotional blunting, diet changes, incontinence, swallowing difficulties.
features of mild dementia - stage 1, and how long does it last
mainly able to function independently
occasional forgetfulness, confusion and lapse in judgement
lasts 2-4 yrs
features of moderate dementia - stage 2, and how long does it last
may require assistance with daily activities
greater extent of memory loss with other symptoms, including sundowning (agitation in late afternoon/evening)
lasts 4-12 yrs
features of severe dementia - stage 3
all day care required - a care is needed
loss of mobility and difficulty performing functions like swallowing
3 warning signs of Alzheimer’s dementia
- Short term memory deficits.
- Difficulty performing familiar tasks.
- Language problems and word finding difficulties.
- Disorientation to time and place.
- Misplacing items.
- Personality and behavioural changes ( easily
upset, inappropriate behaviour, loss of initiative). - Mood changes
2 benefits of early diagnosis
allows patients and carers to learn better about their condition (psychoeducation)
early access to treatment which slows down disease progression
to access support for both patient and carers (early)
gives the patient/person/carer a chance to arrange legal aspect (e.g lasting power of attorney, wills)
financial planning
management of dementia
no cure for dementia
there is antidementia medication
what is antidementia medication
Symptomatic treatment: aimed at minimising the impact of the
illness.
medications to give for mild to moderate dementia
Donepezil, Rivastigmine, Galantamine.
(Cholinesterase inhibitors)
how do Donepezil, Rivastigmine, Galantamine work
Cholinesterase inhibitors
these medications Improve challenging behaviour and daily functions
medication to give for moderate to severe dementia
Memantine
[NMDA antagonist (glutamate antagonist)]
