Final Exam review Flashcards
Dementia background
-AD is most common
-prevalence is expected to increase
-huge cost to healthcare system
Social cognition
-recognizing other’s emotions
Learning and memory
-long term memory
-cued recall
-unprompted recall
Executive function
-planning
-decision making
-IADL functions
Complex Attention
-processing speed
-divided attention
Language
-object naming
-animal fluency
-receptive language
Early stages of dementia
-chronic cognitive decline
-Instrumental activities of Daily Living affected: Managing finances, medication managment, Housekeeping, driving, shopping, meal prep
Middle to later stages of dementia
-activities of daily living
-bathing
-toileting
-dressing
-grooming
-walking
-eating meals
Lab tests in demential
-used to rule out differential diagnosis
-Vitamin B12: < 400
-TSH
-CBC: anemia and infection
-BMP: hyponatremia
-HIV
-Syphilis
Mini-cog for dementia
-3 item repeat
-clock draw
-3 item recall
Medications that contribute to cognitive changes
-ANTICHOLINERGICS
-antihypertensives
-benzos
-corticosteroids
-hypoglycemic agents
-muscle relaxants
-opioid
-NSAIDs
-sedative hypnotics
Alzheimer’s risk factors
-age
-genetics
-vascular
-head injury
-poor education
-poor hearing
-depression
-social isolation
Alzheimer’s pathophysiology
-accumulation of lesions leads to neurodegeneration and cognitive decline
-Aggregated amyloid and tau
-begins 20 years before symptoms develop
-affects language. learning/memory, and executive function
Alzheimer’s lifestyle modifications
-Omega 3
-folic acid
-Vitamin B
-Vitamin E
-physical activity
-mental activity
-social engagement
-music therapy
Vascular dementia
-caused by stroke/TIA, uncontrolled BP, diabetes, high cholesterol
-affects executive function and complex attention
-Donepezil, galantamine, rivastigmine
Lewy Body Dementia(DLB)
-fluctuating cognition, hallucinations, parkinsonism
-affects learning/memory and cognitive function
–Donepezil, galantamine, rivastigmine
-avoid antipsychotics
-levodopa for parkinsonism
-fludrocortisone or midodrine for orthostatic hypotension
Frontotemporal Dementia (FTLD)
-affects younger patients
-behavioral disinhibition, apathy, and compulsivity
-NO PLAQUES OR TANGLES
-affects executive function and social cognition
-no FDA approved treatments
-nonpharmacologic interventions focus on safety and health maintenance
-AChE inhibitors may worsen symptoms
Type III diabetes
-insulin resistance in the brain leads to increased plaque formation
-impacts neurocognition
-risk is modifiable
Prevention of Dementia
-controlling cardio risks
-depression management
-social engagement
-early detection
Acetylcholinesterase Inhibitors: Dementia
-Donepezil
-Galantamine
-Rivastigmine
NMDA receptor antagonists: dementia
memantine
Monoclonal antibodies: dementia
-Docanemab
-Lacanemab
-Aducanumab
mild-moderate Alzheimer’s treatments
-donepezil
-galantamine
-rivastigmine
Moderate-severe Alzheimer’s treatments
-Donepezil
-memantine
-Rivastigmine PATCH