Frailty_and_Dementia Flashcards
What factors have contributed to the changing age structure of the UK population?
Lower birth rates (higher cost of living), reduced child deaths, and longer life expectancy due to medical and public health advancements.
How does the rising age of the population affect the prevalence of dementia?
Dementia prevalence increases because the risk doubles every five years over age 65, despite falling incidence.
What are the two types of Lasting Power of Attorney (LPA)?
Health & Welfare LPA and Property & Financial Affairs LPA.
Under what circumstances can an LPA’s powers be revoked?
An LPA’s powers can be revoked by a court if they are not acting in the patient’s best interests.
What are the criteria for determining mental capacity under the Mental Capacity Act?
Understanding, retaining, using/weighing up information, and communicating the decision.
How can mental capacity fluctuate in a person with dementia?
Mental capacity can fluctuate during delirium or when taking sedative medications, but it may return when these resolve.
What are the five principles of the Mental Capacity Act?
Assume capacity unless proven otherwise. Provide reasonable support for decision-making. Respect unwise decisions. Decisions must be in the person’s best interests if capacity is lacking. Choose the least restrictive option.
Under what conditions can confidentiality about a dementia diagnosis be broken?
Confidentiality can only be broken if it is clearly in the patient’s best interests.
What societal attitudes can negatively impact the care and wellbeing of older people?
Patronizing attitudes, ignoring symptoms as inevitable, unnecessary polypharmacy, and lack of autonomy in decision-making.
What strategies can healthcare providers use to improve communication with older people?
Active listening, avoiding jargon, using a clear adult tone, and recognizing the patient’s full life experience.
What is the electronic frailty index (eFI), and what information does it use?
The eFI uses primary health record data, scoring disease states, symptoms, signs, disabilities, and social vulnerability.
What is the Rockwood Frailty Score, and how is it used?
The Rockwood Score is a simple tool to assess frailty and guide clinical decisions.
What factors are assessed when taking a history of falls from a frail patient?
Details of the fall (timing, location, preceding symptoms, what happened before/during/after), frequency, and triggers.
What are the major system reviews to perform when assessing a frail patient with falls?
Cardiovascular (palpitations), neurological (dizziness, LOC), respiratory (SOB), gastrointestinal, and musculoskeletal systems.
What medications can increase the risk of falls in frail individuals?
Beta blockers (bradycardia), antihypertensives (hypotension), benzodiazepines (sedation), and diabetic medications (hypoglycemia).
What are the clinical features of Parkinson’s disease that impair mobility?
Tremor, cogwheel rigidity, bradykinesia (slow movement), postural instability, and freezing of gait.
What are Parkinson’s-plus syndromes, and how do they differ from idiopathic Parkinson’s disease?
Parkinson’s-plus syndromes involve additional features like cranial nerve involvement, cognitive decline, and atypical progression.
What are the major causes of dementia?
Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia.
What are the macroscopic and microscopic pathological changes in Alzheimer’s disease?
Macroscopic: atrophy of frontal, temporal, and parietal lobes; microscopic: amyloid-beta plaques and neurofibrillary tau tangles.
What are the clinical features and risk factors for vascular dementia?
Stepwise progression, patchy cognitive deficits, and risk factors like hypertension, stroke, diabetes, and smoking.
What are Lewy bodies, and how do they contribute to dementia?
Lewy bodies are protein deposits (alpha-synuclein) that disrupt brain function, causing symptoms like hallucinations and Parkinsonism.
What are the clinical features of frontotemporal dementia?
Early-onset dementia with behavioral changes (e.g., disinhibition), language difficulties, and compulsive behaviors.
What commonly used tools assess cognitive function, and what are their limitations?
MMSE, MoCA, Mini-Cog, and 6-CIT; limitations include education bias, incomplete cognitive testing, and reduced sensitivity in early dementia.
What are the differences between episodic memory, semantic memory, and procedural memory?
Episodic: memory of events; Semantic: knowledge of facts; Procedural: unconscious skills like riding a bike.
