Impact of Dementia on Patients, Family and Carers Flashcards
What is the most common group of dementias?
Neurodegenerative disorders
What is the second most common group of dementias?
Vascular dementias
What are the most common causes of dementia by proportion?
Alzheimer’s disease = 50-60%
Vascular disease = 15-20%
Rest = 10%
What are some other causes of dementia?
Normal pressure hydrocephalus
Metabolic disease
Toxins
Nutritional deficiency
What are the clinical features of depressive pseudodementia?
Psychomotor retardation Weakness Cognitive slowing Impaired concentration Sadness Hopelessness Inactivity/agitation
Is depressive pseudodementia reversible?
Potentially via antidepressant medication
What are the prominent features of Lewy-body dementia?
Fluctuating alertness and attention
Recurrent well-formed visual hallucinations
What is the onset and progression of dementia of the Alzheimer’s type?
Gradual, insidious onset
Increased occurrence with age
Progressive decline
What are the physical clinical features of dementia of the Alzheimer’s type?
No early neurological signs
What are the cognitive clinical features of dementia of the Alzheimer’s type?
Memory impairment Visuospatial impairment Language impairment - word finding difficulty Impaired attention Executive dysfunction Apraxia
What are the affective clinical features of dementia of the Alzheimer’s type?
Non-specific agitation
What are the behavioural clinical features of dementia of the Alzheimer’s type?
Wandering and becoming lost Purposeless activity Difficulty with daily tasks Failure to recognise others Sleep disturbance
What are the pathological features of dementia of the Alzheimer’s type?
Plaques and neurofibrillary tangles Diagnosis post-mortem only MRI features - Volume reduction in temporal lobes - General cortical atrophy
What is the onset and progression of behavioural variant frontotemporal dementia?
Gradual onset
Younger age
Progressive decline
What are the physical clinical features of behavioural variant frontotemporal dementia?
Cortical release signs
What are the cognitive clinical features of behavioural variant frontotemporal dementia?
Impaired attention and executive dysfunction, cognitive disinhibition
Perseveration, mental rigidity
Aphasia leading to mutism
Reduced speech output
What are the affective clinical features of behavioural variant frontotemporal dementia?
Depression
Anxiety
Excessive sentimentality
What are the behavioural clinical features of behavioural variant frontotemporal dementia?
Personality changes Behavioural disorder including - Disinhibition - Impulsivity - Impaired judgement - Obsessive behaviours - Apathy - Anhedonia Dietary change
What are the pathological features of behavioural variant frontotemporal dementia?
Loss of cortical neurons and gliosis
Primary tauopathy
MRI: focal cortical loss
What is the onset and progression of vascular cognitive impairment?
Gradual onset
Progressive stepwise decline
What are the physical clinical features of vascular cognitive impairment?
Focal neurological deficits - vary with location and severity of lesions
What are the cognitive clinical features of vascular cognitive impairment?
Diffuse cognitive impairment Cognitive slowing Attentional dysfunction Psychomotor retardation Secondary executive features
What are the affective clinical features of vascular cognitive impairment?
Irritability
Apathy
Blunted affect
What are the behavioural clinical features of vascular cognitive impairment?
Withdrawal
What are the pathological features of vascular cognitive impairment?
White matter lesions
MRI: hyperintensities
MRI/CT: ventricular volume loss on structural imaging without pronounced cortical loss
Cardiovascular risk factors - not essential/sufficient
