Impact of Dementia on Patients, Family and Carers Flashcards

1
Q

What is the most common group of dementias?

A

Neurodegenerative disorders

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2
Q

What is the second most common group of dementias?

A

Vascular dementias

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3
Q

What are the most common causes of dementia by proportion?

A

Alzheimer’s disease = 50-60%
Vascular disease = 15-20%
Rest = 10%

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4
Q

What are some other causes of dementia?

A

Normal pressure hydrocephalus
Metabolic disease
Toxins
Nutritional deficiency

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5
Q

What are the clinical features of depressive pseudodementia?

A
Psychomotor retardation
Weakness
Cognitive slowing
Impaired concentration
Sadness
Hopelessness
Inactivity/agitation
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6
Q

Is depressive pseudodementia reversible?

A

Potentially via antidepressant medication

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7
Q

What are the prominent features of Lewy-body dementia?

A

Fluctuating alertness and attention

Recurrent well-formed visual hallucinations

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8
Q

What is the onset and progression of dementia of the Alzheimer’s type?

A

Gradual, insidious onset
Increased occurrence with age
Progressive decline

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9
Q

What are the physical clinical features of dementia of the Alzheimer’s type?

A

No early neurological signs

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10
Q

What are the cognitive clinical features of dementia of the Alzheimer’s type?

A
Memory impairment
Visuospatial impairment
Language impairment - word finding difficulty
Impaired attention
Executive dysfunction
Apraxia
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11
Q

What are the affective clinical features of dementia of the Alzheimer’s type?

A

Non-specific agitation

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12
Q

What are the behavioural clinical features of dementia of the Alzheimer’s type?

A
Wandering and becoming lost
Purposeless activity
Difficulty with daily tasks
Failure to recognise others
Sleep disturbance
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13
Q

What are the pathological features of dementia of the Alzheimer’s type?

A
Plaques and neurofibrillary tangles
Diagnosis post-mortem only
MRI features
- Volume reduction in temporal lobes
- General cortical atrophy
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14
Q

What is the onset and progression of behavioural variant frontotemporal dementia?

A

Gradual onset
Younger age
Progressive decline

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15
Q

What are the physical clinical features of behavioural variant frontotemporal dementia?

A

Cortical release signs

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16
Q

What are the cognitive clinical features of behavioural variant frontotemporal dementia?

A

Impaired attention and executive dysfunction, cognitive disinhibition
Perseveration, mental rigidity
Aphasia leading to mutism
Reduced speech output

17
Q

What are the affective clinical features of behavioural variant frontotemporal dementia?

A

Depression
Anxiety
Excessive sentimentality

18
Q

What are the behavioural clinical features of behavioural variant frontotemporal dementia?

A
Personality changes
Behavioural disorder including
- Disinhibition
- Impulsivity
- Impaired judgement
- Obsessive behaviours
- Apathy
- Anhedonia
Dietary change
19
Q

What are the pathological features of behavioural variant frontotemporal dementia?

A

Loss of cortical neurons and gliosis
Primary tauopathy
MRI: focal cortical loss

20
Q

What is the onset and progression of vascular cognitive impairment?

A

Gradual onset

Progressive stepwise decline

21
Q

What are the physical clinical features of vascular cognitive impairment?

A

Focal neurological deficits - vary with location and severity of lesions

22
Q

What are the cognitive clinical features of vascular cognitive impairment?

A
Diffuse cognitive impairment
Cognitive slowing
Attentional dysfunction
Psychomotor retardation
Secondary executive features
23
Q

What are the affective clinical features of vascular cognitive impairment?

A

Irritability
Apathy
Blunted affect

24
Q

What are the behavioural clinical features of vascular cognitive impairment?

A

Withdrawal

25
Q

What are the pathological features of vascular cognitive impairment?

A

White matter lesions
MRI: hyperintensities
MRI/CT: ventricular volume loss on structural imaging without pronounced cortical loss
Cardiovascular risk factors - not essential/sufficient