issues related to elderly ass.

Question 1

activities of daily living

Answer 1

They are activities that are necessary for independent life at home or community

Question 2

Instrumental Activities of Daily living (IADLs)

Answer 2

• They are important activities but not necessary on daily basis
• Usually lost before ADLs

Question 3

what determines level of assistance that a patient requires

Answer 3

ability to perform activities of daily living and instrumental activities of daily living

Question 4

aspects of risk asseesment

Answer 4

risk to self
risk to others
risk from others

Question 5

what are the risk to self in elderly patieents

Answer 5

risk of self neglect
risk of falls
risk of wondering
risk of self harm
risk of non compliance

Question 6

risk to other associateed wiith patients with dementia

Answer 6

physical aggression

Question 7

most common risk to other in elderly

Answer 7

verbal aggression

Question 8

what is mild cognitive impairment ( MCI )

Answer 8

stage between benign senile forgetfulness
and dementia

Question 9

primary feature associated with mild cognitive impairment

Answer 9

cognitive impairment, most usually but not always in memory, in the context of otherwise preserved abilities

Question 10

what ar thee types of mildd cognitive impairment ?

Answer 10

amnestic MCI - where memory is affected
non amnestic MCI - memory is not affected
each have a single and multi domain

Question 11

what is used to asses the progression of MCI to dementia ?

Answer 11

serial NPT
neuropsychological testing

Question 12

why is MMSE not good for MCI ?

Answer 12

mini mental state examination lacks sensitivity

Question 13

consensus criteria for MCI

Answer 13

• Moderate cognitive deficits
• Self-reported and/or informant reported cognitive
  complaints
• Impairment on objective clinical cognitive tests
• Preserved basic activities of daily living and minimal impairment in complex instrumental functions

Question 14

rate of progression of MCI to dementia over a 5 year period

Answer 14

10-15%

Question 15

what type of MCI has the highest association of progression to dementia

Answer 15

amnestic multi domain MCI

Question 16

what genotype is associated with a higher risk of MCI to dementia conversion

Answer 16

APOE e-4

Question 17

what imaging changes are associated with a higher risk off MCI to dementia conversion

Answer 17

volume loss in the hippocampus and entorhinal cortex

Question 18

what are the circumstances that warrant the disclosure of patient confidentiality ?

Answer 18

1) to assist in the prevention or the detection of a serious crime
associated with child abuse
associated with someone’s risk of death
2) driving against medical advice
3) a colleague who also happens to be a patient putting other patients at risk