Lecture 15 Old Age Psychiatry Flashcards
What are the cognitive features of dementia
Memory (Dysmnesia)
Dysphasia
Dyspraxia
Dysgnosia
What are the main symptoms of Alzheimers
Early impairment of memory and executive function
Gradual progression with unclear onset
What are the main clinical features of Alzheimer’s
Amyloid plaques and tau tangles
Atrophy following neuron death
Reduction in acetylcholine
What is the presentation of vascular dementia
Unequal distribution of deficits
Evidence of focal impairments on neuro exam
PMH of cerebrovascular disease
Step wise decline with sudden changes
What are the key features of Lewy Body Dementia
Visual Hallucinations Fluctuations Parkinsonism Sleeping during the day Drowsy, lethargic and difficult to rouse
A DATScan on a normal or AD patient will show what?
Normal re-uptake of the dopamin transporter in the head of the caudate nucleus and putamen (comma shape)
A DATScan on a patient with DLB will show what
Re-uptake in the putamen is reduced (full stop sign)
What is Pick’s Disease
A rare type of age-related dementia that affects the frontal lobes of the brain and causes speech problems like aphasia, behaviour difficulties
What are the symptoms of Pick’s disease
Abrupt mood changes. Compulsive or inappropriate behavior. Depression-like symptoms, Withdrawal from social interaction. Difficulty keeping a job. Poor social skills. Poor personal hygiene. Repetitive behavior.
What is the drug treatment for mild to moderate AD and LBD
Ach Inhibitors (donepezil, rivastigmine, galantamine)
What is the drug treatment for moderate to severe AD
Memantine
What antipsychotics can be used in the treatment of AD
risperidone, quetiapine
What antidepressants can be used in the treatment of AD
Mirtazapine
Sertraline
What Anxiolytics can be used in the treatment of AD
Lorazepam
What anticonvulsants can be used in the treatment of AD
Valproate
Carbamazepine
