Lecture 17 - Introduction To Dementia Flashcards
What is the most common type of dementia?
Alzheimer’s - 60%
What is dementia?
Interferes with the ability to function, represents a decline from previous levels of function, impairments in a minimum of 2 domains, detected through history taking and objective cognitive assessment.
Syndromal diagnosis not a disease.
What types of clinical assessment can be done?
Memory clinic receives information from GP initial exam.
Converse with patients family and the patient themselves.
Describe the localisation of functions of dementia.
Executive function has impaired decision making.
Space perception has spatial neglect, visuo-constructive impairment and agnosia.
Visual function has agnosia and prosopagnosia.
Language and motor has aphasia, Alexia and apraxia.
Episodic memory affected.
What are some non-cognitive symptoms of dementia?
Major cause of disability and distress.
Physical/motor symptoms, autonomic symptoms, personality/behaviour change and other neuropsychiatric symptoms.
Incontinence, constipation, postural hypotension, poor balance, falls and Parkinsonism.
Apathy, depression, sleep disturbance, agitation, aggression, psychosis, sexual disinhibition.
Describe Alzhiemer’s disease.
Insidious onset and gradual progression.
Anterograde memory typically prominent.
Most prominent deficits in memory or language/visuospatial/executive functions.
Hippocampus atrophy, brain atrophy where fluid replaces the spaces left.
High tau deposition in temporal areas of the brain.
Ventricles in the brain get larger.
Describe dementia with Lewy bodies.
Insidious onset and gradual progression, though episodes of delirium and fluctuation may be present.
Predominant executive and visuospatial deficits, cognitive fluctuations.
Visual hallucinations, Parkinsonism, REM sleep behaviour disorder, loss of sense of smell.
Alpha synuclein deposits in the brain rather than amyloid or tau.
Describe frontotemporal dementia.
Gradual progressive decline, frontal executive, apathy, disinhibition, loss of sympathy/empathy, repetitive behaviours, dietary changes.
Changes in the frontal and temporal lobes.
Describe vascular dementia.
Abrupt or stepwise decline, decline following stroke, variable pattern of cognitive impairment, focal neurological sign, gait disturbance/falls, incontinence.
Describe the biopsychosocial treatment for dementia.
Biological - drug treatments (cholinesterase inhibitors, mematine, optimise physical health).
Psychological - cognitive stimulation therapy, carer support.
Social - housing and care needs, activities.
