Lecture 3 - Cognition and Dementia

Question 1

Fluid Intelligence

Answer 1

ability to adapt to and use new information (new info, problem solving, reasoning)

Question 2

Crystallized Intelligence

Answer 2

practical skills and knowledge of the person accumulated over a long period of time (decline is linked to changes in the CNS - speed, info processing)

Question 3

What are the instances in which vocational performance is affected by cognitive declines?

Answer 3

• decline in fluid intelligence
• increased cautiousness
• decreased processing speed
• declines in secondary memory

Question 4

Definition of Dementia

Answer 4

deterioration of cognitive functions that does not allow them to function in the world

Question 5

What is the impact of dementia?

Answer 5

• decreased day to day functioning
• feeling incompetent, frustrated, loss of control
• need to adapt (simplify tasks, give up roles/tasks

Question 6

Alzheimer’s Disease (AD)

Answer 6

• cause is unknown
• Dx: individual demonstrates insidious onset of impaired memory (episodic and recent) and at least one other cognitive domain (aphasia, agnosia, apraxia, executive functioning, and personality or social behavior, emotional awareness or expression)

Question 7

What are the predispositions for AD?

Answer 7

• female, family hx, ethnicity and age

Question 8

Vascular Dementia (VaD)

Answer 8

• caused by cerebral vascular damage
• demonstrate perseverating behaviors, difficulties with verbal fluency
• impairments: attention working memory, abstract thinking

Question 9

What are the risk factors for VaD?

Answer 9

• male, hx of stroke, HTN, age, vascular risks

Question 10

Dementia with Lewy Bodies (DLB) indicators?

Answer 10

• Parkinsonism
• Cognitive Fluctuations (with prominent deficits in attn)
• Visual hallucinations
• repeated falls, nonvisual hallucinations, delusions, syncope

Question 11

Lewy Body

Answer 11

round neurofilament inclusion body that holds damaged nerve cell deposits

Question 12

Frontotemporal Dementia (FTD)

Answer 12

• includes more focal conditions with progressive aphasia, semantic aphasia and frontal dementia with motor neuron disease
• insidious onset with slow progression

Question 13

What are the early signs of FTD?

Answer 13

behavioral disturbances, changes in social awareness, and evident changes in personality (gradual, but prominent)

Question 14

Parkinson’s Disease (PD) with Dementia (PDD)

Answer 14

• develops around 10 years after PD
• clinically looks very similar to DLB
• slowed psychomotor speed, difficulties with attention and initiation
• decline in delayed recall, semantic knowledge, frontal EF, memory (specific aspects) and visuospatial functions

Question 15

Pre-Dementia Stage

Answer 15

no sx, only way to distinguish is through autopsy; OTs need to see if they can manage their ADLs

Question 16

Mild Dementia

Answer 16

subjective deficits, word finding, memory loss, usually the stage where the clinical dx of AD can be made, difficulties with demands and work, difficult maintaining attention, confusion, time where a lot of individuals hide their deficits; repeating stories and questions, impaired comprehension

Question 17

Moderate Dementia

Answer 17

usually no longer to can live on their own; changes in gait; might start not to remember distant family members; coping with change; loss of impulse control; inappropriate behavior

Question 18

Severe Dementia

Answer 18

require assistance with basic ADLs, urinary/fecal incontinence, difficulty remembering family

Question 19

Role of the OT with Dementia

Answer 19

• educate family members
• evaluate the pt with dementia
• maintenance and modification