Lecture 4- Dementia

Question 1

Which of the following is the strongest evidence of the patient’s risk for unsafe driving?
A. Patient’s self-restriction and situational avoidance
B. History of traffic citation in the past 5 years
C. Spouse’s concern
D. Score of less than 24 on MMSE
E. Patient’s self-rating of driving ability

Answer 1

C- Spouse’s concern

Question 2

Which of the following is true about risk of Alzheimer Disease?
A. Mutations in 4 known deterministic genes are associated with autosomal-dominant AD
B. The lifetime risk of developing AD in the genral population is approx. 20% assuming a life span of 75-80 years
C. AD is sporadic in approx. 75% of cases
D. Genetic risk for AD varies by race and ethnicity

Answer 2

C. AD is sporadic in approx 75% of cases

Question 3

Is Dementia an inherent part of aging?

Answer 3

NO

Question 4

What are the top 3 types of dementia?

Answer 4

1. Alzheimer Disease
2. Vascular dementia
3. Dementia with Lewy Bodies

Question 5

Primary treatment goals with dementia

Answer 5

• enhance quality of life and maximize function by improving cognition, mood, and behavior

Question 6

Treatment types for dementia

Answer 6

SHOULD include both pharmacologic and nonpharmacologic interventions

Question 7

What is delerium?

Answer 7

Acute change in mental status

- underlying stress disorder

Question 8

What is the ONLY type of dementia with fluctuations?

Answer 8

Diffuse Lewy Bodies

Question 9

DEMENTIAS mneumonic

Answer 9

D- Drugs
E- Emotional disorders
M- Metabolic disorders
E- Endocrine problems
N- nutritional and neurologic disease
T- Trauma and tumor
I- Infection, Ischemia, Inflammation
A- Anemia, Arrhythmia 
S- Social, Sensory, Spiritual isolation

Question 10

Delerium

Answer 10

• Acute onset
• cognitive fluctuations over hours or days
• impaired consciousness and attention
• altered sleep cycles

Question 11

Depression

Answer 11

• impaired concentration
• Lack of motivation, of interest, apathy
• psychomotor retardation
• sleep disturbance

Question 12

Pharmacologic managment of dementia

Answer 12

• Cholinesterase inhibitors

- Memantine

Question 13

Most common cause of dementia

Answer 13

Alzheimer’s Disease

Question 14

Delerium-

Answer 14

Acute change in mental status and always has an underlying disease

Question 15

Diffuse Lewy-Body disease

Answer 15

Only dementia to show true fluctuations day-to-day

Question 16

Frontotemporal disease

Answer 16

Heterogeneous group of disorders we are learning more about

Question 17

Normo-pressure hydrocephalus

Answer 17

Enlargement of ventricles with fluid causing pressure on neurocircuitry around ventricles, curable with shunting if caught early enough
- abnormal gait (feet stuck to the ground), urinary incontinence, and cognitive decline

Question 18

Overlapping Symptoms of depression and dementia

Answer 18

• Impaired concentration
• Lack of motivation, loss of interest, apathy
• Psychomotor retardation
• Sleep disturbance

Question 19

DEFINITE risk factors for dementia

Answer 19

• age
• family history
• APOE4 allele
• Down Syndrome

Question 20

what percentage of people over 65 have Alzheimers

Answer 20

6-8%