Major Neurocognitive Disorders- Dementia specific Flashcards
what is the most common type of dementia (Major Neurocognitive Disorder)
Alzheimer’s disease. Alzheimer’s accounts for 60-80% of dementia cases
Alzheimer’s onset and course is generally:
A) sudden onset with progressive decline
B) gradual onset with progressive decline
C) sudden onset, progressive improvement until remission is reached
D) the trajectory depends on the person, it could be any of the above.
B
what age group is most commonly affected by Alzheimers
people age 65+, it is also more common in women
Alzheimers is characterized by a build up of what in the brain
Amyloid Plaques and tangles (Tau).
The presence of these leads to cell death in the brain which causes brain shrinkage
true or false: the first symptom of alzheimers is usually changes in motor function
False. The first symptom is memory loss, though in later stages changes, motor function and sensory processing are usually effected.
Other common symptoms that appear early in the course of the disease are: changes in thinking, reasoning, behaviour, planning, language, etc.
what is vascular dementia caused by?
brain cell death due to hypoxia (could be due to hemorrhage, stroke, narrowing of blood vessels, etc)
the onset and course of disease progression for vascular dementia is most commonly:
A) sudden onset with progressive stepwise decline
B) gradual onset with progressive stepwise decline
C) sudden onset, progressive improvement until remission is reached
D) the trajectory depends on the person, it could be any of the above.
A
but it can also at times be gradual onset with progressive stepwise decline
what is the typical age of onset of vascular dementia?
approximately 60-75 years of age
list 5 lifestyles risk factors for vascular dementia
- poor cardiovascular health
- high cholesterol
- high BP
- diabetes
- smoking
True or false: vascular dementia is characterized by FOCAL neurological deficits.
True. the area of the brain affected by the hypoxic brain injury will result in specific symptom presentation.
describe the most common clinical features of vascular dementia
- *1. focal neurological deficits
- *2. slowed thinking and difficulty problem solving
3. poor concentration, disorganization, impulsiveness.
4. confusion
5. gait disturbance, unsteadiness
6. sudden/frequent urge to urinate, incontenence
7. depression, apathy, emotional liability, personality changes
Dementia with Lewy Bodies commonly co-occurs with which other type of dementia?
Alzheimers
What are the most common clinical symptoms of Lewy Body Dementia?
- hallucinations and delusions
- fluctuating confusion, and alertness
- movement disorders (parkonsonian like)
- malfunctions in autonomic nervous system
- dizziness
- impaired thinking and reasoning
- significant sleep disturbances
Dementia with Lewy Bodies overlaps and can progress to what disease
Parkinson’s disease and parkinson’s dementia
What is the difference in cause in Lewy Body dementia and Alzheimers dementia?
Both are characterized by a buildup of proteins. Lewy Body dementia is caused by a buildup of Lewy Bodies (an abnormal protein) whereas Alzheimers is caused by a build up of amyloid plaque and Tau proteins. Alzheimers and LBD often occur simultaneously, they can also be misdiagnosed as each other.
what is the typical age of onset for LBD?
50+ years
LBD’s disease trajectory is best described as which of the following:
a) gradual onset, progressive and degenerative
b) very rapid onset, progressive and degenerative
c) it depends on the person, it can be extremely rapid or gradual
A
List 3 characteristics of Fronto-temporal dementia
- extreme behaviour and personality changes
- speech and language problems
- movement disorders
the location of the degeneration in the brain will determine what characteristic(s) a patient presents with
Fronto-temporal dementia is best described as:
a) one specific type of dementia that is localized to the frontal and temporal lobes
b) a group of disorders that cause shrinking of the frontal or temporal lobes of the brain
c) progressive and degenerative
d) a and c
e) b and c
E
fronto-temporal dementia is often misdiagnosed as what?
a pyschiatric condition. This is due to the characteristic behaviour and personality changes it causes.
What is the cause of Wernicke Korsakoff Syndrome
Thiamine (B1) deficiency
In Wernicke Korsakoff syndrome, Wernicke syndrome refers to what?
the acute phase of the disease which, while a medical emergency, can be reversed. It usually manifests as: confusion, ataxia, and involuntary eye movements.
In Wernicke Korsakoff Syndrome, Korsakoff syndrome refers to what?
the chronic phase of the disease. It is non reversible (permanent) and is characterized by short term memory impairment and ataxia
Wernicke Korsakoff Syndrome is more likely to affect people experiencing one of which two conditions?
- Alcoholism
- eating disorders
it also has a higher prevalence in people who have AIDS
Name 2 broad populations who are at a higher risk of experiencing chronic traumatic encephalopathy
- athletes (especially athletes in high contact sports)
2. veterans
symptom presentation of chronic traumatic encephalopathy (CTE) often occurs:
a) immediately following a head trauma
b) approximately 72 hours after an traumatic brain injury has occurred
c) years to decades after a single traumatic brain injury has occurred
d) years to decades after a person has experienced repetitive head traumas.
D
What is Chronic Traumatic Encephalopathy?
it is a degenerative brain disease found in people who have experienced repetitive head traumas, which leads to degeneration of brain tissue and build up of Tau protein.
Describe the first, second, third and fourth stages of CTE
stage 1: ADHD, headaches, confusion, mild memory loss
stage 2: memory loss, impulse control, impaired executive funcitoning
stage 3 & 4: progressive dementia, movement disorders, language disorders, psychotic symptoms.
general OT tips for working with dementia:
- most effective interventions are person centered and environment based
- look at sensory interventions
- identify unmet needs (often show up as behaviours) and find creative ways to address them.
- avoid use of antipsychotic medications as there is limited evidence for efficacy in adults with dementia
