Memory Flashcards
(23 cards)
What are the different types of memory?
- sensory
- short term memory
- long term memory which includes the following
- explicit memory (conscious) > declarative memory (facts, events) > episodic memory (events, experiences) > semantic memory (facts, concepts)
- implicit memory (unconscious) > procedural memory (skills, tasks)
What are the four steps of memory processing?
- attention
- encoding
- storage
- retrieval
What is anterograde amnesia?
Difficulty in acquiring new material and remembering events since the onset of the illness of injury
What is retrograde amnesia?
Difficulty in remembering information prior to the onset of the illness or injury
What is assessed in cognitive screening?
- memory
- attention and concentration
- executive functioning
- visuo-spatial functioning
- language
What is the 4AT?
- rapid assessment test for delirium
- aimed at detecting moderate-severe cognitive impairment
What are the components of 4AT?
- alertness (normal/ mild sleepiness / clearly abnormal)
- AMT-4 (age, DOB, place, current year)
- attention (months backwards)
- acute or fluctuating course
Which test is useful in the diagnosis of dementia?
MMSE
What is the MMSE?
- mini mental state examination
- a screening test scored out of 30
- orientation, memory, visuospatial and language
- crude test
What is the MoCA?
- montreal cognitive assessment
- rapid screening instrument for mild cognitive dysfunction
- assesses multiple cognitive domains
What are the components of the addenbrookes cognitive examination?
- scored out of 100 with 5 domains;
- orientation and attention
- memory
- fluency
- language
- visuospatial functioning
Describe the features of mild cognitive impairment
- noticeable cognitive impairment with little deterioration of function
- ACE-III usually 75-90, MoCA usually 24-26 but can vary
- repeat cognitive testing yearly
- may benefit from home based memory rehabilitation
Describe the subjective cognitive impairment
- patient feels that they are cognitively impaired but cognitive testing and day to day function are normal
- patients often have a relative or friend with dementia
- vicious cycle of increasing anxiety about memory causing more memory lapses is common
Name possible presenting complaints of alzheimers disease
- memory loss particularly short term
- dysphasia
- dyspraxia
- agnosia
What can be seen on CT/MRI in alzheimers disease
- can be normal
- medial temporal lobe atrophy or temporoparietal atrophy
- variants; frontal or posterior cortical atrophy
Name possible presenting complaints in vascular dementia
- dysphasia, dyscalculia, frontal lobe symptoms and affective symptoms more common than in alzheimers
- may have focal neurological signs
- may have vascular risk factors
- may have step wise decline
Describe what can be seen on CT/MRI and SPECT scanning in vascular dementia
- CT/MRI; moderate-severe small vessel disease or multiple lacunar infarcts
- SPECT; patchy reduction in tracer uptake throughout brain
Describe the 3 syndromes of frontotemporal dementia
- behavioural variant; behavioural changes, executive dysfunction, disinhibition, impulsivity, loss of social skills, apathy, obsessions, change in diet
- primary progressive aphasia; effortful non-fluent speech, speech sound / articulatory errors, lack of grammar, lack of words
- semantic dementia; impaired understanding of meaning of words, fluent but empty speech, difficulty retrieving names
Describe what can be seen on CT/MRI and SPECT scanning in frontotemporal dementia
- CT/MRI; frontotemporal atrophy
- SPECT; frontotemporal reduction in tracer uptake
Describe the criteria for dementia with lewy bodies
- dementia; common early involvement of reduced attention, executive function and visuospatial skills
- two of; visual hallucinations, fluctuating cognition (delirium like). REM sleep behaviour disorder, parkinsonism (not more than 1 year prior to onset of dementia), positive DAT scan
Name examples of cholinesterase inhibitors used in alzheimers disease
- donezepil
- rivastigmine
- galantamine
Name side effects of cholinesterase inhibitors
- GI (nausea and diarrhoea most common)
- headache
- muscle cramps
- bradycardias
- worsen COPD / asthma
Describe the features of memantine and its use in dementia
- low affinity voltage-dependent non-competitive antagonist of NMDA receptors
- may preferentially inhibit excessive NMDA receptor activation associated with excitotoxicity and spare normal function
- also a weak antagonist at other amine receptors
