Memory Flashcards
what is dementia
two or more of the following:
forgetfulness memory loss confusion poor reasoning or logic personality changes poor judgement ability to focus visual percentopn
What initial cognitive test can be done quickly in individuals with suspected cognitive impairement
MMSE
what other test should be done to improve initial cognitive testing
addenbrookes cognitive exam
What is the MMSE out of and what are the cut offs
out of 30
more than 27 is normal
less than 24 suggest cognitive impairement/dementia
what are the disadvantages of the mmse
does not assess executive function well
not a good test in people who were very ‘high functioning’ premorbidly
may not indicate problems in early stage
what are the steps to diagnosing dementia
exclude other organic cause of dementia eg depression. delirium
MMSE –> Addenbrooks –> neuropsychological assessment
when do symptoms of delirium typically get worse
a night - ‘sundowning’
what drugs can cause delerium
anticholinergics anticonvulsants anti parlinsonian drugs steroids - IMPORTANT opiates cimetidine sedatives
alcohol
illicit drugs
what are the risk factors for delirium
elderly cognitive deficit - dementia sensory deficit previous episode perioperative hypo/hyperthermia immobile social isolation new environement stress
should formal cognitive tests be done in diagnosing delerium
yes - MMSE, CAM, ACE-R, MoCA
What is used as a sedating drug in delirium (unless due to alcohol withdrawal)
haloperidol - smaller dose in elderly
- please not this may need to be continually prescribed thereafter
what should always be done when someone has been successful treated for delerium
repeat cognitive assessment to avoid misdiagnosis of dementia
What should be used as a sedative drugs for patient who are delirious but also have comorbid Parkinson or lewy body dementia
Lorazepam (not diazepam)
what is the average duration of delerium
1-4 weeks
often longer in elderly
can become chronic
is delirium a mental disorder
yes - if not induced by alcohol or illicit drugs
