Memory Problems Flashcards

1
Q

is clouding of consciousness seen in dementia?

A

no

only in delirium

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2
Q

3 main groups of human memory?

A
sensory memory (<1 sec)
short term/working memory
long term memory
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3
Q

types of long term memory?

A

explicit memory (conscious) and implicit memory (unconscious)

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4
Q

types of explicit memory?

A

declerative memory (facts, events)

  • episodic (events/experiences)
  • semantic (facts, concepts)
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5
Q

example of implicit memory?

A

procedural (skills/tasks)

- e.g driving, becomes an unconscious action

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6
Q

stages of memory processing?

A

attention
encoding
storage
retrieval

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7
Q

what is anterograde amnesia?

A

difficulty in acquiring new memories

cant remember events since onset of illness/injury

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8
Q

what us retrograde amnesia?

A

cant remember information prior to the inset of illness/injury

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9
Q

what things are classified as normal memory loss?

A
sometimes misplaces keys, glasses etc
momentarily forgets acquaintance's name
occasionally has to search for words
occasionally forgets to run an errand
may forget event from distant past
may momentarily forget where to turn while driving but quickly orientates self
jokes about memory loss
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10
Q

what things are classed as mild cognitive impairment?

A

frequently misplaces items
frequently forgets people’s names and is slow to recall them
has more difficulty using the right words
begins to forget important events and appointments
may forget more recent events or newly learned information
may temporarily become lost more often, may have trouble understanding/following map
worries about memory loss, family and friends notice the lapses

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11
Q

what things are classed as dementia?

A

forgets what an item is used for or puts it in an inappropriate place
may not remember knowing a person
begins to lose language skills and may withdraw from social interaction
loses sense of time, doesnt know what day it is
has serious impairment of short term memory and difficulty learning/remembering new information
becomes easily disorientated or lost in familiar places, sometimes for hours
may have little or no awareness of cognitive problems

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12
Q

how does delirium differ from dementia?

A
acute onset
hours/days/weeks/months duration
fluctuating course
impaired alertness and orientation
can have paranoid and bizarre thinking
hallucinations more common
more likely to be irritable, aggressive and fearful
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13
Q

useful questions to ask the patient when assessing cognition?

A

has memory problem affected day to day life?
any problems in the kitchen?
can you still use home appliances (remote, phone, microwave, washing machine etc)
do you follow the news? tell me something specific you’ve seen in the news
have you ever got lost or disorientated?
do you drive? any recent accidents?
can you still enjoy hobbies? (golf,bingo,bridge etc)

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14
Q

important aspects of corroborative history from family?

A

functional abilities at home
help required to support them while at home?
any significant cognitive, physical or emotional changes in recent weeks
rate and pattern of cognitive decline

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15
Q

what should be assessed in cognitive screening?

A
memory
attention and concentration
executive functioning
visuo-spatial functioning
language
consider screen to rule out co-morbid psychological problems (e.g depression)
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16
Q

what is the 4AT?

A

rapid assessment screening test for delirium
quick, pragmatic, validated
aimed at detecting mod-severe cognitive impairment
uses the months backwards test and AMT-4 (abbreviated mental test-4)

17
Q

what 4 things does 4AT measure?

A

alertness
AMT-4 (age, DOB, place, year)
attention (months backwards)
acute or fluctuating course

18
Q

SIGN guidelines on testing for dementia?

A

MMSE should be used in diagnosis of dementia in individuals with suspected cognitive imapirment
initial cognitive testing can be improved by use of addenbrookes cognitive examination

19
Q

cut offs for MMSE?

A
>27 = normal
25-26 = borderline cognitive impairment
<24 = supports dementia diagnosis
20
Q

drawbacks of MMSE?

A

not adjusted for age
wont pick up early stages
poor measure of executive functioning

21
Q

what bedside tests can be used in suspected cognitive impairment?

A

GPCOG
6CIT
clock drawing test

22
Q

what does clock drawing test measure?

A
executive functioning (planning)
visuo-spatial ability
abstraction (ability to use symbols)
correlates well with overall cognitive functioning
frontal-parietal functioning
23
Q

what is MoCO?

A

montreal cognitive assessment
rapid screening tool for mild cognitive dysfunction
assesses multiple cognitive domains

24
Q

what is addenbrooke’s cognitive examination?

A

upgraded from first issue (ACE-R)
bridges the gap between MMSE and neuropsychological assessment
scored out of 100 with 5 domains

25
Q

what are the 5 domains of addenbrookes?

A
orientation and attention
memory
fluency
language
visuo-spatial functioning
26
Q

cut offs in addenbrookes?

A

> 88 = normal
<82 = supports dementia diagnosis
84 generally ok, may be borderline