NDD-Dementia

Question 1

What are the different types of dementia?

Answer 1

Alzheimer’s disease, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies

Question 2

Which type of dementia results in a progressive impairment of memory, executive function, attention, language, visual processing and praxis with commonly associated behavioral disturbances?

Answer 2

Alzheimer’s disease

Question 3

What is the pathology of Alzheimer’s disease?

Answer 3

cortical atrophy of the frontal, parietal, and temporal lobes as well as the hippocampal region caused by an accumulation of amyloid beta senile plaques and tau protein neurofibrillary tangles

Question 4

T or F: Alzheimer’s disease has a rapid progression.

Answer 4

False, it is slow and progressive until death

Question 5

How many stages are there for Alzheimer’s disease?

Answer 5

Three, early stage, middle stage and late stage

Question 6

The symptoms of AD gradually lead to…

Answer 6

behavior and personality changes, a decline in cognitive abilities, such as decision-making and language skills and problems recognizing family and friends.

Question 7

T or F: Medical management for AD includes disease treatment to cure the disease

Answer 7

False, to slow the progression

Question 8

Medical management to cure symptoms target what areas?

Answer 8

cognitive decline, psychiatric symptoms and behavior disturbances

Question 9

Pharmacotherapy is used with clients with AD to manage what symptoms?

Answer 9

cognition, depression, delusions, hallucinations, agitation and aggression

Question 10

What is the pathology for vascular dementia?

Answer 10

cerebrovascular disease (often a series of small strokes) leading to focal lesions in the brain and neurotransmitter disruption

Question 11

T or F: There is a continuous decline in patients with vascular dementia

Answer 11

False, it is abrupt or step wise

Question 12

T or F: Cognitive decline in patients with vascular dementia is similar to AD but often has more severe memory involvement

Answer 12

False, it’s often LESS severe memory involvement

Question 13

What is a common clinical feature in clients with vascular dementia?

Answer 13

Gait disturbance

Question 14

What is the common course and prognosis of vascular dementia?

Answer 14

sudden appearance of symptoms, with a stepwise pattern of increased symptoms and it may also progress slowly, similar to AD

Question 15

T or F: Immediate emergency medical treatment isn’t needed for clients with vascular dementia.

Answer 15

False, it is needed

Question 16

What is involved in the medical management of vascular dementia?

Answer 16

treatment of cardiovascular factors (management of diabetes, high cholesterol and heart disease), pharmacotherapy to prevent future blood clots and in some cases, surgery to remove blockages in blood vessels.

Question 17

What is the pathology for frontotemporal dementia?

Answer 17

neuronal, intranuclear inclusions

Question 18

What are the clinical features of frontotemporal dementia?

Answer 18

progressive aphasia, corticobasal syndrome, or symptoms similar to AD or Parkinson’s disease

Question 19

What is the course and prognosis of frontotemporal dementia?

Answer 19

immediate, distinct onset, progressive, varied symptom patterns among individuals

Question 20

T or F: Medications have been developed to treat frontotemporal dementia

Answer 20

False, future research needed; medications currently in development

Question 21

What is the pathology of Dementia with Lewy bodies?

Answer 21

Lewy body proteins present in the brain, usually predominant in the limbic or neocortical areas; overall decline in acetylcholine and dopamine levels

Question 22

What are the clinical features of Dementia with Lewy bodies?

Answer 22

Progressive deficits in attention and executive function, memory impairment, fluctuation cognition, visual hallucinations, parkinsonism, autonomic dysfunction, and falls

Question 23

What disorder is a possible prodromal symptom of Dementia with Lewy Bodies?

Answer 23

rapid eye movement sleep behavior disorder

Question 24

What are some early disease symptoms of dementia with lewy bodies?

Answer 24

problems in exective function, visuospatial abilities, attention and memory function

Question 25

What are some symptoms of dementia with Lewy bodies over time?

Answer 25

aphasia, apraxia, and spatial disorientation

Question 26

T or F: The course and prognosis of dementia with lewy bodies is gradual and insidious.

Answer 26

True

Question 27

What does the medical management for dementia with lewy bodies involve?

Answer 27

It's similar to that for AD, increased family involvement, safety assessment, neuroleptics, cholinesterase inhibitors

Question 28

What is procedural memory?

Answer 28

recall of information on how to perform a task, such as knowing how to write or ride a bike

Question 29

Which type of memory remains intact during the primary signs and symptoms of dementia?

Answer 29

procedural memory

Question 30

What is recent memory?

Answer 30

recall of recent events

Question 31

What type of memory is affected first for clients with dementia?

Answer 31

recent memory

Question 32

What is personal episodic memory?

Answer 32

recall of time-related information about oneself, such as where and whether one ate breakfast

Question 33

What is semantic memory?

Answer 33

The ability to remember the names of objects

Question 34

What two types of memory show deficits during the primary signs and symptoms of dementia?

Answer 34

personal episodic memory and semantic memory

Question 35

What is aphasia?

Answer 35

difficulty with expressive language, receptive language or both

Question 36

What is apraxia?

Answer 36

loss of skilled, purposeful movements that cannot be attributed to either deficits in primary motor skills or problems in comprehension

Question 37

What is the inability to recognize the importance of sensory impressions despite being able to recognize the elemental sensation of the stimulus?

Answer 37

agnosia

Question 38

What is the disruption of the broad band of skills that allow a client to engage in independent, self-directed behavior including volition, planning, purposeful action and self-awareness?

Answer 38

disturbance in executive functioning

Question 39

What are some cognitive deficits that are primary signs and symptoms of dementia?

Answer 39

aphasia, apraxia, agnosia, and disturbance in executive functioning

Question 40

What is difficulty with topographic orientation?

Answer 40

orientation of the self within the environment

Question 41

T or F: Individuals with dementia may experience poor judgement, anxiety and defensiveness, disinhibited behavior, psychotic symptoms and difficulty with spatial tasks

Answer 41

True

Question 42

What are some motor deficits individuals with dementia show during their primary symptoms?

Answer 42

gait disturbances, hyperflexia, paratonia, and dysphagia

Question 43

What is hyperflexia?

Answer 43

overflexion of a limb

Question 44

What is paratonia?

Answer 44

involuntary resistance to passive movement of the extremities

Question 45

What is known as difficulty swallowing?

Answer 45

dysphagia

Question 46

How severe are the primary symptoms for individuals with dementia?

Answer 46

sufficient to affect occupational performance and represent a decline from previous functional level

Question 47

During which stage does dementia affect orientation to place, which affects community mobility?

Answer 47

early stage

Question 48

T or F: ADLs remain intact during the early stage of dementia

Answer 48

True

Question 49

The first signs of memory loss manifest during which stage of dementia and what tasks?

Answer 49

early stage, IADLs

Question 50

During which stage of dementia does financial management, shopping, meal preparation, communication, health management and work performance become impaired?

Answer 50

early stage

Question 51

During which stage of dementia should driving skills be reevaulated?

Answer 51

early stage

Question 52

During which stage of dementia does the person withdraw from social participation?

Answer 52

early stage

Question 53

During which stage of dementia does impairment occur in all areas of occupation?

Answer 53

middle stage

Question 54

During which stage of dementia can the person no longer live alone?

Answer 54

middle stage

Question 55

During which stage of dementia do eating problems and weight loss occur?

Answer 55

middle stage

Question 56

During which stage of dementia is the person dependent in community mobility, financial management and shopping?

Answer 56

middle stage

Question 57

During which stage of dementia is safety a major concern due to risks of wandering, letting a stranger in the house or causing a fire?

Answer 57

middle stage

Question 58

What happens during the late stage of dementia?

Answer 58

all areas of occupations are lost, the person is dependent in all ADLs, the person can no longer ambulate safely, communication is lost, the person has no understanding the cultural, social or spiritual contexts

Question 59

What are some standardized function-based cognitive screening instruments you can use with clients with dementia?

Answer 59

Allen cognitive level screen or the enlarged allen cognitive level screen, assessment of motor and process skills, cognitive performance test, executive function performance test, independent living scales, kitchen task assessment, and Arnadottir OT-ADL neurobehavioral evaluation

Question 60

What are some standardized cognitive screening instruments you can use with clients with dementia?

Answer 60

blessed dementia scale, cognitive competency test, lowenstein occupational therapy cognitive assessment, middlesex elderly assessment of mental state, mini-mental state exam, modified mini-mental, neurobehavioral cognitive status screening exam, repeatable battery for the assessment of neuropsychological status

Question 61

What are some memory assessments you can use with clients with dementia?

Answer 61

contextual memory test, hopkins verbal learning test-revised, prospective memory screening and rivermead behavioural memory test-extended version

Question 62

Which cognitive level is known as planned actions?

Answer 62

level 6

Question 63

What is characteristic of cognitive level 6?

Answer 63

client is independent and disability is absent

Question 64

Which cognitive level is known as exploratory actions?

Answer 64

level 5

Question 65

In which cognitive level does the client have difficulties with judgement, reasoning, planning, semantic memory and episodic memory?

Answer 65

level 5

Question 66

In which cognitive level can a client follow four to five step processes and learn new concrete ideas?

Answer 66

level 5

Question 67

In which cognitive level is the caregiver standby or supervision is needed for cognitive assist?

Answer 67

level 5

Question 68

Which cognitive level is known as goal-directed activity?

Answer 68

level 4

Question 69

During which cognitive level can a client no longer problem solve?

Answer 69

level 4

Question 70

During which cognitive level can the client follow two or three step activities?

Answer 70

level 4

Question 71

In which cognitive level does the client require task set up for bathing and grooming?

Answer 71

level 4

Question 72

In which cognitive level does the client require 24 hour supervision?

Answer 72

level 4

Question 73

In which cognitive level can the client eat independently but require supervision for the amount of food eaten?

Answer 73

level 4

Question 74

In which cognitive level does the client need protection against safety hazards and wandering?

Answer 74

level 4

Question 75

Which cognitive level is characterized as manual actions?

Answer 75

level 3

Question 76

In which cognitive level should attention be directed to tactile cues?

Answer 76

level 3

Question 77

In which cognitive level are motor actions limited to one-step, familiar, and action-oriented activities?

Answer 77

level 3

Question 78

In which cognitive level can the client no longer learn new behaviors?

Answer 78

level 3

Question 79

In which cognitive level should adapted activities be used to reinforce the connection between predictable tactile effects on the environment and client actions (i.e. walking, washing cars, drying and washing dishes, wiping countertops, vacuuming)?

Answer 79

level 3

Question 80

In which cognitive level should the client avoid sensory overload and require a routine?

Answer 80

level 3

Question 81

In which cognitive level is the client able to wash hands, face and brush teeth while requiring that items be presented to the client one at a time and in sequential order of use?

Answer 81

level 3

Question 82

What is cognitive level 2 characterized as?

Answer 82

postural actions

Question 83

In which cognitive level is the client's thinking highly disorganized?

Answer 83

level 2

Question 84

In which cognitive level are motor actions one step, imitated, near reflexive and familiar and involve gross motor patterns?

Answer 84

level 2

Question 85

In which cognitive level can ADLs be accomplished by imitating the caregiver?

Answer 85

level 2

Question 86

In which cognitive level does the client pace and wander and should be taken to the restroom every 2 hours?

Answer 86

level 2

Question 87

In which cognitive level does attention involve internal cues and spontaneous behaviors are common?

Answer 87

level 2

Question 88

What is cognitive level 1 known as?

Answer 88

automatic actions

Question 89

In which cognitive level do motor actions respond to one-word, near-reflexive directions (i.e. sip)?

Answer 89

level 1

Question 90

In which cognitive level does the client need passive, active, or assistive ROM for prevention of bed sores, osteoporosis, infections and contractures?

Answer 90

level 1

Question 91

In which cognitive level should the environment be consistent, familiar and modified to elicit orienting experiences?

Answer 91

level 1

Question 92

In which cognitive level is the client dependent on caregivers for ADLs, needs monitoring for adequate nutrition, and requires assistance with ambulation and transfers?

Answer 92

level 1

Question 93

Which cognitive level is the terminal phase of the disease?

Answer 93

level 1

Question 94

T or F: Death usually occurs before the last stage of cognitive level 1 for patients with dementia

Answer 94

True

Question 95

What are some things you should do to manage behavior in clients with dementia during communication?

Answer 95

avoid reasoning with the client, listen, maintain a trusting relationship, offer choices when possible, decrease demanding social situations and simplify approaches to the environment during sundowning

Question 96

What is sundowning?

Answer 96

an increase in activity and often agitation that begins in the late afternoon and extends into the evening or night

Question 97

What are some things you should do to manage behavior in clients with dementia during sundowning?

Answer 97

use adequate lighting, provide a safe area for physical activity, provide reassurance in a calm and caring manner, provide the client with fluids during the day, reduce noise and clutter and avoid using restraints

Question 98

What are some things you should do to manage behavior in clients with dementia during anger?

Answer 98

anticipate problems and stressors, rephrase negatives as positives, distract the client by using food or asking for assistance, adhere to familiar routines, simplify tasks, allow time for response, allow physical movement, reduce stimuli in the environment

Question 99

What are some things you should do to manage behavior in clients with dementia during wandering?

Answer 99

assess the reason for wandering, use a calm approach, provide signs in the environment for cueing, use distraction to interrupt pacing, simplify tasks, provide a rocking chair or opportunities for activities and movement, ensure good lighting, keep area safe/uncluttered, monitor fatigue/fluid intake/client's feet, walk with client, use medicalert identity wristband and provide reassurance, attentiveness and acceptance

Question 100

What are some things you should do to manage behavior in clients with dementia during pillaging and rummaging?

Answer 100

learn the client's favorite hiding spaces, give the client a familiar item to hold, involve the client in activities that involve sorting items, accompany the client to make it fun, provide the client with rummaging closets or areas, do not scold, tease or punish the client or respond with anger, use distractions, etc. (more listed in PDF)

Question 101

What are some things you should do to manage behavior in clients with dementia during activities and occupations?

Answer 101

focus activity on the client's abilities (not limitations), be purposeful, provide the client with a sense of belonging, promote positive behaviors and appropriate verbal/nonverbal communication

Question 102

T or F: Part of your intervention should include caregiver training in activities to enhance the client's fine and gross motor abilities, provide sensory stimulation, reinforce old learning, self-image and dignity and improve sense of reality.

Answer 102

True

Question 103

T or F: The promotion of physical activity will help address sleep functioning in clients with dementia

Answer 103

True

Question 104

What are some sensory-preceptual modifications you can make for clients with dementia?

Answer 104

appropriate lighting, high-contrast coloring or textured surfaces, objects for stimulation, varied, safe and tactile objects, visual blocks and soundproofing

Question 105

What are some memory enhancement intervention ideas you can do for clients with dementia?

Answer 105

large print calendars, daily schedules, seasonal decorations, familiar furniture, photographs, favorite music, notices of current events

Question 106

T or F: Simplified and structured environments help to promote ADL task performance in clients with dementia

Answer 106

True

Question 107

T or F: It is beneficial to have inconspicuous locks on cabinets and doors, safe indoor walking space or garden and a monitoring system for clients with dementia

Answer 107

True