Neuro - Dementia Flashcards
What is the most common cause of dementia?
Alzheimer’s Disease
How is dementia categorized?
progressive cognitive + social + functional impairment
What medication can benefit dementia in early stages?
acetylcholinesterase inhibitors
Why is it hard to diagnose dementia in the clinic?
→ The disease follows a heterogenous course
→ In old age the disease presentation is of multiple co-morbidities
→ Lots of mixed and uncertain pictures
→ Younger patients are more typical
→ Clinical history, the function of the patient and how they change is paramount
How is a clinical diagnosis for dementia usually made? What is it based on?
History-taking
What is the checklist to interview patients+ collateral?
(long list)
What is dementia?
Severe memory loss + other cognitive abilities which leads to impaired daily function
What are you looking for when examining patients for signs of cognitive impairments?
Neurological mental state
What are investigations that can be done to help diagnose dementia?
→ neuropsychology
→ bloods
→ PET
→ MRI
What tests are used to assess cognitive function?
MMSE = mini mental state examination ACA = Addenbrooks Cognitive Assessment
What investigations are done as part of a blood test for dementia?
Long list lol
What are the different causes of dementia?
→ Alzheimer's → Vascular → Lewy Body → Frontotemporal → Depression → Delirium → No cause
How do you manage dementia?
→ acetyl cholinesterase inhibitors → watch + wait → treating behavioral/psychological symptoms → occupational therapist → social services → specialist therapies
How Alzheimer’s symptoms differ from other dementias?
→ subtle
→ insidious
→ can have amnestic or non-amnestic
How do vascular dementia symptoms differ from other dementia?
→ associated with cerebrovascular diseases
→ has classic step-wise deterioration
→ +- multiple infarcts
How does Lewy body dementia differ from the other dementias?
→ cognitive impairment before/within 1 year of Parkinsonian symptoms → visual hallucinations → fluctuating cognition → REM sleep disorder → high risk of falls
How does frontotemporal dementia differ from other dementias?
→ behaviour variant FTD
→ semantic dementia
→ progressive non-fluent aphasia
What kind of memory loss does Alzheimer’s initially present with?
Episodic memory deficits
What parts of the brain are particularly dysfunctional in Alzheimer’s?
Medial temporal lobe - entorhinal cortex + HIPPOCAMPUS
What causes Alzheimer’s ?
V
What causes Lewy body dementia?
Aggregation of alpha-synucleid leads to deposition of Lewy bodies
What causes frontotemporal dementia?
Deposits of beta-Amyloid plaques and increased Tau protein
