Old Age Flashcards
Mini mental state examination
Name time date day month and a year - five points
Name place floor Street town country -five points
Repeat and remember Apple table penny
Can you spell world and then world backwards
Can you recall the three objects I just told you?
Name two objects e.g. pen and watch
Close your eyes
Write a sentence
Three stage task with paper
Repeat no ifs ands or buts
Copy intersecting pentagons
Frontal lobe testing
Personality
Ask about personality changes or if others feel that they have changed recently
Abstraction
Proverb interpretation
too many cooks spoil the broth or all that glitters is not gold
Cognitive estimates
How many camels in Sweden
How tall is the average woman
Abstract similarities
Apple and banana
table and chair
Verbal fluency
Lexical fluency
name as many words beginning with P has possible try to avoid using names
Category fluency
Name as many animals as you can
Executive function
Key is lost in a field
Response inhibition
Go no-go test
Tap twice when I tap once then later a tap once when I tap twice
Luria test (Motor sequencing) Fist edge palm
Alzheimer’s
Healthy brain cells are gradually replaced with abnormal proteins which progressively Impacts upon memory behaviour and general function
Signs usually appear slowly and other causes of impairment need to be ruled out first
Bloods including FBC, urea, Electrolytes thyroid function tests bob and folate, calcium glucose
ECG and CT head
MSU
No cure and progressively worsens though some minimal benefit from cognitive enhances
There is a familial form which can occur in younger people (genetic testing useful in such families) those with down syndrome are also more prone to Alzheimer’s
Management
SSRIS Antipsychotics for severe behavioural disturbance
Ginkgo biloba shows some minimal improvements for memory and concentration
Cognitive enhances are usually acetylcholine esterase inhibitors (riverstigmine, donepazil, Gelantamine)
Also Memantine (NMDA antag) that’s not currently recommended for use in NHS)
Feast drugs can cause nausea, headache, sleep disturbance reduced and reduced appetite
Usually given when MMSE between 10 and 20
