Old Age Psychiatry Flashcards
what are the most common mental illnesses in old age?
dementia
depression
delirium
what are the ABCD features of Dementia?
- Activities of Daily Living (ADLs)
- Behavioural and psychiatric symptoms of dementia (BPSD)
- Cognitive Impairment
- Decline
what features related to memory loss can present in dementia?
dysphasia (expressive or receptive)
dyspraxia
dysgnosia
dysexecutive functioning
define dysphasia, dyspraxia, dysgnosia and dysexecutive functioning
dysphasia - inability to communicate
dyspraxia - inability to carry out motor skills
dysgnosia - inability to recognise objects
dysexecutive functioning - inability to organise/plan activities
what are the two main cognitive features of dementia?
memory
functional decline
name some neuropsychiatric disturbances that can occur in dementia
- psychosis
- depression
- altered circadian rhythm
- agitation/aggression
- anxiety
what are the three most common types of dementia?
alzheimer’s disease
vascular dementia
mixed alzheimer’s and vascular dementia
what is the average timescale between diagnosis and death?
7 years
alzheimer’s disease represents how much of the overall prevalence of dementia?
50%
name a few common symptoms found in Lewy body Dementia (DLB)
- attention/frontal executive and visuospatial deficit
- fluctuation
- visual hallucinations
- parkinsonism
- sleep disorder
what type of scan is done for patients with Lewy Body Dementia, and what does it look for?
DATScan - looks at the reuptake of dopamine transporter in the caudate nucleus
which type of dementia is characterised by personality changes and apathy?
frontotemporal dementia (FTD)
name a few features of frontotemporal dementia
personality changes early onset emotional blunting speech disorder abnormalities in frontotemporal lobe
what is the firstline drug treatment for mild to moderate Alzheimer’s dementia?
Acetylcholinesterase Inhibitors
- donepezil, rivastigmine, galantamine
what is the first line treatment for moderate to severe Alzheimer’s?
Memantine
name a few neuroleptic drugs that are sometimes used for dementia
- antipsychotics
- anxiolytics
- anticonvulsants
- antidepressants
- mood stabilisers
- hypnotics
what are the two areas of remit for Power of Attorney and guardianship?
financial
welfare
what are the 5 principles to establish if someone has capacity?
Act Make Communicate Understand Retain memory of
what is the difference between guardianship and power of attorney?
- PoA is appointed by a patient who has capacity
- guardianship is appointed when a patient does not have capacity
what percentage of elderly admissions are due to late onset schizophrenic psychosis?
10%
what is a typical feature of elderly patients presenting with late onset schizophrenia?
elderly patients with sensory loss, often deafness
do patients need to tell DVLA when they get diagnosed with dementia?
yes
what are the common brain scans carried out to confirm a diagnosis of dementia?
CT scan
SPECT scan
name the most common tests for cognitive function
MMSE questionnaire
MOKA questionnaire
