Presentation Flashcards
What is dementia?
Syndrome resulting from acquired brain disease. It is characterized by a progressive decline in memory and other cognitive domains that, when severe enough, interferes with daily living and independent functioning
Common NeuroDegenerative diseases that cause dementia
Alzheimer’s disease (leading cause of dementia)
Lewy body disease
Vascular pathology (e.g., multi-infarct dementia)
Frontotemporal dementia (FTD)—Pick’s disease (behavioral variant) and primary progressive aphasia (language variant)
Huntington’s disease
Parkinson’s disease
Conditions that mimic dementia
Metabolic conditions Neoplasms Toxins Infections Autoimmune disorders Nutritional disorders Drug Effects Because of a number of mimics it is important there is an extensive range of testing to understand the diagnosis of dementia.
Depression and Dementia
Co-occurs with dementia
Often undiagnosed
Can mimic symptoms of dementia - cognitive impairment, sleep disturbances, appetite loss, poor concentration on memory.
Effects on communication - reduced intonation, slow response, brief replies.
Types of dementia by frequency
AD - Highest at 62%
Vascular Dementia - 17%
FTD - 2%
Fronto-temporal dementia
Behavioural variant and language variant - including primary progressive aphasia, semantic dementia, progressive non-fluent aphasia, logopenic PPA.
Impaired with ppt in communication - engagement and paying attention to CP.
Characteristics of Logopenic PPA
Slow rate of speech
Sentence and phrase repetition impaired but repetition of short single words spared
Reading and writing abilities may be preserved longer than speech, but will decline.
Over time - difficulties with understanding long or complex verbal info - :( WM.
May become completely non-verbal .
Initial Primary Non-fluent aphasia
Non-fluent Breakdown in language output Effortful speech Phonemic speech Impaired comprehension Difference with aphasia - is symptoms are progressive and these are followed with other symptoms.
Alzheimer disease
Word finding pauses - loses train of thought
Initiates messages - makes word errors but not sound
Grammar, articulation, prosody - generally normal.
Visual and semantic naming errors
Ferris and Farlow (13) - difficulties in compre of spoken and written lang.
Comprehension at single lvl - intact
Difficulties as syntax becomes more complex.
May have difficulty on repetition of sentences
reduced verbal fluency.
Main problem: in sense of message (not making sense).
Vascular Dementia
Slow speech, word finding pauses Articulation may be impaired Semantic and phonological errors are rare and grammar is normal. Impaired attention Bradyphenia - slowness of thought Primary deficit is variable
Primary progressive aphasia/non-fluent aphasia
Thinking unaffected in early stages
Language impairment - prominent feature
Aprosidic
Comprehension impaired at single level.
Difficultly repeating polysyllabic words
Hesitant, effortfull speech
Phonemic errors, but not semantic
Agrammatic speech - effortful stuttering
AoS
Primary deficit = structure of the message/motor programme.
Semantic Dementia
Breakdown in the conceptual database of thinking
As progression - profound semantic loss with failur of word comprehension and naming/face recognition.
Speech is fluent and empty - circulmatory
Continues to initiate.
Severe anomia
May have visual agnosia
Repetition is intact if word is recognised.
Comprehension impaired at single word lvl.
Primary deficit = sense of the message (meaning).
Behavioural variant of FTD
Short terse phrases
Difficulty in message initiation
Normal prosody, articulation and grammar
Echolalia
May have hypergraphia - wants to write
Disinhibited responses - random/inapprop
Primary deficit = sense of the message or initiation of speech.
Quality of life (ICF - activity and ppt) Presentation
Anxiety Isolation Inability to learn new info Disorientation Stress and Distress Risk
Impact on social relationships
PPl with language impairments are more likely to find it problematic to retain exisiting friendships = social withdrawal.