S2_L3: Dementia Flashcards
Most common neurodegenerative disease
Alzheimer’s disease
Country with the highest population of adults older than 65 years old
Sweden
In the Philippines, how many years of age is considered as elderly?
60 years old
TRUE OR FALSE: The majority of demeted elders live in less developed regions such as South-East Asia. Asia is the most populous continent in the world.
True
The person who discovered Alzheimer’s & treated Auguste D
Dr. Alois Alzheimer
Additional: Alzheimer found the characteristic plaques throughout the cerebral cortex, but also found clumping and distortion of fibrils in the neuronal cytoplasm
Source: Adams & Victor
51 y/o female from Frankfurt, Germany, who is the first Alzheimer’s disease patient. She had progressive cognitive impairment, focal symptoms, hallucinations, and delusions. She died within 5 years.
Auguste D
Order of Forgetting in pts with dementia
- Grandchildren
- Youngest children
- Oldest children
- Wife
- Mother or Father
Determine whether the s/sx is present in which stage
- Difficulty following simple commands
- Difficulty learning new things
- Emotional deterioration
- Difficulty recalling familiar words
- Social skills decline
A. Early stage
B. Intermediate stage
C. Advanced stage
- C
- A
- C
- A
- B
Determine whether the s/sx is present in which stage
- Paranoia
- Loss of insight
- Physical / verbal aggression
- Bladder / bowel control declines
- Fatigue
A. Early stage
B. Intermediate stage
C. Advanced stage
- B
- C
- B
- C
- A
Determine whether the s/sx is present in which stage
- Deterioration in judgment and social behavior
- Loss of logic, memory, motor ability; Restlessness
- Impatience
- Hallucinations
- Forgetful and absent-minded
A. Early stage
B. Intermediate stage
C. Advanced stage
- A
- B
- B
- C
- A
It is a syndrome of cognitive decline with variable non-cognitive features of behavioral and psychiatric symptoms and disturbances in ADLs. The sustained acquired decline in intellect which interferes with an individual’s daily activities.
Dementia
Determine if the clinical feature corresponds to normal aging or dementia.
- Poor memory
- Intact ADLs
- Decline in other cognitive domains
- Minimal forgetfulness
- Abnormal n/p test result
A. Normal aging
B. Dementia
- B
- A
- B
- A
- B
TRUE OR FALSE: Alzheimer’s disease is the most common cause of dementia, followed by CVD, then AD with infarcts, then chronic, subdural hematoma, and slow-growing tumor.
True
Most common and important degenerative disease and dementia of the brain, having an immense societal impact. It is the underlying cause of memory loss in most cases of dementia.
Alzheimer’s Disease
Sources: Adams & Victor; Merritt
Average duration of Alzheimer’s Disease
8-11 years
Enumerate the 8 risk factors for Alzheimer’s disease.
- Age
- Gender
- Ethnicity
- Education
- Occupation
- Head trauma
- Comorbid conditions
- Life events
Country that has an association with life events for development of dementia, especially bereavement. The culture of this country has the longest time for mourning.
China
Most important risk factor for dementia
Age
TRUE OR FALSE: Prevalence of Alzheimer’s disease is higher in women than men.
True
Type of vascular dementia that leads to significant parenchymal volume loss not necessarily in critical locations
Multiple Large-Vessel Infarctions / Multiple ischemic infarcts affecting large vessels
Source: Merritt
Type of vascular dementia that is critically located. The ACA, PCA & MCA may be occluded.
Strategic (Single) Infarctions
Additional: If ACA, (B) frontal infarction; if MCA, frontal / parietal infarcts; if PCA, (B) thalamic infarction. Inferior medial temporal lobe infarcts can also occur.
Source: Merritt
TRUE OR FALSE: The brain-battering hypothesis states that lower education leads to a higher dementia prevalence
True
TRUE OR FALSE: Early-life stimulation can contribute to cognitive reserve and may decrease risk for AD. Adult education enhances cognitive reserve.
True
In DSM-IV for dementia - Alzheimer’s type: Gradual, progressive decline in memory plus one or more of the ff:
1-4.
- Aphasia
- Apraxia
- Agnosia
- Executive function disturbance
Warning signs: Normal or possibly dementia
- Trouble balancing a checkbook
- Rapid mood shifts
- Forgetting for a moment where you are going
- Forgetting that a meal was ever prepared
- Unable to find the right word, but using a substitute
A. Normal
B. Possibly dementia
- A
- B
- A
- B
- A
Warning signs: Normal or possibly dementia
- Getting lost on your own street
- Temporarily forgetting a colleague’s name
- Talking on the phone and temporarily forgetting to watch a child
- Drastic changes in personality, all of a sudden
- Putting a wristwatch in the sugar bowl
- Tired of housework but getting back to it
A. Normal
B. Possibly dementia
- B
- A
- A
- B
- B
- A
Enumerate 4 risk factors for vascular dementia
- Demographic factors
- Stroke features
- Vascular risk factors
- Psychological factors
TRUE OR FALSE: Mild cognitive impairment (MCI) is a cognitive state that falls between normal aging and dementia. This includes amnesia, dysnomia, visuospatial disorientation, paranoia and personality changes, and executive dysfunction.
True
Sources: Adams & Victor; Merritt
TRUE OR FALSE: Individuals with MCI, particularly amnestic MCI, are at increased risk for progressing to dementia, most often Alzheimer’s disease.
True
Source: Merritt
Match the treatments for AD & their corresponding presumed mechanism
- Donepezil hydrochloride
- Memantine hydrochloride
- Rivastigmine tartrate
- Galantamine hydrobromide
A. Cholinesterase inhibition
B. NMDA receptor inhibition
- A
- B
- A
- A