T. Delirium, Alzheimer’s Disease Flashcards
3 D’s
Delirium – acute confusion
Dementia
Depression
Delerium
• A state of temporary but acute mental confusion
• A possible symptom of a serious medical condition
Often the result of the interaction of the patient’s underlying condition with a precipitating event.
• The development of the disturbance over a short time (hours to days)
Hyperactive Delirium
may include restlessness (for example, pacing), agitation, rapid mood changes or hallucinations, and refusal to cooperate with care
Hypoactive Delirium
This may include inactivity or reduced motor activity, sluggishness, abnormal drowsiness, or seeming to be in a daze.
Mixed Delirium
This includes both hyperactive and hypoactive signs and symptoms. The person may quickly switch back and forth from hyperactive to hypoactive states.
Dementia
- loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life
- A collection of symptoms caused by various diseases affecting the brain.
- Occurs most often in older adults.
- Not a normal part of aging
Alzheimer’s disease
- Chronic, progressive, degenerative disease of the brain
- Most common form of dementia
- Amyloid plaques
- Neurofibrillary tangles
- Loss of connections between cells and cell death
- ↑ β-amyloid protein = ↑ risk
- Diagnosis of exclusion (Made once all other possible conditions causing cognitive impairment have been ruled out)
- Memory loss more prominent in early stages
- Balance, walking problems in later stges.
Vascular dementia
- Decline in thinking skills caused by reduced blood flow to various regions of the brain.
- Second most common cause of dementia after AD
- loss of cognitive function resulting from ischemic or hemorrhagic brain lesions caused by cardiovascular disease.
Dementia with Lewy bodies
- Characterized by presence of Lewy bodies in brain stem, amygdala and cortex
- Dementia symptoms often appear within one year after movement symptoms.
- Hallucinations, delusions and misidentification of familiar people are significantly more frequent in early-stages
- REM sleep disorders more common in early stages
- Disruption of the ANS more common in early stages
- Movement disorders in early stages
Frontotemporal dementia
- shrinking and atrophy of the frontal and temporal anterior lobes of the brain and often misdiagnosed as a psychiatric disorder or AD.
- Progressive nerve cell loss in the brain’s frontal or temporal loves
- Deterioration in behaviour, personality and/or producing or comprehending language
- Most individuals are diagnosed in their 40’s and early 60’s
- Inherited in about 1/3 of all cases.
Cholinesterase inhibitors
- Improve or stabilize cognitive decline but do not cure or reverse
- Block cholinesterase, enzyme responsible for breaking down acetylcholine
SUNDOWNING
- Client becomes more confused and agitated in late afternoon or evening.
- Cause is unclear – possible disruption with the circadian rhythm.
- behaviours commonly exhibited include agitation, aggressiveness, wandering, resistance to redirection, and increased verbal activity such as yelling.
Creutzfeldt-Jakob disease
- Rare and fatal brain disorder – human form
- Caused by a prion protein
- Rapid decline in thinking, reasoning, involuntary muscle movments, confusion, difficulty walking and mood changes
- “mad cow disease”
Confusion Assessment Method (CAM)
delirium is diagnosed as positive with the presence of: - acute onset - fluctuating course - inattention and either -- disorganized thinking or -- altered level of consciousness.
Normal Pressure Hydrocephalus
Characterized by an obstruction in the flow of cerebrospinal fluid (CSF), causing a buildup of CSF in the brain and enlargement of the ventricles. It may be caused by meningitis, encephalitis, or head injury.
