Unit 5 - Dementia and Delirium

Question 1

How can we distinguish the symptoms of cognitive impairments between dementia, delirium, and depression? (5)

Answer 1

• onset
• course (how long it lasts)
• Consciousness
• orientation
• thinking

Question 2

What is the onset of dementia?

Answer 2

• onset of cognitive impairment is gradual and/or insidious

Question 3

What are the common types of dementia in the older adult? (5)

Answer 3

• alzheimer’s type
• Vascular dementia
• Lewy body dementia
• fronto-temporal
• mixed

Question 4

Why does vascular dementia occur?

Answer 4

• small areas in brain where blood flow is not as good

Question 5

What does lewy-body dementia cause?

Answer 5

• hallucinations
  visual or auditory

Question 6

What is fronto-temporal dementia? (3)

Answer 6

• younger in 50s
• assumes depression
• uninterested in social interaction

Question 7

What is the prevalence of Alzheimer’s disease (AD)? (8)

Answer 7

• 60-80% of dementia is AD
• Prevalence increases with age
• 1% of Canadians have dementia
• early onset (30-60) represents 5% of the cases of AD
• 25% are 85+
• Women are more likely to have dementia than men
• Higher proportion of First Nations people and younger age onset dementia
• Indigenous men are more likely than women

Question 8

What is Alzheimer’s disease?

Answer 8

• disease of the brain with a gradual onset

Question 9

What are the signs of Alzheimer’s? (4)

Answer 9

• no changes in consciousness
• Depression (mood signs) can occur up to 3 years prior to diagnosis
• memory loss, including orientation, word finding problems, vision or spatial issues, impaired judgment, difficulty managing day to day
• change in judgment, reasoning, behaviour, and emotion

Question 10

How long and what is the severity of Alzheimer’s?

Answer 10

• course can be from 1-20 years (usually 8-9 years)
• irreversible or chronic and progressive

Question 11

How do we diagnose AD? (4)

Answer 11

• confirmation based on postmortem brain brain biopsy
• interview with older adult and with their family or close others
• history of gradual deterioration of cognitive function (screening tests)
• Rule out other causes (neuroimaging to rule out malignancy)

Question 12

What are the risk factors of AD? (3)

Answer 12

• vascular disorders
• obesity, dyslipidemia, hypertension, smoking, stroke
• head trauma

Question 13

What are the protective factors of AD? (4)

Answer 13

• higher education
• brain training
• regular exercise
• socially integrated lifestyle

Question 14

What are the components of cognitive assessments for AD? (6)

Answer 14

LOC - normal
Memory - difficulty remembering names and recent events, disorientation in later stages
Language - difficulty expressing self
Visual spatial cognition - Where the person is in space
Attention -
Abstract reasoning - impaired reasoning, language

Question 15

What are the later symptoms of Alzheimer’s? (3)

Answer 15

• difficulty walking and swallowing
• expect decline first in executive function, then decline in IADLs, then decline in ADLs
• maintain social abilities through different stages