Visual Impairment 7- Dementia Flashcards
What does dementia effect?
Memory Thinking Congniton Orientation Learning Language Judgement
What are the risk factors for dementia?
AGE! Depression Isolation Low education attainment Air pollution Cognitive activity Down syndrome
How can we reduce or prevent the risk of dementia?
Keep active Cognitive activities No smoking Harmful alcohol use Control weight Eat healthy diet Healthy BP, cholesterol and blood sugar
What can dementia give rise to?
Alzheimaer disease Vascular dementia Mixed dementia Lewy bodies Picks disease (rare form)
What biological changes would occur in dementia?
Brain changes- protein plaques, thickened meninges
Tau proteins- occur naturally, protein altered, microtubules destroyed
Lewy bodies- abnormal aggregation of protein
Why are down syndrome patients more susceptible to early alzhaeimers disease?
Extra copy of chrom 21
What causes alzhaeimers?
Brain cell due to neurofibrilly tangles and senile plaques
Where in the brain does alzheimers effects the patient?
Occipital and parietal lobe
What is the onset of alzheimers?
Mid 50s to early 60s
What difficulties can people with AD face?
Faces and objects
Numeracy and literacy
What are AD risk factors?
Age
Gender- F>M (2x)
Health- DM, HT, Stroke, CV probs, high cholesterol, obesity
What are the AD sxs?
Memory loss
Language problems
Confusion
Personality changes
What leads to vascular dementia AKA Subcortical dementia?
Brain circulation changes
What can cause VD?
Stroke/TIA
What are the risk factors of VD?
Age >65yrs (2x)
M>F
Health- DM, HT, prev. troke, CVD, high cholesterol, obesity
Ethnicity- SE asians and afro caribbeans
What sxs are u likely to encounter with VD?
Memory probs Language probs Visuospatial- 3D concept Concentration /confusion Depression
What is the 4th most common form of dementia?
Lewy bodies
What are LB associated with
Parkinsons disease
What are LB a result of?
Loss of connection b/w nerve cells
What are the 2 positions of lewy bodies?
Base of brain- movement difficulties
Outer brain layers- cognitive function
What are the risk factors of LB?
Age
>65yrs common
M=F
What are the main sxs of LB?
Attention and alertness
Hallucination and delusions
What is mixed dementia?
A combo of AD and VD
Common >75yrs
WhR cause picks disease AKA Fronto temp dementia?
Lobes shrink (less common)
What 2 areas of the brain are effected with picks disease and what are their functions?
Frontal lobe- behavior/emotional control
Temporal lobe- Left= words meaning/obj names, Right= facial recognition
Once dx eith dementia, what meds licensed in the UK are possibly taken? (Mild to mod and mod to severe)
Mild to mod:
Donepezil
Galantamine
Rivastigmine
Mod to severe
Memantine
What visual changes maybe presented?
CV Loss Reduced VA Reduced CS Reduced Stereoacuity Reduced motion detection Visual hallucinations
In severe cases of dementia, how is VA assessed?
Teller acuity grating
What test may indicate the strongest and weakest associations to severity of dementia?
Strongest associaton= Stereoacuity and motion detection
Weakest association= colour vision test
Which form of dementia effects 3D vision more?
Vascular dementia
Which form of dementia is it likely to experience hallucinations?
Lewy bodies
What can optometrists do to help those c dementia?
Advise on spec use, lighting, contrast
What 3 things that are included in the college guidelines about dementia and optometrists?
Prescribing
Supply and after care
Regerall and support
