Week 10 - Dementia & Delirium Flashcards
What is delirium?
Syndrome that is usually characterised by transient global disturbance of attention and cognition accompanied by abnormal psychomotor behaviour and altered sleep-wake cycle
Which age group is delirium most common?
Elderly
Is the onset of delirium slow or fast?
Fast - comes on very quickly
Is the course of delirium short or long?
Short - hours to days
Are delirium symptoms worse during the day or at night?
At night
Mental state examination for someone with delirium
- Not fully alert
- Impairment of attention and memory
- Psychomotor agitation
- Abnormal mood
- Visual illusions & hallucinations
- Fragmented thinking
Delusions
Physical examination
- Sympathetic over-arousal (dilated pupils, hypertension)
9 core features of delirium
- Acute onset
- Inattention
- Disorganised thinking
- Altered level of consciousness
- Disorientation
- Memory impairment
- Perceptual disturbances
- Psychomotor agitation or retardation
- Altered sleep/wake cycles
Screening instruments for delirium
- 3D-CAM
2. 4AT
Treatment of delirium
Provide supportive treatment to allow safe recovery
Is the onset of dementia slow or fast?
Slow
Is the course of dementia short or long?
Long
What is dementia?
Significant cognitive decline from a previous level of performance in one or more cognitive domains
Synonym for dementia
Major Neuro-cognitive Disorder
What is mild neuro-cognitive disorder?
Modest cognitive decline from a previous level of performance
What is the most common cause of dementia?
Alzheimer’s disease
- Significant cognitive decline from a previous level of performance
- Objective evidence of cognitive deficit relative to an appropriate reference population
- The person needs assistance with IADLs
Dementia
Assessments for memory impairment
- Bedside testing (recall 3 objects; recall name & address)
- Formal neuropsychological testing (word list learning)
Assessments for executive disfunction
- Bedside testing (animals in 60 seconds, how many camels are there in Italy?)
- Formal testing
>Tower of London test
Assessments for aphasia
- Name objects & parts of objects
- Read/write a sentence
- Boston Naming Test
Assessments for apraxia
- Ask patient to lick lips, cough, wink , whistle
- Ask patient to mime actions
- Clock drawing test
Assessments for agnosia
- Visual recognition of common objects
- recognition of famous faces
Hyperorality, disinhibition, inertia are symptoms of
bvFTD
- Severe impairment of new learning ability
- Inability to recall previous memories
- No general loss of intellectual ability
- No clouding of consciousness
- Evidence of a specific organic cause
Amnestic disorder
