Week 12 - Dementia Flashcards

1
Q

What is dementia?

A

An acquired, progressive cognitive impairment resulting in a gradual decrease in a person’s ability to think, remember and function

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2
Q

What cognitive factors does dementia involve?

A
One or more of:
Memory
Concentration
Language
Learning
Judgement and executive function
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3
Q

What is the most common type of dementia?

A

Alzheimer’s disease (70%)

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4
Q

What percentage of patients in aged care have dementia?

A

50%+

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5
Q

What are the early signs of dementia?

A
Recent memory loss that affects job skills
Difficulty performing familiar tasks
Problems with language or word finding
Disorientation of time and place
Poor or decreased judgement
Problems with abstract thinking
Misplacing things
Changes in mood or behaviour
Changes in personality
Loss of initiative
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6
Q

What is vascular dementia?

A

The broad term for dementia resulting from problems with blood supply to the brain

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7
Q

What are the two most common types of vascular dementia?

A

Multi-Infarct dementia

Sub cortical dementia

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8
Q

What is Lewy body disease?

A

Caused by the degeneration and death of nerve cells in the brain due to abnormal protein deposition.

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9
Q

What are the signs and symptoms of Lewy body disease?

A

Motor symptoms similar to parkinson’s disease
Visual hallucinations
Sleep disturbances
Fluctuations in cognitive state

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10
Q

What is the second most common dementia?

A

Lewy body disease

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11
Q

What is frontotemporal dementia?

A

Dementia due to progressive damage of the frontal and/or temporal lobes of the brain

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12
Q

What are the common symptoms of Frontotemporal dementia?

A

Behaviour and/or dramatic personality changes
Socially inappropriate, impulsive, or repetitive behaviours
Impaired judgement
Apathy
Lack of empathy
Decreased self awareness

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13
Q

What is alcohol related dementia?

A

A form of dementia related to the excessive drinking of alcohol. This affects memory, learning and other mental functions

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14
Q

What causes alcohol related dementia?

A

Direct toxicity of alcohol to brain structures

Secondary effect of nutritional deficiencies (B1)

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15
Q

What are the 2 types of alcohol related dementia?

A

Korsakoff’s syndrome

Wernicke syndrome

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16
Q

What are the symptoms of Korsakoff’s syndrome?

A

Confusion
Visual problems
Ataxia
It is a chronic condition

17
Q

What are the symptoms of Wernicke’s syndrome?

A

Nystagmus
Ataxia
Confusion
It is acute and potentially reversible

18
Q

What is HIV associated dementia?

A

HIV and AIDS may lead to complications known as HIV associated dementia

19
Q

What are the symptoms of HIV associated dementia?

A

Early:
Behaviour and motor changes
Memory impairment
Difficulties concentrating

Late:
Severe cognitive impairment
Mutism
Incontinence
Paraplegia
20
Q

True or false; Alzheimer’s disease can be both sporadic and familial?

21
Q

What are the symptoms of Alzheimer’s disease?

A

Persistent and frequent memory difficulties
Vagueness in everyday conversation
Apparent loss of enthusiasm for previously enjoyed activities
Taking longer to do routine tasks
Forgetting well known people or places
Inability to process questions and instructions
Deterioration of social skills
Emotional unpredictability

22
Q

What changes to the brain are caused by Alzheimer’s disease?

A

Large numbers of neuritic plaques develop, consisting of altered axons and dendrites

23
Q

Where are plaques and tangles found in Alzheimer’s disease?

A

The cortex, particularly the temporal parietal lobes and other areas that play a role in memory

24
Q

Where are plaques and tangles found in Alzheimer’s disease?

A

The cortex, particularly the temporal parietal lobes and other areas that play a role in memory

25
True or false, acetylcholine is unaffected in Alzheimer's disease?
False, acetylcholine is grossly depleted in AD
26
What are the un-modifiable risk factors of AD?
Old age Gender Family history
27
What are the modifiable risk factors of AD?
``` D - Drugs E - Emotional disorders M - Metabolic and endocrine disorders E - Eye and ear dysfunction N - Nutritional Deficiencies T - Tumour and Trauma I - Infection A - Atherosclerotic disease or alcohol ```
28
How id AD diagnosed?
``` Detailed medical history Cognitive assessment - MMSE, RUDAS, MOCA Neuropsychological tests Lumbar puncture of CFS EEG medical imaging (CT/MRI/Nuclear medicine) Blood and urine tests ```
29
How do we reduce dementia risk?
``` Be physically active Quit smoking Have a balanced diet Drink alcohol in moderation Cognitive training Be socially active Maintain healthy weight Manage HTN Manage diabetes Manage cholesterol Manage depression Manage hearing loss ```
30
How is dementia treated?
Medications Management strategies/Intervention Support of patient and carers Planning
31
What are the 4 medications used for dementia?
1. Cholinesterase inhibitors 2. NMDA receptor antagonists 3. Sedative/hypnotics 4. Antipsychotic drugs
32
How is dementia managed?
Cognitive therapy - counselling, validation therapy, reality orientation, reminiscence therapy Management - behavioural interventions
33
How do you improve communication with a dementia patients?
Reduce distractions Stay still Repeat the message in the exact same way
34
How is nutrition affected by dementia?
Appetite loss/overeating Reliance on being fed Swallowing difficulties Difficulties with attention and behaviour at a table
35
How can hygiene be improved for dementia patients?
Routines Reduce distractions Privacy Assistive devices
36
How can toileting be improved for dementia patients?
``` Consider visuals for locating toilet Establish routines Incontinence aids Simplify clothing Equipment ```
37
How can mobility be improved for dementia patients?
Remove all trip hazards Look at safe footwear Consider hip protectors Use of mobility aids
38
What safety needs to be considered in the home of a dementia patient?
``` Remove clutter and trip hazards Non-slip mats in bathroom Personal alarm Nightlights Equipment Safe storage of medicines and chemicals Automatic shut off appliances ```
39
What can be done for carers of someone with dementia?
Education Respite Assistive devices Care package support