Week 12 - Dementia Flashcards
What is dementia?
An acquired, progressive cognitive impairment resulting in a gradual decrease in a person’s ability to think, remember and function
What cognitive factors does dementia involve?
One or more of: Memory Concentration Language Learning Judgement and executive function
What is the most common type of dementia?
Alzheimer’s disease (70%)
What percentage of patients in aged care have dementia?
50%+
What are the early signs of dementia?
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
What is vascular dementia?
The broad term for dementia resulting from problems with blood supply to the brain
What are the two most common types of vascular dementia?
Multi-Infarct dementia
Sub cortical dementia
What is Lewy body disease?
Caused by the degeneration and death of nerve cells in the brain due to abnormal protein deposition.
What are the signs and symptoms of Lewy body disease?
Motor symptoms similar to parkinson’s disease
Visual hallucinations
Sleep disturbances
Fluctuations in cognitive state
What is the second most common dementia?
Lewy body disease
What is frontotemporal dementia?
Dementia due to progressive damage of the frontal and/or temporal lobes of the brain
What are the common symptoms of Frontotemporal dementia?
Behaviour and/or dramatic personality changes
Socially inappropriate, impulsive, or repetitive behaviours
Impaired judgement
Apathy
Lack of empathy
Decreased self awareness
What is alcohol related dementia?
A form of dementia related to the excessive drinking of alcohol. This affects memory, learning and other mental functions
What causes alcohol related dementia?
Direct toxicity of alcohol to brain structures
Secondary effect of nutritional deficiencies (B1)
What are the 2 types of alcohol related dementia?
Korsakoff’s syndrome
Wernicke syndrome
What are the symptoms of Korsakoff’s syndrome?
Confusion
Visual problems
Ataxia
It is a chronic condition
What are the symptoms of Wernicke’s syndrome?
Nystagmus
Ataxia
Confusion
It is acute and potentially reversible
What is HIV associated dementia?
HIV and AIDS may lead to complications known as HIV associated dementia
What are the symptoms of HIV associated dementia?
Early:
Behaviour and motor changes
Memory impairment
Difficulties concentrating
Late: Severe cognitive impairment Mutism Incontinence Paraplegia
True or false; Alzheimer’s disease can be both sporadic and familial?
True
What are the symptoms of Alzheimer’s disease?
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
What changes to the brain are caused by Alzheimer’s disease?
Large numbers of neuritic plaques develop, consisting of altered axons and dendrites
Where are plaques and tangles found in Alzheimer’s disease?
The cortex, particularly the temporal parietal lobes and other areas that play a role in memory
Where are plaques and tangles found in Alzheimer’s disease?
The cortex, particularly the temporal parietal lobes and other areas that play a role in memory
True or false, acetylcholine is unaffected in Alzheimer’s disease?
False, acetylcholine is grossly depleted in AD
What are the un-modifiable risk factors of AD?
Old age
Gender
Family history
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
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
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
How is dementia treated?
Medications
Management strategies/Intervention
Support of patient and carers
Planning
What are the 4 medications used for dementia?
- Cholinesterase inhibitors
- NMDA receptor antagonists
- Sedative/hypnotics
- Antipsychotic drugs
How is dementia managed?
Cognitive therapy - counselling, validation therapy, reality orientation, reminiscence therapy
Management - behavioural interventions
How do you improve communication with a dementia patients?
Reduce distractions
Stay still
Repeat the message in the exact same way
How is nutrition affected by dementia?
Appetite loss/overeating
Reliance on being fed
Swallowing difficulties
Difficulties with attention and behaviour at a table
How can hygiene be improved for dementia patients?
Routines
Reduce distractions
Privacy
Assistive devices
How can toileting be improved for dementia patients?
Consider visuals for locating toilet Establish routines Incontinence aids Simplify clothing Equipment
How can mobility be improved for dementia patients?
Remove all trip hazards
Look at safe footwear
Consider hip protectors
Use of mobility aids
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
What can be done for carers of someone with dementia?
Education
Respite
Assistive devices
Care package support
