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Clinical Medicine - OT > Week 12 - Dementia > Flashcards

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?

A

True

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
Q

True or false, acetylcholine is unaffected in Alzheimer’s disease?

A

False, acetylcholine is grossly depleted in AD

26
Q

What are the un-modifiable risk factors of AD?

A

Old age
Gender
Family history

27
Q

What are the modifiable risk factors of AD?

A 
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
Q

How id AD diagnosed?

A 
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
Q

How do we reduce dementia risk?

A 
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
Q

How is dementia treated?

A

Medications
Management strategies/Intervention
Support of patient and carers
Planning

31
Q

What are the 4 medications used for dementia?

A
  1. Cholinesterase inhibitors
  2. NMDA receptor antagonists
  3. Sedative/hypnotics
  4. Antipsychotic drugs
32
Q

How is dementia managed?

A

Cognitive therapy - counselling, validation therapy, reality orientation, reminiscence therapy
Management - behavioural interventions

33
Q

How do you improve communication with a dementia patients?

A

Reduce distractions
Stay still
Repeat the message in the exact same way

34
Q

How is nutrition affected by dementia?

A

Appetite loss/overeating
Reliance on being fed
Swallowing difficulties
Difficulties with attention and behaviour at a table

35
Q

How can hygiene be improved for dementia patients?

A

Routines
Reduce distractions
Privacy
Assistive devices

36
Q

How can toileting be improved for dementia patients?

A 
Consider visuals for locating toilet
Establish routines
Incontinence aids
Simplify clothing
Equipment
37
Q

How can mobility be improved for dementia patients?

A

Remove all trip hazards
Look at safe footwear
Consider hip protectors
Use of mobility aids

38
Q

What safety needs to be considered in the home of a dementia patient?

A 
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
Q

What can be done for carers of someone with dementia?

A

Education
Respite
Assistive devices
Care package support

Clinical Medicine - OT (35 decks)

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