Week Ten Flashcards
How many people in 2020 had dementia in New Zealand?
70,000
What are some risk factors for dementia?
- Social isolation
- Physical inactivity
- Hearing loss
- Obesity
- Hypertension
- Less education
What is the definition of dementia?
An acquired and persistent impairment of multiple cognitive domains: memory, language, attention, executive function and visuospatial abilities
Impairment is severe enough to limit competence in activities of daily living, occupation and social interaction
What are the different types of dementia?
- Alzheimer’s 50-70%
- Vascular
- Lewy Body
- Frontotemporal
What is alzheimer’s disease?
Gradual onset of symptoms over months to years
Clear-cut history of worsening cognition
Initial and most prominent cognitive deficits are:
- Episodic memory impairments (amnestic)
- language, visuospatial or executive function deficits (non-amnestic)
Within the brain, there is decrease cerebral volume, ventricular enlargemnt and plaque + tangle at autopsy
How does memory, language and other functions decline in typical alzheimer’s?
MEMORY:
- working/recent memory declines
- “ “ + prospective memory
- not recognizing family
- Older memories and procedural memory better preserved (elementary school, how to drive)
LANGUAGE:
- Amonia + tangential discourse
- Semantic/verbal paraphasias, empty speech, impaired clarity
- Not making sense, impaired comprehension, echolalia
-phonology and grammar better preserved
OTHER:
- Executive functions, awareness of deficits
-Paranoia, less awareness
- slef-care, swallowing, motor functions
What language problems may you see with someone with Alzheimer’s?
- Significant decline in semantics
- Spared phonological and syntactic components
-Less complex sentences
-Difficulty with tasks requiring creative, novel generation of language
- Circumlocutions, perseverations, and paraphasias
- Formulaic language
-Impaired written language
True or false: verbs are more affected than nouns for people with alzheimer’s
Both
Verbs are more effected at the word level, but not at the discourse level
Overview of vascular dementia
- Post stroke dementia or multi-infarct
- Clear relationship between a vascular event (stroke) and onset of cognitive deficits
- Symptoms are very varied due to location of stroke
Overview of Lewy bodies and Parkinsons Disease dementia
- characterised by a combination of cognitive impairments and extrapyramidal signs and symptoms
Overview of frontotemporal lobar degeneration
- changes in behaviour, personality, judgement, social function and language
-Isolated speech-language impairment often the earliest appearing symptom
- Relatively young age of onset 50-60’s
Different variants:
-Behavioral variant of FTLD
- Semantic variant of FTLD*
- Progressive nonfluent aphasia *
- Logopenic varient*
*= primary progressive aphasias
What is the role of the SLT in regards to dementia?
-Educate
-Counseling
-Assess cognitive communication disorders
-Treatment: the goal of treatment is to preserve as much as you can but prepare for the next stage of decline
What is a way to assess dementia
Screening:
- Addenbrooke’s Cognitive Examination (Mini- ACE)
When providing treatment for dementia, what are the theoretical principles?
- Capitalize of spared cognitive abilities and reduce demand on impaired ones (e.g., episodic memory not good, use procedural)
- Use stimuli to evoke positive emotions
-Focus on strengthening knowledge & processes that have potential to improve
Treatment approaches
Create opportunities for social interaction
- Reminiscence therapy
- Memory books and wallets
-Cognitive stimulation groups
Spaced Retrieval Training
- When they need to learn something new
- Teach names, room numbers, medications…
Anomia treatments
- Semantic maps
- Cueing hierarchies
Caregiver education
- slower speech rate
- Repeating and paraphrasing
- Summarising
- Yes no questions
*however this is highly individualized based on each person and type of dementia. May not work for everyone.
