Dementia (general

Question 1

define dementia

Answer 1

Acquired, chronic and progressive cognitive impairment -siufficient to impair ADLs

if before 65 -early onset dementia
10% of over 65s, 20% of over 80
alzheimers (70%)> vasc> lewy body

Question 2

Sx of general dementia

Answer 2

1st - forgetfulness (stepwise or progressive)
Disorientation (time-> place-> person-> management)
Wandering, sleep disturbances
delusions, hallucinations, calling out, inappropriate behaviours

BDSP- behaviou and psych sx of dementia
mood changes, abnormal behaviours and hallucinationss

Question 3

Ix of dementia

Answer 3

cognitive assessment -screening
AMTS (<7 suggest cog impair), CPCOG
detailed- MMSE, MocA, ACE-R
use ACER and MOCA more
MMSE -anything under 24 fine

Dementia/delirium screen–
TFT (hypo can cause decline), LFT (korakoff), UE ( infection, diabtes), HbA1C, VitB12 and folate

further-
Alzheimers - MRI (atopohy, wide ventricules, temporal lobe atrophy)
vasc - ECG (AF), MRI CT
Lewy body =DAT Scan
Frontotemporal -MRI

ddx - creutzfeld jakobs, huntingtons, delirium, psp, cbd

Question 4

Mx of general dementia

Answer 4

MMemory assessment clinic -after GP
Take collateral Hx and check blood, risk assess
Cognitive asseess
brain scan -

individual mx to be found on cards of each dementias :)