Old Age Psychiatry Flashcards

1
Q

ABCD of dementia

A
  • A → activity
  • B → behaviour and psychiatric symptoms of Dementia
  • C →cognitive impairment
  • D → decline
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2
Q

Neuropsychiatric disturbances in dementia

A
  • Anxiety
  • Agitation
  • Altered circadian rhythm
  • Depression
  • Psychosis
  • Activity disturbances
  • Paranoia
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3
Q

Dementia vs delirium vs depression

A
  • Delirium
    • Abrupt, precise and known onset
    • Acute, lasting days or weeks
    • Reversible
    • Disorientation ine early disease
    • Fluctuations
    • Short attention span
  • Dementia
    • Insidious onset
    • Slow, gradual, progressive onset
    • Irreversible
    • Slight variation
    • Clouded consciousness
    • Normal attention span
  • Depression
    • Abrupt onset
    • History of depression
    • Diurnal variation
    • Fluctuating cognition
    • Associated anxiety
    • Memory loss associated with depressed mood
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4
Q

Clinical assessment of dementia

A
  • History and collateral info
  • Risk assessment
  • Cognitive testing → MSSE/ MOCA
  • Physical and bloods
  • Neuroimaging
  • Follow up
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5
Q

Types of dementia

A
  • Alzheimers’ disease
  • Vascular
  • Lewy body
  • Front-temporal
  • Secondary to other brain disorder (Huntington’s chorea
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6
Q

Features of dementia with Lewy bodies (LWD)

A
  • Marked fluctuations
  • Deficits in attention, executive function, visuospatial function
  • Amnesia not prominent
  • Visuospatial hallucinations
  • Parkinsonism
  • Associations
    • REM sleep disorder
    • Abnormal DAT scan
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7
Q

Features of frontotemporal dementia

A
  • Behaviour changes
  • Speech disorder → altered output, echolalia, mutism
  • Frontal dysexeutive syndrome
  • Relatively spared memory, visuospatial function
  • Associated with Parkinsonism and MND
  • Knife bladed atrophy of frontal and temporal lobes
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8
Q

Management of Dementia

A
  • Acetylcholinesterase inhibitors
  • Memantine
  • Other psychotropics
    • Antipsychotics
    • Antidepressants
    • Anxiolytics
    • Hypnotics
    • Anticonvulsants
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9
Q

Fitness to drive

A
  • Dementia or Organic Brain Syndrome
  • Notify DVLA at diagnosis
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10
Q

Define power of attorney

A
  • Control in areas of finances, welfare and medical care
  • Solicitor assesses capacity
  • Act in best interest of patient
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11
Q

Common mental disorders in elderly

A
  • Depressive symptoms
  • Depressive illness
  • Anxiety disorders (GAD, PTSD, Agoraphobia, panic)
  • Mania
  • Schizophrenia
  • Psychosis
  • Alcohol problems
  • Suicidal ideations
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12
Q

Common mental disorders in elderly

A
  • Depressive symptoms
  • Depressive illness
  • Anxiety disorders (GAD, PTSD, Agoraphobia, panic)
  • Mania
  • Schizophrenia
  • Psychosis
  • Alcohol problems
  • Suicidal ideations
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13
Q

Risk factors of suicidality in the elderly

A
  • Loneliness
  • Widowed
  • Ill health
  • Chronic pain
  • Recent life events
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