Dementia Flashcards
What is dementia?
Dementia is a syndrome evidenced by multiple acquired cognitive deficits that are due to direct physiological effect of a general medical condition, to the persisting effect of a substance or multiple aetiologies. Memory and one additional cognitive impairment, including aphasia, apraxia, agnosia and executive function are required to be affected according to common criteria in the (DSM-IV) Deficits must: be sufficiently severe to cause impairment in occupational or social functioning Represent a decline from a previously higher level of functioning In the DSM-5, however, dementi ahs been replaced with Major Neurocognitive Impairment. This focuses on a decline of function rather than deficit, Cognitive deficits that interfere with independence and places less emphasis on memory
What is the prevelance of dementia?
In 2010, dementia was estimated to affect 35.7 million people worldwide Alzheimer’s disease is the most common form of dementia in people over the age of 65, yet Alzheimer’s disease is often accompanied by vascular disease or Lewy body symptoms. The latter two types can occur as a pure form.
What is Alzheimer’s? - definition
Alzheimer’s disease is a neurodegenerative disease of the brain, characterised by a clinical dementia with prominent memory impairment and specific microscopic pathology including senile plaques and neurofibrillary tangles. Over time, Alzheimer’s disease produces neurochemical deficits and prominent brain atrophy. It has an insidious onset and gradual decline. (3)
What is Alzheimer’s? - diagnostic critera
for alzheimer’s (major neurocognitive disorder in DSM5)to be present, it is required that the person has both: Presence of dementia Deficits in multiple cognitive areas (two or more) Gradual progression The ruling out of other causes
What is Alzheimer’s? - prevelance
Either alone or in combination with other disorders, Alzheimer’s disease causes around 60- 75% of dementia cases. It is the most common of all dementias. Alzheimer’s disease becomes more prevalent with age, although it is not a normal process of ageing.
What is Alzheimer’s? - cognitive symptoms
In the early stages of AD, lapses in attention, concentration may be present, often with awareness of these symptoms. The most common and earliest symptom, is however memory loss. Semantic memory deficits, noted as word finding difficulties. Remote autobiographical memory gradually deteriorates over time .Although working memory remains relatively intact in early AD, central executive function becomes impaired over the course of the disease. Visuospatial abilities have been reported to decline in a progressive fashion overtime. These deficits contribute to the deficits in everyday functioning, language and behaviour.
What is Alzheimer’s? - behavioural symptoms
have been reported in 90% of people with dementia including personality changes, delusions, hallucinations, mood disorders, sleep, eating and sexual disorders, restlessness, pacing and repetitive behaviours.
What is vascular dementia? - defentition
vascular dementia is a type of dementia that occurs when cognitive dysfunction is due to cerebrovascular disease (stroke). .
What is vascular dementia? - prevelance
Approximately 5-10% of patients with dementia have pure vascular dementia, another 10-15% patients of dementia have mixed dementia of cerebrovascular disease plus neurodegenerative disease.
What is vascular dementia? - diagnostic criteria
VaD is distinguished from AD by its onset. It is characterised by a stepwise decline of cognitive function as a result of a stroke.
What is vascular dementia? - cognitive symptoms
Persons with VaD may have an abrupt onset of the cognitive changes but the exact cognitive symptoms depend on the area affected. Some exhibit signs of memory loss, executive dysfunction, personality changes and depression, others show more impaired executive dysfunction and less severe memory impairment than people with AD (more common).
What is vascular dementia? - behavioral symptoms
neuropsychiatric symptoms are common in people with VaD, especially depression, agitation, anxiety and apathy. Delusions of jealousy, persecution and theft are also common, as well as disinhibited syndromes, hallucinations and depression.
What is Lewy Body Dementia? - definition
Lewy body dementia is a type of dementia distinguishable from other types of dementia by the presence of parkinsonisms, neuroleptic sensitivity, fluctuations of consciousness, and spontaneous hallucinations by Lewy body formations (spherical protein that forms in neurones). Although patients vary in specific combinations of signs and symptoms. In contrast to idiopathic Parkinson’s disease, parkinsonism in Lewy body dementia tends to occur in the absence of rest tremor, is more symmetrical, and does not respond as well to dophamagenic drugs.
What is Lewy Body Dementia? - prevelance
Accounts for around 20% of all cases of dementia, either by itself or in combination with other disorders and is most common in men over 70.
What is Lewy Body Dementia? - cognitive symptoms
Lewy body dementia is characterised by distinctive pattern of cognitive, psychiatric and motor patterns, including early attentional and visuospatial deficits, with relatively preserved memory. There is a gradual increase in fluctuating cognitions and consciousness with recurrent visual and auditory hallucinations, delusions, depression and falls, as well as mood changes misidentification and sleep disorders (REM sleep). These neuropsychiatric deficits are the most salient features of LBD, as a person with LBD can have significantly higher frequencies of theses (except delusions) than people with AD. Additionally, people with LBD are more impaired than people with AD in verbal fluency, psychomotor speed , executive functioning and visual spatial constructional ability, but they are similarly impaired on episodic memory and language.
