Dementia

Question 1

Define what is meant by Dementia

Answer 1

A chronic and progressive deterioration of cognitive function due to organic brain disease which is irreversible and conciousness is not impaired

Question 2

What are the different types of dementia?

Answer 2

• Alzheimer’s disease (50%)
• Vascular Dementia (25%)
• Lewy Body Dementia (15%)
• Frontotemporal Dementia

Question 3

What is Alzheimer’s disease dementia?

Answer 3

Degeneration of the cerebral cortex, with cortical atrophy and reduction in acetylcholine production

Question 4

What is Vascular dementia?

Answer 4

Brain damage due to several incidents of cerebrovascular disease (e.g. strokes/TIAs)

Question 5

What is Lewy Body dementia?

Answer 5

Deposition of abnormal proteins (Lewy bodies) within the brain stem and neocortex

Question 6

What is frontotemporal dementia?

Answer 6

Specific degeneration of the frontal and temporal lobes

Question 7

What is the epidemiology of dementia?

Answer 7

Prevalence increases with age

Prevalence of 20% in patients aged > 80 yrs

Question 8

What are the signs and symptoms of dementia?

Answer 8

• Alzheimer’s disease - insidious onset
• Vascular dementia - step-wise decline
• Lewy Body dementia - fluctuating levels of consciousness, hallucinations, falls and Parkinsonian symptoms
• Frontotemporal dementia - behavioural changes and intellectual changes

All forms of dementia are associated with a progressive loss of memory and cognitive function

Question 9

Investigations for dementia

Answer 9

• Diagnosis is based on the HISTORY
• Ensure no treatable cause is missed (e.g. hypothyroidism, vitamin B12/folate deficiency, space-occupying lesion, normal pressure hydrocephalus)