Common dementias Flashcards
what are the risk factors for vascular dementia
CV risk factors - diabetes, atrial fibrillation, high cholesterol, previous hear attacks and strokes, family history
what is seen on brain imaging with vascular dementia
vascular changes
what is the treatment for vascular dementia
focus on risk factors
secondary prevention (antiplatelets, antihypertensives, cholesterol-lowering drugs)
prevalence of vascular dementia
10-40% of all dementia cases
10-15% of Alzheimers cases are mixed
overview of frontotemporal dementia
age of onset is 45-60yrs
behavioural and personality changes
progressive memory problems
language impairment
can be associated with motor deficits
what are the subtypes of frontotemporal dementia
BvFTD and FTD-MND - disinhibition, compulsive or perseverative behaviour, apathy, emotional bluntness, extrapyramidal signs are common, MND disease develops in up to 15%
progressive non-fluent aphasia - reduced speech production
semantic dementia - difficulty in understanding words and recognising objects
what are potentially treatable cognitive impairment/dementias
drug toxicity
autoimmune/paraneoplastic encephalopathies
mass lesion (tumour, chronic subdural)
infectious process (meningitis, syphilis)
inflammatory disorders (SLE (lupus), sarcoid)
endocrine disorder (thyroid, parathyroid)
nutritional disease (B12, thiamine, folate)
what are the types of rapidly progressing dementias
autoimmune limbic encephalitis
prion diseases
paraneoplastic syndromes
post-viral encephalitis
rare cases of Alzheimers, frontotemporal dementia, Lewy-body dementia
how is dementia clinically evaluated
history, collateral history from caregiver or spouse
general and neuro exam
cognitive screening tests
exclusions of reversible causes
neuroimaging
what are the screening tests
Addenbrooke’s cognitive assessment (ACE-II)
mini-mental state examination (MMSE)
clock drawing test
mini-cog
time and change
7 minute screen
