CSFC Dementia Flashcards
Which gender is more affected by suicide?
How many of those who have committed suicide have been in recent contact with a health care professional
Male suicides account for 3/4 of suicides
1/4 of those who commit suicide have been in contact with a healthcare professional in the previous week, and most within the past month
Name seven risk factors for suicide
- Male
- Older
- Widowed/separated/single
- Living alone/social isolation
- Low income
- Certain occupations (doctor, farmer)
- FH
- Previous attempt
Name six ‘diagnoses’ that greatly increase one’s risk of suicide (by multiple fold)
- Previous attempt
- Anorexics
- Hemodialysis
- Recreational opiate use/dependence
- Alcohol dependence
- Acute mental disorder (schizophrenia, severe depression)
Name five things you might assess to determine whether a patient is planning their suicide
Are they..
- Researching methods
- Final acts like writing a will
- Precautions taken against being found
- Patient is resisting/trying to evade medical intervention
- Downplaying the seriousness of suicidality
Name four ‘protective factors’ that cam prevent a patient from committing suicide
- Positive family support
- Children at home (or a sense of responsibility for others)
- Strong religious faith
- Problem solving skills
What characterizes dementia?
- Decline in memory
- Failure of higher cognitive function (analysis, judgement, etc)
- Consciousness isn’t impaired
- Can result in challenging behaviour
Name the six main subtypes of dementia within young or late-onset
Divided into Young-onset and late-onset
- Alzheimer’s
- Vascular dementia
- Dementia with levy bodies
- Frontotemporal
- Parkinson’s disease
- Creutzfelldt-Jakob disease
Which subtype of dementia is most prevalent? What can trigger it? What rarely causes it?
Alzheimer’s dementia
Caused by complex gene and environmental interactions
Early onset is rarely caused by single gene mutation
Describe the histopathological findings in Alzheimer’s
Amyloid plaques (beta-amyloid proteins) and tau protein neurofibrillary tangles - which accumulates as insoluble tangles that damages microtubules and cell signalling
What gene might specifically risk your increase of Alzheimer’s? What is this gene involved in?
Carriers of apolipoprotein E gene (APOE protein) involved in lipid metabolism (cholesterol transport)
Name the second most common subtype of dementia. What causes it and which other subtype is it commonly associated with?
Vascular dementia: the vascular supply to the brain is damaged leading to cell death and declined cognitive function
Commonly associated with Alzheimer’s dementia
Name four risk factors for developing vascular dementia
Primary CVS RFs
- Hypertension
- Diabetes
- Smokers
- Hyperlipidemia
* age also increases the development of these risk factors
Which occupations are at a higher risk of developing dementia?
- Jobs with low pay and job security can induce familial and financial stress
- Publicans (owns a pub)
- Access to or knowledge of a method of suicide; doctors, dentists, agricultural workers, easy access drugs/firearms
What are some early signs of vascular dementia?
What do the signs depend on?
Signs depend on the location and size of the vascular injury; multiple lacunar (Small penetrating blood vessels), multi infarct (med sized blood vessels) and strategic single infarct (in crucial area, suddenly causes dementia symptoms)
- Impaired judgement, planning and decision making
- Motor function deficiencies; slow gait and poor balance
- Language impairment
- Can also be asymptomatic due to multiple little lacunar infarctions which only cause symptoms once they accumulate
What is the most common form of ischemic stroke?
Multiple lacunar infarctions
What is Binswanger dementia/subcortical vascular dementia? What is it associated with and what can be damaged?
Form of small vessel disease, associated with poorly controlled hypertension and atherosclerosis, can have diffuse changes which fundamentally affects the white matter
What are lewy bodies?
Abnormal clumpings of protein in the cerebral cortex
What diseases are Lewy bodies commonly associated with?
Parkinson’s and dementia
Name __ possible early signs of dementia with Lewy bodies
Starts with behavioural
- Visual hallucinations
- Visuospatial impairment (lost sense of “whereness”)
- Marked cognitive fluctuations
- Dream enactment behaviour (sleep walking, talking, etc)
How do the onset of symptoms differ between Parkinson’s and dementia with Lewy bodies?
In dementia with lewy bodies the cognitive decline PRECEDES any motor impairments (opposite in Parkinson’s)
What is the frontotemporal lobe involved in?
Frontal lobes involved in behaviour, emotional control, problem solving, words, names, facial and object recognition
How do patients suffering with FTD often present? What is the general epidemiology and aetiology?
Present with changes in personality/behaviour and learning difficulties BEFORE memory difficulties
Commonly in younger people, stronger genetic component
Name three early symptoms of Parkinson’s disease, how soon does cognitive decline occur in relation to Parkinsonism movement disorder in Parkinson’s dementia?
Rigidity, tenor and gait changes
Parkinsonism movement disorder occurs at least 1 year prior to cognitive decline.
What causes creutzfeldt Jakob disease?
Name the three ‘types’ and identify which is the most common
Abnormal prion protein accumulation in the brain
- Sporadic - most common
- Familial
- Acquired
