DEMENTIA Flashcards
(26 cards)
What is the commonest cause of dementia?
Alzheimer’s disease
What is dementia characterised by?
Progressive cognitive, social and functional impairment
What can be given to dementia patients early on to provide modest symptomatic benefit?
Acetylcholinesterase inhibitors
Name the common causes of dementia
Alzheimer’s disease
Vascular dementia
Frontotemporal dementia
Dementia with Lewy bodies
What are some potentially reversible causes of dementia?
Depression Alcohol related brain damage Endocrine B1/B1112/B6 deficiency Benign tumours Infections Inflammatory Limbic encephalitis
What is the pattern of cognitive function in dementia patients over the years?
Overall decrease but with many ups and downs which has many factors affecting
Why is it hard to accurately diagnose dementia in clinics?
- Disease follows a heterogenous course
- In old age the disease presentation if of multiple co-
morbidities - Lots of mixed and uncertain pictures
- Often has mixed pathologies
What can cause delusions/hallucinations in dementia patients?
Alcohol withdrawl/dependence
If there are subtle deteriorations in symptoms which subtype of dementia is that indicative of?
Alzheimer’s disease
If there are large deteriorations in symptoms which subtype of dementia is that indicative of?
Vascular dementia
What investigations can you undertake for dementia?
Neuropsychology (MMSE for cognitive function)
Bloods
MRI
PET
What 2 tests can be undertaken to evaluate a dementia patient’s cognitive function?
Mini-mental state examination (MMSE) ACE III (more memory focused)
What blood investigations can be undertaken in dementia patients?
Affecting cognition:
- Full blood count
- Inflammatory markers
- Thyroid function
- Biochemistry and renal function
- Glucose
- B12/folate
- Clotting
Other causes of dementia:
- Syphilis serology
- HIV
- Caeruloplasmin
As dementia progresses what can be seen on an MRI?
Narrow sulci/widened gyri
Dilated ventricles
What two proteins are characteristic of Alzheimer’s disease?
Amyloid and Tau
Describe the management of dementia
Acetylcholinesterase inhibitora Watch and wait Treat behavioural/psychological symptoms OT/social services Specialist therapies
How does Alzheimer’s usually present?
Subtle, insidious amnestic/non amnestic
Initial episodic memory deficits secondary to dysfunction of medial temporal lobe structures
How does vascular dementia usually present?
Related to cerebrovascular diseases with classical step-wise deterioration +- multiple infarcts
How does dementia with Lewy bodies present?
Cognitive impairment before/within 1 year of parkinsonian symptoms, visual hallucinations, fluctuating cognition and REM sleep disorder
How does frontotemporal dementia present?
Behavioural variant FTD, semantic dementia, progressive non-fluent aphasia
How can you analyse the levels of amyloid and tau in patients?
Antibody histochemistry
PET scan
Lumbar puncture to analyse CSF
Which medial temporal lobe structures are affected in Alzheimer’s?
Entorhinal cortex
Hippocampus
What is the difference between AD and DLB on MRI
Alzheimer’s: atrophied hippocampus
Lewy bodies: preserved hippocampus volume
What would an MRI of a patient with frontotemporal dementia look like?
Lateral fissure volume loss
Temporal lobes volume loss
Frontal opercula volume loss
