Dementia

Question 1

What is dementia

Answer 1

brain disorder causing progressive change and deterioration in cognitive ability, behavior, emotion and personality

Question 2

Why can diagnosing dementia be difficult?

Answer 2

shares similarities with normal age and other diseases/conditions (ie MDD).

Question 3

What needs to be established before diagnosing dementia

Answer 3

Evidence of decline in function

Question 4

What are 4 types of demetia

Answer 4

Alzheimer’s disease (AD)
Vascular Dementia
Lewy-Body Disease (LBD)
Frontotemporal dementia (FTD)

Question 5

What is the most common form of dementia

Answer 5

Alzheimer’s disease (AD)

Question 6

What are the key features of AD

Answer 6

1. Insidious onset
2. Early memory impairment (rapid forgetting)
3. Gradual decline leading to the loss of more
   cognitive functions

Question 7

What are three diagnoses of AD

Answer 7

1. Definite – clinical diagnosis with histology
2. Probably – clinical syndrome without histology
3. Possible – atypical clinical features but no alternative diagnosis

Question 8

What 4 cognitive areas does AD efffect

Answer 8

1. Memory
2. Language & semantics
3. Executive function
4. Spatial abilities

Question 9

What structures are effected early during AD

Answer 9

Medial temporal lobe / hippocampus

Question 10

How is memory affected by AD

Answer 10

The ability to learn and remember information is compromised.

Question 11

What kind of memory is particularly affected by AD

Answer 11

Episodic memory tests are sensitive to AD, even in the early stages (long-term memory for specific event and experiences)

Question 12

impairment of recall and recognition suggest deficits in what?

Answer 12

consolidation and rapid forgetting rather than

difficulties with retrieval.

Question 13

What language impairments are there with AS

Answer 13

object naming

Verbal Fluency and semantic categorization

Question 14

What does categorization problems mean?

Answer 14

knowledge of concepts and associations between them appears to be compromised

Question 15

What area does categorisation problems suggest is affected

Answer 15

Temporal lobe

Question 16

What is a test of object naming for AD

Answer 16

Boston Naming Task

Question 17

What is a test of verbal fluency for AD

Answer 17

FAS

Question 18

What visio-spatial deficits are common in AD

Answer 18

problems with visual orientation and visuoperception

Question 19

What are 3 tests for visio-spatial deficits in AD

Answer 19

• Clock drawing task
• Ray complex figure
• Clock Drawing task

Question 20

What particular areas of executive function are impaired in AD

Answer 20

Set shifting

self-monitoring

Question 21

What executive functions become impaired later in the disease

Answer 21

Working memory

sustained attention

Question 22

What are 4 tests of executive function in AD

Answer 22

• Tower of London
• Wisconsin card sort
• Porteus maze
• Trail Making part B

Question 23

What are some tests of memory in AD

Answer 23

• Free recall
• Recognition
• Paired-associate learning

Question 24

Crystallized intellect is preserved in AD - what does this mean

Answer 24

can remember facts

Question 25

How is LTM effected in AD

Answer 25

can still recall information about their life

Question 26

What is the main differentiator between AD and Lew's Body Disease

Answer 26

LBD has Recurrent visual hallucinations – well formed and detailed

Question 27

How is memory effected in Lewy-Body Disease (LBD)

Answer 27

Memory not early feature but hippocampus is | affected late in the disease

Question 28

How is movement effected by LBD and give examples

Answer 28

Spontaneous motor features of Parkinsonism later in the disease - Rigidity – Hypophonic speech (weak voice due to incoordination of vocal muscles) – Masked facies (persons face is not expressive) – Stooped posture – Slow shuffling gait

Question 29

How do AD and LBD differ in terms of spatial deficits

Answer 29

DLB more impaired on visual-perceptual and visuoconstructional tasks than AD eg Clock Drawing

Question 30

What is Frontotemporal dementia (FTD)

Answer 30

spectrum of disorders involving degeneration of the frontal and temporal lobes.

Question 31

What are the 3 subclasses of FTD

Answer 31

1. FTD affecting behaviour (behavioural variant) 2. Semantic dementia (SD) affecting meaningful speech 3. Progressive nonfluent aphasia (PNFA) affecting speech production.

Question 32

What is the most common variant of FTD

Answer 32

FTD affecting behaviour (behavioural variant)

Question 33

How is the behavioural variant of FTD described

Answer 33

includes changes in personality, behaviour, insight and social awareness may display a range of inappropriate behaviours (ie aggression or inappropriate sexual behaviour).

Question 34

What brain area is most effected in the behavioural variant of FTD

Answer 34

orbitofrontal PFC

Question 35

The semantic variant of FTD has what features

Answer 35

can speak fluently but experience word finding problems, loss of semantic knowledge

Question 36

What brain area is most effected in the semantic variant of FTD

Answer 36

Temporal lobe

Question 37

What are 2 crucial differentials to exclude when diagnosing dementia

Answer 37

Depression | Delerium

Question 38

What is the goal of the neuropsych in relation to dementia

Answer 38

``` • Assessment of cognitive strengths and weaknesses • Establish a baseline for later assessment of decline • Diagnosis • Treatment options • Assessment of treatment efficacy (ie has the medication improved symptoms?) ```

Question 39

What important factor must neuropsych take into account when monitoring dementia

Answer 39

what changes are normally expected with age.

Question 40

What 4 cognitive domains should be tested for dementia

Answer 40

executive/attention memory language visuospatial functions

Question 41

What effect does Vascular disease have on AD

Answer 41

can contribute to AD and exacerbate disease progression and deficits