Dementia#

Question 1

What types of dementia are there?

Answer 1

Question 2

What are the most common types of dementia in the UK?

Answer 2

Question 3

What are the differentials for dementia?

Answer 3

Delirium
Depression
Amnesia
Aphasia
Normal memory decline with age

Question 4

What is Alzheimer’s disease?

Answer 4

• Chronic and progressive neurodenegerative disease
• Caused by neurofibrillary tangles & plaques

Causes memory loss and reduction in executive function

Question 5

How is AD diagnosed?

Answer 5

Cognitive testing
Dementia blood screen
CT/MRI head shows general atrophy
Structural imaging - e.g. FDG-PET scan

Question 6

What are the RF for AD?

Answer 6

Age
FHx
Poss link to Down’s
Lifestyle
Poor school education
Link with cerebrovascular disease

Question 7

What is the treatment for AD?

Answer 7

Support
ACh Inhibitors = e.g. donepezil, galantamine, rivastigmine (memantine is 2nd line)
Manage Sx

Question 8

What is vascular dementia?

Answer 8

Chronic progressive
Some overlap with AD
Executive function more affected than memory
Slowed processing - poor attention and apathy
Loss of brain parenchyma

Question 9

How is vascular dementia diagnosed?

Answer 9

Cog testing
Demential bloods
CT/MRI Head
ECG / carotid dopplers

Question 10

What are the RF for vascular dementia?

Answer 10

Age, obesity, HT, smoking
PHx stroke
DM, hypercholesterolaemia

Question 11

What is the Rx for vascular dementia?

Answer 11

Prevent further cerebrovascular disease - anti-platelet therapy, aspirin and coagulation

If mixed with AD - cholinesterase inhibitors

Psychological intervention