Dementia

Question 1

What is dementia?

Answer 1

Progressive and degenerative brain disorder that affects memory, thinking, behavior and ability to carry out daily activities

Question 2

List the symptoms of dementia?

Answer 2

Reduced ability to carry out daily activity
Memory loss
Personality changes
Difficulty reasoning and communication

Question 3

List the four types of dementia?

Answer 3

Alzheimer’s disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia

Question 4

Tell us about Alzheimer’s disease

Answer 4

• Most common type of dementia
• caused by buildup of amyloid plaques and tau tangles in brain

Question 5

Alzheimer’s disease leads to…?

Answer 5

Memory loss and cognitive decline

Question 6

What is vascular dementia

Answer 6

Reduced blood flow to the brain which can be due to stroke or CVD

Question 7

List stmtuokes of Vascular dementia?

Answer 7

Difficulty planning, organizing and decision making

Question 8

What is Lewy bodies dementia?

Answer 8

Buildup of abnormal protein deposits (alpha synuclein) in the brain

Question 9

Lewy body dementia leads to?

Answer 9

Problems with movement, sleep and cognitive function. Causes visual hallucinations

Question 10

What is frontotemporal dementia?

Answer 10

Progressive damage to frontal or temporal lobes of brain. Linked to genetic mutation

Question 11

FT dementia affects your..?

Answer 11

Personality
Behavior
And language

Question 12

List the non modifiable risk factors?

Answer 12

Age
Genetics
Parkinson’s disease
Cerebrovascular disease

Question 13

List the modifiable risk factors?

Answer 13

Smoking
Diabetes mellitus
Lack of physical activity
Obesity

Question 14

List other symptoms of dementia

Answer 14

Memory problem - impaired executive function, disorientation, dysphasia

Behavior symptoms- depression, agitation, delusions and sleep disruption

Difficulty with daily living- eating, hygiene, dressing

Question 15

What are the other conditions similar to dementia?

Answer 15

Depression
Hypothyroidism (mood and cognitive disturbance)
Infections (uti)
Vitamin deficiency
Delirium

Question 16

What is the aim of treatment?

Answer 16

Does cure but
- helps relieve symptoms
- stop progression of dementia

Question 17

What is the first line group class treatment?

Answer 17

Acetylcholinesterase inhibitors

Question 18

List the drugs used to treat mild to moderate Alzheimer’s disease?

Answer 18

Acetylcholinesterase -

Donepazil, rivastigmine and galantamine

(DARG)

Question 19

List drug used to treat moderate to severe Alzheimer’s disease

Answer 19

Glutamate receptor antagonist-
Memantine ( alone or add with first line)

Question 20

Which dementia can you not use Acetylcholinesterase and memantine?

Answer 20

Frontotemporal dementia

Question 21

What are the MHRA warnings in dementia m?

Answer 21

• Do not use antipsychotics in elderly patient with dementia unless you have to. (Risk of stroke- death)
• balance risks and assess if they have previous of stroke, TIA, hypertension, diabetes, smoking and AF (cerebrovascular

Question 22

When can you give antipsychotic trt in dementia?

Answer 22

• Last option
• high risk of harming themselves or others
• hallucinations, delusions, severely distress

Question 23

What are the rules of taking antipsychotics drugs?

Answer 23

• Give lowest dose
• review at least every 6 weeks

Question 24

Antipsychotic can worse motor features of the condition in which dementia?

Answer 24

Lewy bodies
Parkinson’s disease

Question 25

What is the dose of donepezil?

Answer 25

5mg orally OD at bedtime

Question 26

List the side effects of acetylcholinesterase?

Answer 26

Parasympathetic side effects (works in that pathway) Diarrhea, urinary incontinence, muscle weakness, bradycardia Bronchospasm, emesis, lacrimation(flow of tears), salivation (Dumb bels)

Question 27

which acetylcholinesterase is only licensed for dementia with Parkinson’s disease

Answer 27

Rivastigmine

Question 28

which acetylcholinesterase is only licensed for dementia with Parkinson’s disease

Answer 28

Rivastigmine