Dementia

Question 1

What is Dementia?

Answer 1

Progressive, chronic decline in memory and more than one other cognitive domain (i.e. language and personality) severe enough to interfere with daily living
Symptoms progress in severity until death.

Question 2

Life Expectancy

Answer 2

Depends on:
cause, age, and health at onset

Varies from person to person
Anywhere from 1-26 years with average of 10 years.

Question 3

Diagnostic criteria

Answer 3

Significant decline from prior levels of performance in one or more cognitive domains:
Language
Memory
Cognitive skills (Attention, executive function, working memory)

Must interfere with independence in functional activities
Cognitive deficit must not occur exclusively in context of delirium or explained by other mental disorders such as depression or schizophrenia
But also not typical aging

Question 4

Three defining traits of dementia:

Answer 4

Memory
Language
Cognitive skills

Question 5

Mild dementia vs. Mild cognitive impairment

Answer 5

Mild dementia:
Low performance in MORE THAN ONE cognitive domain
SIGNIFICANT interference with daily activities
Unexplained by other major disorders

Mild cognitive impairment: Low performance in ONE OR MORE cognitive domain
INSIGNIFICANT interference with daily activities
Unexplained by other major disorders

Question 6

Incidence and Prevalence

Answer 6

35% of those 85+ have dementia
70% of dementia is Alzheimer’s disease
30% of dementia caused by other such as:
Frontotemporal dementia
Lewy body dementia
Vascular dementia
Huntingtons
Parkinsons

Question 7

Mild dementia Characteristics

Answer 7

Forgetfulness of basic information and routines
Slow vocabulary loss, anomia
Intact comprehension and social skills
Diagnosed by screeners and interviews and questionnaires
More than one domain and functional difficulties

Question 8

Moderate dementia Characteristics

Answer 8

Time and place disorientation
Poor attention and memory
Significant anomia
Difficulty with repetition
Significant personality and behavioral change
Change in sleeping patterns

Question 9

Severe dementia Characteristics

Answer 9

Extreme disorientation
Significant cognitive impairment
limited meaningful communication
Frequent jargon and echolalia
Severe comprehension impairment

Question 10

Dementia Assessment

Answer 10

Screening measures:
MOCA (Montreal cognitive assessment)
MMSE (Mini-mental state exam)
ACE-III
ABCD (Arizona battery)

Question 11

Dementia Treatment

Answer 11

Maximize cognitive communication functioning
Compensate for deficits
Environmental changes
Family education and support groups

Maintenance of functions and engaging in meaningful activities, increasing mood, quality of life and changes in caregiver stress, burden, coping and quality of life

Question 12

Spaced retrieval training

Answer 12

Strengthen conceptual associations via repeated activation of stimulus-response pairing
Intervals between recall lengthened to facilitate production of a high number of correct responses over time
Retrieving information in longer spaced intervals to improve LTM
Goal: Improved recall of factual information and tasks

Question 13

Errorless learning

Answer 13

Procedures structured to reduce opportunity for errors during learning trials
Technique in practicing with patient: When you give them time to answer, you give them an opportunity to make an error and learn the error

Instead, prompt them the correct answer so that they have no opportunity to get it wrong

Goal: Improved factual information/memory