dementia Flashcards
(15 cards)
What is the clinical definition of dementia according to DSM-5 criteria?
Dementia is characterized by significant cognitive decline from a prior level of performance in one or more cognitive domains that interferes with independence in everyday activities.
This includes deficits in learning & memory, language, executive function, perceptual-motor function, complex attention, and social cognition.
What are the non-modifiable risk factors associated with Alzheimer’s Disease?
Non-modifiable risk factors include:
* Age > 65 years
* Females
* Black and Hispanics
* Apolipoprotein E4 (APOE4) allele
The APOE4 allele disrupts lipid metabolism and increases amyloid plaque deposition.
What are the modifiable risk factors associated with Alzheimer’s Disease?
Modifiable risk factors include:
* Use of anticholinergics
* Hypertension (HTN)
* Diabetes Mellitus (DM)
* Smoking
* Binge drinking
* Obesity
* Limited physical activity
* Hearing loss
* Depression
Anticholinergics include first-generation antihistamines and some antidepressants.
What neurocognitive domains are affected by dementia?
Affected neurocognitive domains include:
* Learning & memory
* Language
* Executive function
* Perceptual-motor function
* Complex attention
* Social cognition
Each domain involves specific cognitive processes such as recall, word finding, and decision making.
What are the early stage manifestations of dementia?
Early stage manifestations include:
* Short-term memory loss
* Word-finding difficulties
* Memory loss in working memory
* Expressive difficulties
* Apathy
* Depressive symptoms
These symptoms may lead to significant challenges in daily functioning.
What are the late stage manifestations of dementia?
Late stage manifestations include:
* Marked expressive difficulties
* Aggression
* Hallucinations
* Wandering
* Gait impairment
* Seizures
Patients may experience severe cognitive and behavioral disturbances.
What is the pathophysiology of Alzheimer’s Disease?
Pathophysiology includes:
* Brain shrinkage and neuron loss
* Loss of cholinergic neurons
* Presence of amyloid plaques and neurofibrillary tangles
Amyloid plaques are aggregates of Aβ fragments, and tau tangles involve hyperphosphorylated Tau protein.
What is the preferred pharmacological treatment for mild-moderate Alzheimer’s Disease?
Preferred treatment is:
* Anticholinesterase inhibitor (AI) monotherapy
If contraindicated or not tolerated, memantine may be considered.
What are the side effects of acetylcholinesterase inhibitors?
Side effects include:
* Nausea and vomiting
* Diarrhea
* Loss of appetite
* Vivid dreams and insomnia
Galantamine has the most significant nausea side effect.
What is the mechanism of action of NMDA antagonists like memantine?
Memantine acts as a weak NMDA antagonist that selectively inhibits excessive NMDA receptor activation, preserving physiological activation and reducing glutamate levels.
This mechanism helps protect neurons from excitotoxicity.
What are behavioral and psychological symptoms of dementia (BPSD)?
BPSD includes:
* Depression
* Anxiety
* Agitation
* Aggression
* Hallucinations
These symptoms can be stressful for both patients and caregivers.
What non-pharmacological management strategies are recommended for BPSD?
Non-pharmacological strategies include:
* Understanding the patient’s background
* Addressing environmental triggers
* Providing cognitive stimuli
* Ensuring safety and proper hygiene
These strategies help manage symptoms and improve quality of life.
True or False: Antipsychotics are preferred for managing BPSD in patients with dementia.
False
Antipsychotics should only be used if symptoms cause severe distress or pose immediate risks, due to their associated risks in older adults.
What caregiver support resources are available for those caring for dementia patients?
Available resources include:
* Dementia Day Centres
* Respite Care
* Online resources (e.g., AIC, Dementia Hub)
These resources help alleviate caregiver burdens and provide necessary support.
