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Flashcards in Dementia Deck (37)
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1

Definition of dementia

- a syndrome of progressive and significant impairment of ADL

- memory loss + 1 other cognitive impairment (language, visuospatial ability, calculation, judgement, problem solving)

2

Major RFs of dementia

age, fhx, low education level, females, vascular disease (smoking, DM, BMI>30, HTN)

3

Mild cognitive impairment

measurable cognitive impairment that does NOT disrupt ADL

4

Neurobiology of dementia

- Disruption of cerebral neuronal circuits
- Memory and cognitive functions (ACh receptors)
- Behavior and mood (noradrenergic, serotonin, dopamine)

5

Alzheimer's Disease on imaging

diffuse atrophy of cerebral cortex, secondary enlargement of ventricular system, amyloid plaques

6

AD symptoms

MEMORY

frontal lobe: anosognosia, executive fxtn impairment (navigation)
parietal/temporal: aphasia, visuospatial skills
Hippocampus: impaired ability to form new memories

7

Frontal lobe impairment

executive function
anosognosia

8

Parietal/temporal impairment

Language
Visual-spatial skills

9

Hippocampus impairment

impaired ability to form new memories

10

2 types of vascular dementia

multi-infarct
diffuse white matter

11

multi-infarct vascular dementia signs on PE

focal neuro signs: hemiparesis, unilateral Babinski, visual field defect

12

multi-infarct vascular dementia on imaging

multiple lesions with focal damage

13

diffuse white matter vascular dementia

Chronic ischemia small vessels
Insidious and slowly progressive

14

diffuse white matter vascular dementia signs

Pyramidal signs
Cerebellar signs

15

signs of frontotemporal dementia

behavior/mood changes - poor personal and social skills, repetitive behaviors, disinhibition

MEMORY spared

16

Pick's disease

rare subset of frontotemporal dementia with Pick's bodies on microscope

17

Parkinsonian dementia

dementia follows Parkinson's disease

18

What are Lewy Bodies?

very tiny abnormal protein structures found in brain neurons

19

CJD

prion disease of infectious proteins
rapidly progressive dementia
issues with muscle coordination
myoclonus
eventually can't move or speak and enter coma
subtypes: Kuru, Mad Cow

20

Huntington's Disease

- autosomal dominant degenerative brain disorder
- chorea, behavior disturbances, executive impairment

21

Wernicke's Encephalopathy

MALNOURISHED individual (freq alcoholic)
Vit B1/thiamine deficiency

22

Where does Vit B12 absorption occur?

distal ileum

23

Korsakoff's Syndrome

IRREVERSIBLE dementia from CHRONIC B1 deficiency

24

Vit B12 deficiency

pernicious anemia

25

Lewi Body dementia

Abnormal aggregates of proteins that develop in nerve cells of substantia nigra and cortex in PARKINSON’S DISEASE

Dementia precedes Parkinsons

26

Most common cause of dementia

Alzheimer's (55%)

27

Drugs that increase incidence of dementia

ANTICHOLINERGICS
Tricyclic antidepressants (doxepin)
antihistamines (chlorpheniramine)
antimuscarinics for bladder control (oxybutynin)

28

Meds to treat cognitive symptoms

Cholinesterase inhibitors: Donepezil (Aricept)

Neuropeptide Modifying Agents: Memantine (Namenda) - blocks glutamine

29

Meds to treat behavioral symptoms

SSRI: Prozac (fluoxetine), Celexa (citalopram)

Antipsychotics: Risperdone (risperdal)

30

Diffuse atrophy of cerebral cortex

Alzheimer's