Dementia Flashcards
What is dementia
Progressive decline of cognitive function usually affecting the cerebral cortex as a whole
consciousness not clouded
common causes of dementia
fronto-temporal dementia
vascular dementia
dementia with lewy bodies
alzheimer’s disease
primary degenerative cerebral disease
classic pathological features of alzheimer’s
neuronal reduction
neurofibrillary tangles
argentophile plaques - amyloid protein
clinical features alzheimers
insidious onset - progression over years
ST memory loss early symptom
slow disintegration of the personality & intellect, eventually affecting all aspects of cortical function
language decline, visuospacial skills, apraxia, agnosia
apraxia?
impaired ability to carry out skilled motor tasks
agnosia?
failure to recognise objects eg clothing, people, places
investigations alzheimer’s
Mini mental state exam to screen cog function
exclusion of rare treatable causes of dementia should be considered eg vit B12 def, thiamin def, hypothyroidism, subdural haematoma
bloods
brain CT
social and fhx
what bloods for alzehimers
FBC
liver biochem
thyroid func
B12 and folate
management alzheimers
no specific rx
anxiety and depression rx
acetylcholinesterase inhibitors inc cholinergic transmission by inhibiting cholinesterase at the synaptic cleft
examples of acetylcholinesterase inhibitors
donepezil
vivastigmine
galantamine
vascular multi infarct dementia
second most common cause of dementia
stepwise deterioration with declines followed by short periods of stability
hx of TIAs
dementia with lewy bodies
fluctuating cognition with pronounced variation in attention and alertness memory loss not in early stages depression and sleep disorders delusions and visual hallucinations parkinsonism common (slowing, rigid)
what present on autopsy dementia with lewy bodies
cortical lewy bodies
