Dementia Flashcards
(36 cards)
What tasks do people struggle with as they get older?
Mobility:
- Stairs
- Getting to the shops
- Some people will only use the lower level of their home
Dexterity:
- making a cup of tea - holding the kettle can become dangerous
- brushing teeth can become difficult
Communication:
- sight and hearing deterioration
- can lead to social isolation
What are some examples of medical diseases that increase in the older population?
- Musculoskeletal – Arthritis, Osteoporosis, gout, fractures
- Diabetes, Hormonal dysfunction
- Cognitive Impairment and Visual conditions
- Hearing conditions
- Cardiovascular conditions
- GI condition
- Malignancy
What are some things that older people value?
Company and relationships
Time
A desire to contribute to society
Someone listening
What is dementia?
- A chronic syndrome that is of progressive nature (keeps getting worse)
- an acquired progressive loss of cognitive functions (i.e. the ability to process thought), intellectual and social abilities
What cognitive functions does dementia affect?
Memory Thinking Orientation Comprehension Calculation Learning capacity Language Judgement
What is dementia characterised by?
- Amnesia (especially for recent events) [memory loss]
- Inability to concentrate,
- Disorientation in time, place or person,
- Intellectual impairment
What are some examples of things that a patient with dementia will have problems with?
- Day-to-daymemory- difficulty recalling events that happened recently
Concentrating, planning or organising - difficulties making decisions, solving problems or carrying out a sequence of tasks (eg cooking a meal)
Language - difficulties following a conversation or finding the right word for something
Visuospatial skills - problems judging distances (eg on stairs) and seeing objects in three dimensions
- Orientation - losing track of the day or date, or becoming confused about where they are.
Is the consciousness of a patient with dementia affected?
no (they always have some awareness)
What are the 4 more common forms of dementia?
- Alzheimer’s
- Vascular dementia
- Dementia with Lewy Bodies
- Frontotemporal dementia
What are some rarer forms of dementia?
- HIV – related genitive impairment
- Parkinson’s disease
- Corticobasal degeneration
- Multiple Sclerosis
- Niemann-Pick disease
- Creutzfeldt-Jakob disease
Give a brief aetiology of Alzheimer’s.
- Reduction size of the Cortex, severe in hippocampus
- Plaquesare deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells. (results in loss of brain function)
What are the distinctive features of Alzheimer’s?
- short-term memory loss
- aphasia
- communication difficulties
- muddles over everyday activities
- mood swings
- withdrawn
- loss of confidence
What are some risk factors/associated factors related to Alzheimer’s?
-increased age
-gender (woman>men)
-Head injury
-lifestyle: Increased risk = Smoking, hypertension, low folate and high blood cholesterol
Reducing risk = physical, mental and social activities
-genetic factor (abnormalities on chromosome 1, 14 or 21
What is vascular dementia caused by?
caused by reduced blood flow to the brain, which damages and eventually kills the brain cells
What can cause the reduced blood flow in the brain that leads to vascular dementia?
- narrowing and blockage of small blood vessels deep inside the brain
- a single large stroke
- lots of mini strokes that cause tiny, but widespread, damage to the brain
What are distinctive features of vascular dementia?
Memory problem of sudden onset
- visuospatial difficulties
- anxiety
- delusions
- seizures
Describe the aetiology of Dementia with Lewy Bodies.
-there are deposits of anabnormal protein called Lewy bodies inside brain cells.
What are some distinct features of dementia with Lewy bodies?
- STML
- Cognitive ability fluctuates
- visuospatial difficulties
- attentional difficulties
- overlapping motor disorders
- speech and swallowing problems
- sleep disorders
- delusions
What do the frontal lobes of the brain deal with?
- behaviour
- problem solving
- planning
- control of emotions
What are some distinctive features of frontotemporal dementia?
- STML not always present
- uncontrollable repetition of words
- mutism
- repetition of words of other people
- personality change
- decline in personal and social conduct
Compare the cost of dementia in society and the research investment.
Costs the UK economy a huge sum of money but has very little funding
What are the general risk factors for dementia?
- Age
- Gender
- Genetic background
- Medical history
- Lifestyle
Why should we be aiming to diagnose early?
insert flow chart
Is more about increasing the quality of the patients life than the longevity. If diagnosed early have time to have difficult conversations and plan what they want for themselves when they no longer have the capacity.
What are the early stage symptoms of dementia?
Loss of short-term memory
Confusion, poor judgement, unwilling to make decisions
Anxiety, agitation or distress over perceived changes
Inability to manage everyday tasks.
Communication problems – a decline in ability or interest in talking, reading
and writing.
