Dementia

Question 1

What are tasks that older people can struggle with

Answer 1

mobility
dexterity
communication

Question 2

What are the medical diseases that are common in elderly

Answer 2

musculoskeletal
diabetes, hormonal dysfunction
cognitive impairment
visual conditions
hearing conditions
CV conditions
GI conditions
malignancy

Question 3

What do older people value

Answer 3

company and relationships
time
a desire to contribute to society
someone listening

Question 4

What is dementia

Answer 4

a syndrome
usually of a chronic or progressive nature
results in deterioration in cognitive function beyond what might be expected from normal age

Question 5

What does dementia effect

Answer 5

memory
thinking
orietnation
comprehension
calculation
learning capacity
language
judgement

Question 6

What is dementia defined as

Answer 6

an acquired progressive loss of cognitive functions, intellectual and social abilities
severe enough to interfere with daily functioning

Question 7

What is dementia characterized by

Answer 7

amnesia
inability to concentrate
disorientation in time, place or person
intellectual impairment

Question 8

What are issues that those with dementia may have

Answer 8

day to day memory 
concentrating, planning or organizing 
language
visuospatial skills
orientation

Question 9

How is day to day memory effected

Answer 9

there is difficulty recalling events that happened recently

Question 10

How is concentrating, planning or organizing effected

Answer 10

difficulties making decisions, solving problems or carrying out a sequence of tasks

Question 11

What is language effected

Answer 11

difficulties following a conversation or finding the right word for something

Question 12

How is visuospatial skills effected

Answer 12

problems judging distances e.g on stairs and seeing objects in 3D

Question 13

How is orientation effected

Answer 13

losing track of the day or date, or becoming confused about where they are

Question 14

What is the impairment in cognitive function commonly accompanied or preceded by

Answer 14

deterioration in

emotional control, social behavior, motivation

Question 15

What is alzheimer’s

Answer 15

most common type of dementia

Question 16

What is alzheimer caused by

Answer 16

reduction size of the cortex, severe in the hippocampus

caused by plaque and tangle

Question 17

Describe the plaques seen in Alzeihmers

Answer 17

protein called beta amyloid build up in the spaces between nerve cells

Question 18

Describe the tangles seen in Alzeihmers

Answer 18

twisted fibers of tau protein build up inside cells

Question 19

What are distinctive features of alzeihmers

Answer 19

STML
aphasia
communication difficulties
muddled over everyday activities
mood swings
withdrawn
loss of confidence

Question 20

What are associated factors with Alzeihmers

Answer 20

age
gender (women>men)
head injury
lifestyle 
genetic

Question 21

What lifestyle factors increase risk of Alzeihmers

Answer 21

smoking, hypertension, low folate, and high blood cholesterol

Question 22

What lifestyle factors reduce risk of alzeihmers

Answer 22

physical, mental and social activities

Question 23

What is the genetic factor that contributes to risk of alhzeihmers

Answer 23

abnormalities on chromosome 1, 14, 21

Question 24

What is vascular dementia

Answer 24

caused by reduced flow to the brain which damages and eventually kills the brain cells

Question 25

What can vascular dementia develop as a result of

Answer 25

small vessel disease a single large stroke lots of mini strokes linked to underlying health conditions such as high blood pressure and diabetes as well as other lifestyle factors

Question 26

What are distinctive features of vascular dementia

Answer 26

memory problem of sudden onset, visuospatial difficulties, anxiety, delusions, seizures

Question 27

What is dementia with lewy bodies due to

Answer 27

deposits of an abnormal protein called Lewy bodies inside the brian cells these deposits which are also found in people with Parkinson's disease, build up in areas of the brain responsible for things such as memory and muscle movement

Question 28

What are distinctive features of Lewy body dementia

Answer 28

``` STML cognitive abilityfluctuates visuospatial difficulties attentional difficulties overlapping motor disorders speech and swallowing problems sleep disorders delusions ```

Question 29

What is frontotemporal dementia

Answer 29

effects frontal lobes of the brain ubiqitin associated clumps of protein TDP-43

Question 30

What is the age of onset of frontotemporal

Answer 30

younger

Question 31

What are distinctive features of frontotemporal dementia

Answer 31

``` STML not always present uncontrollable repetition of wards mutism repetition of words of other people personality change decline in personal and social conduct ```

Question 32

What are the rarer forms

Answer 32

``` HIV - related genitive impairment Parkinson's disease corticobasal degeneration MS niemann-pick disease creutzfeldt-jakob disease ```

Question 33

What are dementia risk factors

Answer 33

``` age gender genetic background medical histroy lifestyle ```

Question 34

What are early stage symptoms often misattributed to

Answer 34

stress, bereavement or normal aging

Question 35

What are the early onset symptom

Answer 35

loss of short term memory confusion, poor judgement, unwilling to make decisions anxiety, agitation or distress over perceived changes inability to manage every tasks communication problems - a decline in ability or interest in talking, reading and writing

Question 36

What are the middle stage symptoms

Answer 36

more support required, including reminders to eat, wash, dress and use the toilet increasing forgetful and may not recognize people mood changes (aggression) risk of wandering may behave inappropriately may experience hallucinations or throw back memories

Question 37

What are late stage symptoms

Answer 37

inability to recognize familiar objects, surroundings or people - but there may be some flashes of recognition increasing physical frailty, may start to shuffle or walk unsteadily, eventually becoming bed/wheelchair confined difficulty eating and sometimes swallowing, weight loss incontinence and gradual loss of speech symptoms are progressive and reversible

Question 38

What is the diagnosis and measurement of dementia tests

Answer 38

dementia screen to eliminate treatable causes glucose, serum B12, folate and calcium, C-reactive protein and urinalysis if indicates - syphillis serology, autoantibody screen, serum cholesterol and CT neurological examination and detailed cognitive testing

Question 39

What does the cognitive testing consist of

Answer 39

mini-mental state examination blessed dementia scale the montreal cognitive assessment (MoCA) single neuropsychological tests clock draws, delayed word recall, category fluency combined single tests

Question 40

What are the pros of the mini mental state exam (folstein)

Answer 40

well known easy to administer samples range of cognitive function test - retest and inter rater availability

Question 41

What are the cons of the mini mental state exam (Folstein)

Answer 41

only 3 words to be remembered on recall not sensitive to mild impairment old non standardized time between registration and recall not sensitive in testing frontal lobe

Question 42

What is the treatment of dementia

Answer 42

no pharmocological, surgical or behavioral cure consoling may delay residential care by up to a year aspirin and reducing cardiac risks may halt deterioration of vascular types NSAIDs may slow progression vitamin E and ginkgo biloba may slow progression

Question 43

What is the drug treatments

Answer 43

anticholinesterases

Question 44

What is a dementia friendly care home

Answer 44

walls, floor coverings, skirting boards and doors are all in different colors providing good visual contrast to aid way finding fix labels and images to drawers to help let people find what they need without assistance bedroom WC should be visible from bed and when lying down position personal pictures radiators should be low temp futrnite and traditional domestic

Question 45

What are dementia friendly healthcare environments

Answer 45

reception desk visible from the entrance door ceilings, floors and floor coverings should be acoustically absorbent to support audible communication colors and tone of walls should be distinctive from the flooring color and tone of furniture should be distinctive from the flooring avoid non essential signs any signage should be at eye level with simple clear use of text and color. use of pictorial elements ensure good levels of natural light to minimize artificial light any staff or locked rooms should be colored the same as the walls to avoid attention