Dementia Flashcards
(47 cards)
define dementia
an acquired progressive impairment of cognition without clouding of consciousness that has been present for at least 6 months
state the 6 domains that cognition is assessed in
language movement visuospatial memory executive functioning behaviour
for a dementia to be present there must be how many cognitive domains affected
2
outline some general features of cognitive decline
memory loss slow, muddled thinking disorientated in space and time restlessness reduced attention and concentration loss of insight repetitive actions odd and disorganised behaviour
outline some primary causes of dementia
Alzheimers
Lewy body
Pick’s disease
outline some secondary causes of dementia
vascular dementia due to CVS disease
CJD or infection
huntingtons and Parkinson’s causing secondary dementia
alcohol abuse or head injury
what is the most common cause of dementia
Alzheimers disease
what gene has a defect in Alzheimers
ApoE gene
what are the macroscopic features of Alzheimers
cortical atrophy with thinning of gyri and sulci - occipital lobe spared
compensatory ventricular enlargement
what protein is there depositions of in Alzheimers disease
B-amyloid proteins
what are neurofibrillary tangles in Alzheimers and what protein are they formed from
filament bundles between the neurones - formed from tau protein
what is the effect on ACh neurotransmission in Alzheimers
reduced ACh in the nucleus Basilis of meynet
what is the initial symptom seen in Alzheimers
progressive memory loss, initially short term then followed by long term memory
describe the speech disorder in Alzheimers
dysphasia, trouble getting words out and understanding speech
describe some of the behavioural changes in Alzheimers
restlessness, agitation, aggressive outburst
associated with low mood and poor sleep
what are the findings on MRI in Alzheimers
usually normal, may have medial temporal lobe atrophy
usually imaging not required in suspected Alzheimers
who is at risk of developing vascular dementia
more common in men
those with increased CVS risks such as hypertension, hyperlipidaemia etc
what causes vascular dementia
develops as a result of small vessel infarcts within the white matter, grey nuclei and thalamus
what is the initial presentation in vascular dementia
functional deficits such as gait disturbance and urinary incontinence before memory problems
how does vascular dementia progress
in a stepwise progression, disease worsens then remains the same before getting worse even more
what are the emotional changes seen in vascular dementia
mood disturbances and disorders are very common
who is most likely to develop Lewy body dementia
men more commonly affected
>50 years
what causes Lewy body dementia
degeneration of substantiated Nigra and cortex
microscopically shows levy body deposition in substantial Nigra and cortex
what domains are affected first in Lewy body dementia
defects in executive functioning and visuospatial skills rather than memory loss
