Elderly Psychiatry, Dementia, and Delerium Flashcards Preview

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Flashcards in Elderly Psychiatry, Dementia, and Delerium Deck (20):
1

Define dementia

A syndrome characterised by chronic progressive cognitive impairment, significant enough to impact on a pts ADLs, existing for at least 6 months. No altered level of consciousness.

2

What are some of the cognitive functions impaired in dementia?

Memory
Attention
Concentration
Language processing
Speech
Thinking
Judgement

3

Define delirium

A syndrome characterised by acute cognitive impairment alongside fluctuating levels of consciousness and attention

4

What % of people over 85 are affected by dementia?

25%

(20% at 80, 15% at 75, 10% at 70, 5% at 65)

5

What is the average time from diagnosis of dementia to death?

10 years

6

What are the main types of dementia?

Alzheimer’s Disease
Dementia with Lewy bodies
Vascular dementia
Frontotemporal Dementia
Alcoholic dementia

7

Which medical conditions are associated with dementia?

Huntington’s
MS
HIV
Down's syndrome

8

Define Alzheimer’s disease

A form of dementia characterised by insidious onset of symptoms, associated with the formation of amyloid plaques, neurofibrillary tangles, and brain atrophy.

9

What are the differentials for dementia wrt cognitive decline?

Depression
Delirium
Physical illness eg infection, pain, poor glycaemic control
******g

10

What are some of the features of early stage dementia?

-Cognitive decline, usually (short term) memory related
-Subtle changes in mood +/or behaviour
-Impact on higher functioning ADLs
-Minimal impact on basic ADLs
-Often have insight

11

What are some of the features of mid stage dementia?

-More pronounced cognitive difficulties
-More pronounced behavioural/mood changes
-Increase in assistance for basic tasks needed
-Insight loss - view deviates from reality

12

What are some of the features of late stage dementia?

-Severe and pervasive memory features/cognitive symptoms
-Marked behavioural changes, both positive and negative
-Severe disability - assistance required almost constantly
-No insight

13

What are positive behavioural features?

Behavioural changes where there is an added or different behaviour exhibited.

14

What are negative behavioural changes?

Behavioural change where a previous behaviour is taken away, or the patient becomes withdrawn.

15

Define frontotemporal dementia

Chronic progressive neurodegenerative syndrome characterised by change in personality and social conduct, with usually preserved memory and visuospatial skills. Due to frontotemporal lobe degeneration.

16

Define vascular dementia

Syndrome of cognitive decline caused by multiple acute ischaemic events that progresses in a step-wise manner.

17

Define Lewy body dementia

Syndrome of cognitive decline characterised by the presence of Lewy bodies in the brainstem and neocortical areas.

18

What is considered when distinguishing between types of dementia?

Course
Onset
Initial symptoms
Mood and behavioural changes
Other symptoms
Neurological features
Structural brain imaging

19

Can pts get mixed type of dementia? Eg?

Yes

Eg Alzheimer’s with vascular dementia

20

What is an important part of the history to get in a pt with suspected dementia?

Collateral Hx (alongside pts own account)