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Flashcards in [MND] Dementia Deck (19):
1

What is Dementia?

A clinical syndrome characterised by disturbance in memory, cognitive and emotional abilities severe enough to interfere with daily functioning and QOL

2

Dementia is not a specific diagnosis, it refers to

A group of symptoms that result from the impact of diseases or conditions affecting the brain

3

Epidemiology: Dementia

- 5 to 8% of NZ'ers aged 65 and over, and 20% of people over 80 have Dementia

- Dementia rates expected to double by 2050

4

Alzheimer's Disease is XX% of all dementia

50-70%

5

Vascular Dementia is XX% of all dementia

15-25%

6

Dementia with Lewy Bodies is XX% of all dementia

10-20% of late onset dementia

7

Diagnosis?

Three Diagnosis Criteria

1) Memory Impairment & changes in another cognitive domain (i.e. language, thinking, judgement)
2) Severe enough to affect social and occupational functioning
3) Decline from a previous higher level of functioning

8

What are the causes/main subtypes of Dementia?

1) Alzheimer's Disease
2) Vascular Dementia
3) Dementia with Lewy Bodies
4) Dementia linked with other medical conditions (i.e. Huntington's/Parkinson's)

9

What are the risk factors for Vascular Dementia?

Stroke and associated risk factors such as hypertension, diabetes, coronary artery disease, and smoking

10

In general, what is the MAIN risk factor for Dementia

Advancing age in most forms of Dementia

11

Prognosis (Alzeimer's & Vascular)

Alzheimers: Variable, death usually from complications

Vascular: Up to 20 years from diagnosis

12

Mixed Dementia is

a combination of Alzheimer's and Vascular Dementia which is very common

13

Pathophysiology of Vascular Dementia?

Loss of oxygen and nutrients due to stroke can lead to sudden onset of cognitive changes

Widespread atherosclerosis causes progressive blood vessel narrowing and ischaemic cell damage or repeated 'mini strokes'

14

Pathophysiology of Dementia with Lewy Bodies?

Dense tissue replaces normal tissue in nerve cells in cortical and subcortical regions causing cell death

15

Clinical Presentation
EARLY STAGE ALZHEIMERS (2-3 Years)

- Early signs mistaken for normal ageing
- Short term memory significantly impaired
- Long term memory impairment begins
- Difficulty making decisions
- Easily distracted
- Mood changes/depression

16

Clinical Presentation
MIDDLE STAGE ALZHEIMERS (2-10 years)

- Earlier symptoms worsen
- Increased personal and daily living dependence
- Behaviour and psychological disturbances (i.e. unusual anger)
- Further decline in memory

17

Clinical Presentation
LATE STAGE ALZHEIMERS

- Earlier symptoms worsen
- Becoming completely dependent/inactive
- Increasing difficulty recognising family/familiar objects
- Muscle strength and voluntary movement reduced
- Increasing difficulty walking, eating, swallowing and communicating

18

Clinical Presentation of Vascular Dementia

Symptoms vary depending on lesion location and extent on damage

Gradual cognitive decline; reasonable brain damage to occur to be noticed as dementia

Increasing symptoms with 'mini-strokes' can cause sudden changes such as memory impairment, then no new symptoms until another mini-stroke

19

A differential diagnosis is normal ageing, why?

mild cognitive impairment associated with memory changes can occur with normal ageing