NCD- Neurocognitve Disorders Flashcards by Rebecca Charidemou

Was dementia redefined in the DSM 5 as an NCD?

Yes

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What are some recognized NCDs?

Vascular

Frontotemporal

NCDLB (Lewy Bodies)

AD (Alzheimer’s)

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What differentiates major and mild NCD?

Level of function

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True or false

To be a major NCD, independence in ADLs is impaired

FALSE: IADL

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True or false

In mild NCD may be capacity for independence in IADLs though the person may need more time, more effort, and compensatory strategies

True

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What is Alzheimer’s disease (AD)?

A progressive dementia that causes cognitive, functional, and behavioral changes

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Does the prevalence of AD approximately double every 5 years after the age of 65 in developed nations?

Yes

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In the US, AD is the 6th leading cause of death for what age groups?

ALL age groups

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True or false

AD isn’t the single major cause of institutionalization of aged people

FALSE: IS THE MAJOR CAUSE

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What is the etiology of AD?

Poorly understood

Diagnosis made by exclusion (ruling out other disease processes abs considering PMH)

Diagnostic tools not completely accurate (ex MRI, PET)

Research in diagnostics not a priority due to lack of effective treatments

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What is the neuropathology of AD?

Cortical atrophy

Widened sulci

Ventricular enlargement

Caused by Neurofibrillary tangles and beta-amyloid plaques

Beta amyloid plaques

Plaques collected outside and around neurons

Neurofibrillary tangles

Tau protein

Abundance of abnormal structure of beta amyloid plaques and neurofibrillary tangles

Neurotransmitter abnormalities

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What does Neurofibrillary tangles and beta-amyloid plaques cause?

Shrink in brain structure

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What are beta amyloid plaques caused by?

Defective breakdown of amyloid precursor protein

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What does plaques collected outside and around the neurons cause?

Neuronal death

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What does neurofibrillary tangles contaminate?

Tau protein

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What does the tau protein do?

Serves as connectors throughout cell body- transports nutrients and molecules

Do the structural changes listed cause AD?

No but they are the end products of a pathological process

Is AD caused by a gene mutation?

What age is early onset of AD?

Before 65

What age is late onset of AD?

At or after age 65

MORE COMMON

Is Down syndrome a risk factor? Why?

Yes

Downs has extra chromosome which contains APP gene

Is there a risk for developing cardiovascular disease?

Yes

What are some AD risk factors?

Low education level

History of head trauma with loss of consciousness

History of depression

Later maternal age

Environmental & occupational therapy (ECT)

Alcohol abuse

Analgesic abuse

Long- standing physical abuse

Vascular risk (high bp, high cholesterol)

Type 2 diabetes

Black or Hispanic ethnicity

High waist to hip ratio

What is the global deterioration scale for assessment of primary degenerative dementia?

Stages of dementia

Stage 1-3 = pre dementia

Stage 4-7 = dementia stages

Stage 5 = beginning of dependent stage

What is the 1st step of the GDS scale?

No symptoms Resident is not aware

What is the 2nd step of the GDS scale?

No One knows there is a problem not even the resident President may have subjective complaints that they have trouble recalling names or they lose objects The resident uses comp and Citori strategies that work for them (writing everything down, repeating numbers in their head)

What is the 3rd step of the GDS scale?

Resident starts to realize there is an issue Compensatory strategies start to break down The resident usually does not tell anyone there is an issue

What is the 4th step of the GDS scale?

Others start to realize there is an issue Resident can follow two-step directives Do you still have the ability for a new learning at this stage. This is important to know because if you resident has dementia and you believe they may need an assistive device in the future You must teach them how to use it and have them use it one time per week in order for it to be remembered as the dementia progresses Residence at this stage can usually function in their own environment but have difficulty adapting to a new environment Depression occurs at this stage

What is the 5th step of the GDS scale?

No new Learning occurs at this stage If they did not use AE prior to the stage they will not independently use it Residence at this stage do not know they have a problem They are able to carry a conversation and look and act normally, however they only have five minutes of memory They will frequently ask the same questions throughout the day

What is the 6th step of the GDS scale?

Physiological changes are occurring Eye gaze lowers to as far as 32 inches from the floor, loss of peripheral vision and loss of depth perception The hypothalamus is affected and therefore they may perceive they are cold even if it is 70 degrees out and they will wear multiple layers of clothes

What is the 7th step of the GDS scale?

At this stage they are dominated by their senses If you feel good, taste good, smells good it is good They stop talking or only make noises As they progress they are unable to hold up their head

What are the 7 stages of the functional assessment staging scale (FAST)?

1- normal adult 2- normal older adult 3- early dementia 4- mild dementia 5- moderate dementia 6- moderately severe dementia 7- severe dementia

What is the 3 stages approach?

Correlates to DSM 5 Mild, moderate and severe

What are the 4 pillars to complete dementia care?

1) supportive care for the patient 2) supportive care for the family and/ or caregiver 3) disease treatment - pharmacotherapy 4) symptom treatment - cognitive - mental - behavioral - environmental