Normal Cognitive Ageing and Dementia Flashcards
1
Q
What are dementia and cognitive impairment not part of?
A
They are not part of the normal aging process; they are diagnosable conditions.
2
Q
Name what happens with normal cognitive aging.
A
- slower to think
- slower to do
- hesitates more
- more likely to “look before you leap”
- know the person not the name
- pause to find words
- reminded of the past.
3
Q
What are NOT characteristics of normal cognitive aging, that people often think are?
A
- confused about past vs. now
- words can’t be retrieved, even later
- can’t place a person
- doesn’t think speech out at all
- can’t think the same
- can’t do like before
4
Q
As we age there are _____________ to the _______.
A
Structural changes to the brain.
5
Q
Name the structural changes to the the brain in healthy aging.
A
Loss of brain volume
Expansion of the ventricles
6
Q
the pattern of brain change in aging is _________.
A
heterogeneous (diverse)
7
Q
What happens to grey matter as we age?
A
The volume of grey matter declines.
8
Q
When does grey matter volume begin to decrease?
A
After the age of 20.
9
Q
Older people have greater decreases in _______ structures.
A
Cortical.
10
Q
Where is atrophy most prominent?
A
The prefrontal cortex.
11
Q
There are more moderate age-related changes in the _______ lobe. What does it involve and cause?
A
Temporal.
Involves decrease in hippocampus volume- memory issues expected.
12
Q
________________ volume decreases are much greater than grey matter volume decreases (with increasing age).
A
White Matter
13
Q
What does decreased parahippocampal white matter lead to?
A
Decreased communication with hippocampal structures- this may cause memory decline/impact how we access memory.
14
Q
Where are the most marked age- related declines?
A
In the anterior white matter.
15
Q
What does decline of anterior white matter cause?
A
deficits in executive function.
16
Q
What may mediate age-related cognitive decline (eg. speed of processes)?
A
Loss of integrity of the central portion of the corpus callosum.
17
Q
Name the 4 possible causes for normal cognitive aging.
A
- Accumulation of Beta-amyloids
- Morphological changes in neurons likely to contribute to the reduction of synaptic density (eg. dendrite length)
- A decrease in neuron size and the number of connections between them
- Neuronal Death
18
Q
What are high levels of beta-amyloiad associated with?
A
- Decreased hippocampal volumes
- Episodic memory
19
Q
What is cognition?
A
The mental action or process of acquiring knowledge and understanding through thought, experience and the senses.
20
Q
What does cognition refer to?
A
- our information processing systems
- our stored knowledge
21
Q
Name the 3 parts of cognition’s mission :)
A
- Analyse Sensation
- Use experience to guide behaviour
- Detect and remember irregularities in incoming sensory information
22
Q
Cognitive change is a _______ process of aging.
A
Normal.
23
Q
What concepts describe the patterns of cognitive change over our lifetimes?
A
Crystallised Intelligence
Fluid Intelligence
24
Q
What is crystalised intelligence?
A
Skills, abilities and knowledge that are well practiced, overlearned and familiar.
25
Name examples of crystalised intelligence.
Vocabulary
| General Knowledge
26
What happens to crystallised intelligence as we get older?
It remains stable or can even gradually improve through the 6th and 7th decades of life :)
27
What is fluid intelligence?
Abilities to problem solve and reason about things less familiar or independent of what one has learned.
28
Fluid intelligence includes the innate ability to process and learn _____ _________, solve ________ and attend to and _______ your ________.
New Information
problems
manipulate, environment,
29
Executive function, _____ speed, _____ and psychomotor ability are considered ______ cognitive domains.
Processing
Memory
Fluid
30
Abstract thinking is an example of ___________.
Fluid intelligence.
31
Is Crystal or fluid intelligence more susceptible to aging?
Fluid intelligence is more susceptible to aging.
32
Name the 6 components of cognition.
- Executive Functioning
- Processing Speed
- Attention
- Visuospatial Abilities
- Language
- Memory
33
Name this:
| Th speed with which cognitive activities are performed as well as the speed of motor response.
Processing Speed.
34
When does processing speed decline begin?
In the 3rd decade of life (20's) and continues throughout the lifespan.
35
Reduced processing speed can have _____ across a variety of _______ domains.
Implications.
| Cognitive.
36
Many cognitive changes reported in healthy older adults are the result of slowed ______ _________.
Processing Speed.
37
What is Attention?
The ability to concentrate and focus on specific stimuli.
38
Simple auditory ________ ______ measured by a string of digits, only shows a slight decline in late life.
Attention span.
39
In terms of attention, when is there a noticeable age effect?
When performing more complex attention task.
40
Name and define the two types of attention.
Selective attention- all attention on 1 thing
| Divided attention- attention on 2 things at once.
41
Older adults also perform worse than younger adults on tasks involving ______ __________.
Working Memory.
42
Name this:
| The ability to understand space in 2 and 3 dimensions.
Visuospatial Abilities/ Visual Construction.
43
________ construction skills decline over time.
visual
44
Visual construction skills decline over time, what remains in tact?
Visuospatial abilities remain intact.
45
Name this:
| Capacities that allow a person to successfully engage in independent, appropriate, purposive and self-serving behaviour.
Executive functioning.
46
Give some examples of executive functioning.
Reasoning, organisation, problem solving, self-monitoring etc.
47
What aspects of executive functioning decline with age, especially after 70? What do they have the tendency to do?
- Concept Formation
- Abstraction
- Mental Flexibility
Tendency to think more concretely.
48
Executive abilities requiring a _______ _______ component are particularly susceptible to age effects.
speeded motor.
49
Aging also negatively affects ________ _____________, the ability to inhibit an automatic response in favour of producing a novel response.
Response Inhibition.
50
__________ with unfamiliar material declines with age.
Reasoning
51
Other types of executive functioning remain stable throughout lifetime, give some examples.
- ability to appreciate similarities
- describe the meaning of proverbs
- reason about familiar material
52
Language is everything that allows ________ _______________.
Meaningful Communication.
53
Overall what happens to language as we age?
It remains intact with aging.
54
_________ remains stable and even improves overtime.
Vocabulary.
55
Visual confrontation naming (word finding) is stable until age ______, then declines in subsequent years.
70.
56
Verbal ______ (semantic field) shows decline with aging.
Fluency.
57
What may age related memory problems be related to?
- slowed processing speed
- reduced ability to ignore irrelevant information
- decreased use of strategies to improve learning and memory.
58
Is this memory stable with age?
- Non-declarative memory
- Retention
- Recognition memory: ability to retrieve info when given cue
Yes it's stable with age.
59
Is this memory stable with age?
- Temporal Order memory: memory for the correct time or sequence of past events.
- Procedural Memory: memory of how to do things.
Yes it's stable with age.
60
Is this memory stable with age?
- Declarative (explicit) memory
- Semantic Memory
- Episodic memory
- Acquisition
No it declines with age.
61
Is this memory stable with age?
- Retrieval
- Delayed free recall: spontaneous retrieval of information from memory without a cue.
No, it declines with age.
62
Is this memory stable with age?
- Source memory: knowing the source of the learned information
- Prospective memory: remembering to perform intended actions in the future.
No, it declines with age.
63
Name the structures that play a role in memory.
```
Prefrontal Cortex
Basal Forebrain
Mediodorsal nucleus
Amygdala
Hippocampus
Inferotemporal cortex
Cerebellum
Rhinal Cortex.
```
64
The input goes to the _______________memory.
Sensory.
65
What happens to the info in the sensory memory?
It is either forgotten (decay) or passed to the central executive.
66
What 3 components that make up the central executive?
- Visuo-spatial scratch pad
- Phonological Loop (articulatory control, phonological store)
- Episodic Buffer
67
From the visuo-spatial scratch pad, episodic buffer and phonological loop, where does the info go?
It goes to the long term-memory.
68
What is between sensory and long term memory?
Working memory (the central executive).
69
Long term memory is split into ________ and ___- ____ memory.
Declarative and non-declarative .
70
What is declarative (explicit) memory?
Knowing that.
71
What is non-declaritive (implicit) memory?
Knowing how.
72
Give examples of declarative/ explicit memory.
- Episodic
- Semantic
- Lexical
73
Give examples of non-declarative/ implicit memory.
- Habits
- Procedural
- Cognitive skills
- Priming
- conditioned response.
74
The term dementia was first used in 1801 by Phillipe Pinel, with a patient presenting with loss of ___________ and ________ function.
Cognitive
| Physical
75
What does demence refer to?
Incoherence or loss of mental function.
76
What does dementia refer to?
Dementia refers to a group of diseases characterised by progressive and, in the majority of cases, irreversible decline in mental functioning.
77
How are cognitive abilities lost?
Due to damage of neurons in certain areas of the brain.
78
In dementia what is the loss of cognitive abilities often accompanied with?
Deterioration in emotional control, social behaviour and motivation.
79
In dementia, the effects of the damage to the brain...
Intensify over time and are disabling & terminal.
80
Dementia is an _____ term used to define over 100 different conditions that impair ________, ___________ and thinking.
Umbrella
| Memory, Behaviors.
81
Name the most common causes of dementia.
- Alzheimer's Disease
- Lewy Body Dementia
- Frontal temporal Dementia
etc. ....
82
In Scotland, 90,000 people live with dementia, why is this number expected to increase by 2020?
Due to aging population (more older people)
83
Globally dementia has a stable or declining ____________.
Prevalence.
84
What is another name for dementia (DSM 5) ?
Major Neurocognitive Disorder.
85
Why was the terminology "dementia" changed by DSM 5?
to. ..
- avoid negative connotation
- distinguish between disorders that have cognitive impairment as their primary feature and those that don't.
- more accurately reflect the diagnostic process.
86
What criteria is used to assess dementia?
DSM 5 Diagnostic Criteria.
87
```
The DSM-5 Diagnostic Criteria is...
one or more acquired significant impairment in cognitive domains such as:
-__________
-Language
-___________
-__________ of purposeful movement
-_______ control
```
Memory
Recognising/Familiarity
Execution
Self
88
Where does assessment normally take place for over 65s?
In regional memory clinics.
89
After an initial ______, where are people with suspected dementia reffered?
Review
| referred for an appointment with neuropyschology, psychiatry or for MRI scan.
90
It is important to implement ______ after a dementia diagnosis.
Support.
91
This assessment proccess is very lengthy:
1. Take __________ _____________
2. ___________ exam
3. ______________ evaluation (including mood)
4. _______ examination eg. mental status
5. ___________ Testing
6. Labs
7. ______imaging
8. Rarely, but sometimes analyse _______.
9. _________ interview.
```
Case/Medical History
Physical
Psychiatric
Cognitive
Neuropsychological
Neuroimaging
CSF
Caregiver
```
92
What does neuropsychology address?
The link between brain and behaviour.
93
What is an objective way to quantify and characterise cognitive, behavioural and emotional changes following a brain disease?
Neuropsychological assessment.
94
In what examination can they get you to draw?
A cognitive examination.
95
Name the domains of dementia that are examined.
- Memory
- Attention
- Visuospatial
- Language
- Effort/Motivation
- Executive Functions
- Praxis
- Mood
- Premorbid function
96
In early stages, ____________________ dieseases show a ______ for certain brain regions with relative sparing of others.
Neurodegenerative
| Preference.
97
Neurodegenerative diseases have ______ cognitive profiles associated with the distributuion of the neuropathology.
Recognisable.
98
What do profiles do?
Theyhelp with the diagnosis process and differentiation from other dementias.
99
What information must we gather in order to make a profile, to then diagnose?
- Detailed Medical History
- Onset and Course of progression
- Profile of cognitive impairment
- Presence of non-cognitive symptoms such as behavioural disturbance, hallucinations and delusions.
- Carer involvement
100
Reversible Causes and progressive decline may be slowed/stopped due to ______ diagnosis.
Differential.
101
Why is differential diagnosis so important?
- different impairments an retained abilities,so in need for different advice to carers and informed management.
- Facilitates legal processes and advanced care planning.
102
Why are legal processes and advanced care planning beneficial?
- The family knows what that person's wishes were (before they progress further)
- Causes family less distress.
103
The Clinical Dementia Rating (CDR)
The Global Deterioration Scale for aging and dementia (GDS)
What are these?
Severity rating scales.
104
CDR 0 means you are _______.
CDR 0.5 means you have _______________.
CDR 1 means you have ______.
Healthy (no dementia)
questionable dementia
mild dementia
105
GDS Stage 1 means _________
Stage 2 is __________ deficits.
Stage 3 is _______ deficits.
Stage 4 is _______ deficits and means you have _______.
You are normal
Subjective
Subtle
Clear, mild dementia.
106
For management, the 5 ____________ _ _______________ are used.
pillars of support.
107
Name the 5 pillars of support.
- Understanding Illness and managing symptoms
- Planning for future decision making
- Supporting community connections
- Peer Support
- Planning for future care.
108
What are these?
- Dementia Coordinator
- support for carers
- personalised support
- community connections
- environment
- mental health care and treatment
- General Health Care and treatment
- Therapeutic interventions to tackle symptoms of the illness.
8 pillars of community support.
109
What are the main roles in the MDT for Dementia?
- Support patient and family
- Help patient stay in familiar environment for as long as possible
- Help with symptoms
- Don't overstep role, but help with other things.
110
How is dementia managed?
- Prevention
- Pharmacological- drugs
- Behavioural
- Rehabilitation
- Psychosocial interventions
- caregiver support, training and education
111
What can delay the onset of dementia?
Intervention.
112
___________ can be used because people with dementia can learn, it's just more difficult.
Rehabilitation.
113
Cholinesterase Inhibitors are drugs used for _____________ _________________.
Cognitive Functioning.
114
Name some other drugs used to manage dementia.
Anti-depressants and anti-psychotics.
115
What is the down side to medication?
Often side effects.
116
There is no ________ to stop or cure dementia.
Medication/Drug.
117
What is psychosocial intervention?
Different ways to support people to overcome challenges and maintain good mental health.
118
What do psychosocial interventions do?
Help maintain independence, quality of life, maintain cognitive function and reduce anxiety and depression.
119
Psychosocial intervention must be tailored to....
Individual needs
120
Name some non-pharmacological interventions for behavioural and psychological symptoms of dementia.
```
Cognitive Behavioural Therapy (CBT)
Environmental Design
Physical Activities
Art Therapy
Simulated Presence
Validation therapy
Reminiscence therapy
family/caregiver intervention programmes.
```
121
What is simulated presence?
Playing recordings of loved ones voices etc.
122
What therapy is this an example of?
| Patient thinks they are in a hotel and staff go along with it.
Validation Therapy.
123
Talking about the past is known as __________ therapy.
Reminiscence.
124
Name the 4 types of dementia.
Cortical eg. Alzheimers Disease
Subcortical
Mixed cortical-subcortical eg. frontotemporal dementia, lewy body dementia
Treatable eg. infections.
125
What is the most common form of dementia?
Alzheimer's Disease.
126
Define Alzheimer's Disease.
A chronic neurodegenerative diseas with an isidious onset and progressive but slow decline.
127
What neuropathology do people with Alzheimer's Disease present with?
Plaques in the brain
Neurofibrillary Tangles
Neuronal loss
128
What is the aetiology of Alzheimers disease?
Nobody knows;
- Possibly genetic factor
- Possibly cholesterol and homocysteine levels
- Possibly Vitamin E and C
129
What is the most common and older theory behind the neuropathology of Alzheimer's Disease?
The Amyloid Hypothesis:
Excess Amyloid peptides
Build up = diffuse plaque
Plaque causes inflammation which leads to formation of neuritic plaques
This causes synaptic and neuritic injury and cell death,
130
A newer, less common theory suggests that Alzheimer's Disease is caused by abnormal aggregation of the ____________. What does this accumulation cause?
Tau Protein
| Tau accumulates into intraneuronal masses (plaques and tangles)
131
The tau protein has direct links to _______ disruption.
Functional.
132
AD deficits progress in a relatively...
Predictable pattern.
133
What are symptoms of AD?
- Memory Problems (recent)
- Language problems (verbal fluency, word finding)
- Visuospatial dysfunction
- Progressive Deterioration of performing every day tasks
- Behavioural Disturbance (wandering, agitation, inappropriacy)
134
What memory is affected in Early/Mild AD?
Episodic Memory
Semantic Memory
Attention/executive function.
135
What symptoms usually appear later on inm the progression of AD?
Visuospatial deficits
| Praxis (motor planning)
136
Name some possible risk factors for AD.
- Down's Syndrome
- Advanced Age
- Female
- Genetic Predisposition
- Family history
- Elevated homocystine levels
- History of TBI
- Lifestyle factors.
137
Name some protective factors for AD.
- Education
- Cognitive Stimulation
- Possibly tobacco
- Wine and Coffee
- Exercise
- Food containing vitamin E
- Aspirin?, anti-inflammatory drugs?
138
What are the main behavioural and psychological symptoms of alzheimer's disease?
```
Anxiety
Aggression
Hallucination
Depression
Agitation
Wandering
Delusions.
```
139
What do these provide us with?:
The National institute on Aging and the Alzheimer's Association Workgroup (2011)
The National Institut of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorder Association (2012)
Diagnostic criteria.
140
A diagnostic criteria is that the onset must be __________.
insidious.
141
AD can be diagnosed from ______ - ______ years.
40, 90
142
In AD diagnosis, what must there be an absence of?
Any strokes or other brain diseases capable of producing dementia syndrome eg. delirium.
143
What is the pharmalogical goal to find for AD?
To find a drug that will either cure AD or to delay the degenration of AD.
144
What is the prognosis for AD?
Natural course of progression decline with some plateaus.
145
What is the ultimate destination for AD?
Death.
146
What is mild cognitive impairment?
Can be a transition stage between normal aging and dementia.
It's a syndrome where cognitive decline is greater than expected for an individual's age and education level but that doesn't interfere with activities of daily life.
147
What are the subtypes of mild cognitive impairment?
Amnestic and non-amnestic.
148
What can Mild Cognitive Impairment affect?
many areas eg. language, attention, judgement, but most commonly affects memory (often leads to alzheimer's)
149
In mild cognitive impairment, what is usually unaffected?
- Normal perception
- Reasoning skills
- normal activities of daily living
All not affected :)
150
What may mild cognitive impairment cause?
Depression, irritability, anxiety and aggression.
151
Mild cognitive impairment has the same neuropathological changes as ________ but to a ______ extent.
Alzheimer's
| Lesser
152
Name the neuropathology of mild cognitve impairment.
- Plaques
- tangles
- shrinkage of hippocampus
153
What in people with Mild Cognitive Impairment (MCI) predicts conversion to AD?
Elevated beta-amyloid in people with MCI.
154
What are some risk factors for MCI?
- Genetic Predisposition
- High Blood Pressure
- Diabetes
- Low levels of physical, social and mental activity
- few years education
155
What subtype of MCI can lead to AD?
Amnestic subtype.
156
What affects cognitive performance in elderly populations?
- education
- vascular risk factors
- psychiatric status
- genetic background
- hormonal changes
- anti-cholinergic drugs.
157
What is vascular dementia?
When executive functions are more affected than memory. Motor and mood changes seen early.
158
In vascular dementia, what changes can be seen early?
Motor and mood changes can be seen early.
159
In vascular dementia, symptom onset may be ________.
abrupt.
160
What is a feature of symptom presentation of vascular dementia?
There may be periods of sudden decline followed by relative stability.
161
Because of periods of plateau, what is the decline in vascular dementia often known as?
stair-step decline
162
For Vascular Dementia- there's vascular pathology cause to both ____ and _____ matter; infarction, _______, ______ and small vessel changes.
grey and white
ischaemia
haemorrhage
163
In the pathophsiology of VAD, often people have multiple large _______ or small ______ in strategic areas.
Infarcts
| Infarcts
164
Another pathophsiology of VAD is;
-loss of axons, myelin and oligodendrocytes
-damage to the capillaries with breakdown of blood-brain barrier and protein leakage.
What is this called?
leukoaralosis.
165
In VAD, people can have large _________ in the basal ganglia (secondary to hypertension), or small ______ in the cortex and white matter (secondary to amyloid angiopathy.
Haemorrhages
| Haemorrhages.
166
Vascular Dementia can often co-occur with _____________, what is this known as?
Mixed Dementia.
167
The Ninds-Airen diagnostic criteria os often used in diagnosing _____________.
VAD
168
What is the difference between VAD and AD?
Vascular Dementia- most likely to have:
- abrupt onset
- fluctuating course
- may include some degree of recover past an episode
- history of stroke
- focal neurological symptoms and signs
169
Describe cognitive functioning in VAD.
- Preserved recent memory
- More diverse language profiles than AD
- Test scores decline less than AD over time.
170
_________ VAD presents with:
- poor general ___________ functioning
- High _______
- _______________
Subcortical
Cognitive
Insight
Depression
171
What is the treatment for vascular dementia?
To prevent vascular injury to the brain (prevention of a stroke).
172
What is the prognosis for VAD?
Life expectancy is significantly shortened with a similar mortality to alzheimer's disease.
173
Dementia is _____________.
Irreversible.
174
Dementia with ______________ ________________ is another type of dementia.
Dementia with lewy bodies.
175
Dementia with lewy bodies is an umbrella term- it includes lewy bodies (LBD) with and without ______ ______.
Parkinson's Disease.
176
Dementia with ___________ _______________accounts for approx.10% of cases of __________________.
Lewy Bodies
| Dementia.
177
What type of dementia was only recently recognised as a disease entity in its own right?
Dementia with lewy bodies.
178
What is the aetiology for dementia with lewy bodies?
Unkown. Some indicators of genetic involvement but most are sparadic.
179
What is dementia with lewy bodies characterized by?
Cognitive Decline with a combination of fluctuating cognition, recurrent visual hallucinations, spontaneous extrapyramidal signs, rem sleep behavioural disorder and antipsychotic sensitivity.
180
What do people with DLB exhibit?
- prominent dysexecutive syndrome
| - visuo-perceptive disturbances
181
______________ and _____________ ________________________ are more affected in DLB than in AD.
Attention
| Visual Perception.
182
What may not occur early in DLB?
Detectable memory loss.
183
In DLB, what types of memory are impaired and what are less impaired?
Impaired: procedural memory and motor skill learning
| Less impaired: episodic memory
184
A person with DLB may have marked day to day _________________ in functioning and transitory episodes of _________________________.
Fluctuating
| Confusion
185
In DLB what may occur?
Paranoid Delirium
186
Why can people with DLB be dangerous in their sleep?
They can act out in their sleep.
187
What is DLB characterised by?
An accumulation of lewy bodies in vulnerable sites, lewy bodies displace nerve cell structures leading to impairments.
188
_______ ________ are beta-amyloid plaques aggregates of alpha-synuclein protein.
Lewy Bodies
189
In DLB, where do Lewy bodies start?
In cortical areas.
190
In parkinsons disease dementia (PDD) describe where lewy bodies acccumulate and what this causes.
- Lewy Bodies Begin to accumulate in upper brainstem (substantia Nigra)
- Leading to tremor, rigidity and slowed movement
- Iewy bodies can sometimes spread to cortical areas (especially frontal) and to basal nucleus to cause cognitive decline
191
Treatment for DLB is __________.
Symptomatic.
192
What is the main goal for the management of DLB?
Stabilise Condition, Behaviour and ADLs (activities of daily living).
193
If a person with DLB has increased sensitivity to ___________ medication, it should be avoided.
Antipsychotic.
194
Describe DLB's progression.
Dementia with Lewy Bodies is a progressive disease with steady decline in functioning.
195
What is the prognosis for DLB?
Survival of 5-7 years after symptom onset.
196
What is the second most frequent type of dementia after Alzheimer's Disease?
Frontotemporal Dementia. (FTD)
197
FTD is a ______- it includes _____ and ______ variants.
Spectrum
| Behavioural and Language
198
When does frontotemporal dementia typically appear?
Mid-life around 53-58 years old.
199
What are some prominent early symptoms of frontotemporal dementia (FTD)?
Progressive coursening of personality, social behaviour, self regulation (of emotions, drives and behaviour) and language.
200
Name the type of dementia:
| The person seems to change personality; gambles, is sexually inappropriate at times.
Frontotemporal Dementia.
201
In FTD big changes in _______ ______ and _________ are seen.
Social Behaviour
| Language
202
What are some symptoms of FTD?
- indifference to self care
- indifference to other's needs
- loss of speech and comprehension
- loss of empathy
- distractibility
- impulsiveness
203
Often in FTD, what is needed for the family?
Counselling for family.
204
When can frontotemporal diagnosis be definitely diagnosed?
From post-mortem examination of the brain.
205
The 2 groups in pathology of FTD are:
FTD-_______ group
FTD-_______ group
Tau
| Ubiquitin
206
Pathophysiology shouldn't be considered in isolation, what should also be considered?
Symptom Formation.
207
What FTD variant has the subtypes:
- Apathetic
- Disinhibited
- Stereotypic
Behavioural variant.
208
What FTD variant has the subtypes:
- Semantic
- Non-fluent/Agrammatic
- Logopenic
Language Variant with PPA.
209
You can also have FTD with or without _______________.
Parkinsonism.
210
What is the behavioural variant of FTD also known as?
Frontal Variant FTD or fvFTD.
211
What do people with fvFTD present with?
an insidious disorder of personality and behaviour.
212
What major changes does fvFTD cause?
It causes major changes in personality with stereotyped behaviour (repetitive), change in eating preferences (non food items), disinhibition (lack of restraint) and loss of empathy.
213
fvFTD has relative preservation of day to day -__________________ __________________.
Episodic memory.
214
In fvFTD, _________ _____________ may be present eg. mood disorder, paranoia.
Psychiatric Phenomena.
215
What must be absent in order to diagnose somebody with fvFTD?
must exclude:
- head injury
- stroke
- chronic alcohol abuse
- major psychiatric illness
216
What is the treatment for frontotemporal dementia based on?
- Ensuring safety of patient and others
- Provide reassurance and support for patient and carers
- Provide guidance and supervision of care team.
217
Treatment for FTD is ______ care and ________ magangement, there's no available disease modifying treatments.
Supportive
| Symptom
218
What is the prognosis for FTD?
Disease progression differs across the variants. Median survival from diagnosis is 6-7 years.
219
What is PPA?
Primary progressive aphasia (PPA) is a form of cognitive impairment that involves a progressive loss of language function.
220
What is PPA caused by?
PPA is caused by degeneration in the parts
| of the brain that are responsible for speech and language.
221
In PPA what areas of the brain are impacted quickly?
Tempero-parietal areas.
222
How is the patterns of degeneration of the brain monitored in PPA?
Through Neuroimaging using an MRI Scan.
223
Name some other causes of dementia.
- HIV
- Huntigton's Disease
- Prion Disease
- Traumatic Brain Injury
- Substance Induced (alcohol) major cognitive disorder.
224
Name some treatable causes of dementia.
- Normal Pressure Hydrocephalus
- Chronic Subdural Haematoma
- Benign Tumours
- Metabolic and Endocrine Disturbances
- Infections
225
What should dementia be differentially diagnosed from?
- Depression
| - Acute confusional state
226
If something isn't actually dementia but can kind of seem like it, what is this called?
pseudodementia
227
What is the role of an SLT with dementia patients?
assess and manage cognitive, communicative and swallowing disorders.
228
What is the problem with SLT intervention in dementia?
It's a progressive disease therefor treatment outcomes are limited to the maintenance of existing functions :)
229
What is delirium?
An acute (hours or days), usually reversible, metabolically induced state of consciousness.
230
What is the difference between delirium and dementia?
```
Delirium = Rapid changes in the level of consciousness and orientation
Dementia= Slow progression of memory and functioning decline
```
231
Delirium has an ______ onset of attentional abnormalities.
abrupt.
232
What can delirium cause?
Disorders of:
- perception
- thinking and memory
- psychomotor activity
- sleep-wakefulness cycle.
233
Delirium involves fluctuations in _____ performance and behaviour.
Cognitive.
