Old Age Psychiatry Flashcards
(18 cards)
Define dementia
Progressive neurological condition impacting on cognition –> Functional impairment
What are the 3 main types of dementia?
1) Alzheimer’s
2) Vascular
3) Lewy body
What are the main DD for dementia/
1) Depression
2) Old age
3) Physical health problems e.g. DM, hypothyroid, vitamin deficiencies
What is the main dementia screening tool?
ACE-III: Attention, memory, fluency, language and visiospatial
What drugs can be used in treatment of dementia?
1) Acetylcholinesterase inhibitors e.g. Donepezil, Rivastigmine
2) NMDA antagonist e.g. Memantine
3) RF reduction in vascular dementia
Define pseudo-dementia
Cognitive impairments as a result of a mental illness e.g. depression/anxiety
How can you differ between pseudo-dem and dementia?
PD: Will say don’t know
D: Confabulation
What is delirium?
Acute confusional state with changes in conscious (Med Emergency but reversible)
What are 3 causes of delirium?
1) Infection e.g. UTI
2) Dehydration
3) iatrogenic
4) Constipation
5) urinary retention
What psychiatric disorder increases chance of delirium?
Dementia (Bidirectional!)
How can delirium be treated
Treat underlying cause and consider environmental support
AP: Used in extreme cases if pt suffering from hallucinations
What is Charles Bonnet syndrome?
Condition characterised by visual hallucination
What are 5 potential causes of depression?
1) Drugs e.g. beta-blockers or opioids
2) metabolic e.g. anaemia, B12/folate deficiency, cancer
3) infective e.g. post-viral, UTI
4) inflammatory e.g. temporal (GCA) arteritis
5) Intracranial e.g. post-stroke, Parkinson’s, Delirium
What are the main treatment strategies for depression?
1) Meds e.g. SSRI
2) Talking therapies
3) Social inclusion/community support
4) ECT
What type of depression doesn’t respond well to AD
Vascular
What are the main factors associated with ageing?
Progressive and generalised impairment of function –> Loss of adaptive response to stress
What are the main symptoms of depression?
Low mood, lacking energy, loss of pleasure, sleep disturbance, appetite change, feelings of guilt, suicidal thought
Why should Lithium be used with care when treating psychiatric conditions?
Narrow therapeutic range –> progress to renal failure
