Week 1 - Geriatrics DDD Flashcards
(29 cards)
T/F: a neurocognitive disorder is a general term that describes decreased mental function due to any medical condition including psychiatric illness
FALSE
what is aphasia, apraxia, and agnosia
aphasia: language expression/comprehension
apraxia: coordinated movement
agnosia: ID familiar objects/people
what is the most common type of dementia
Alzheimer’s disease
what are the 3 stages of Alzheimers disease?
preclinical/pre-symptomatic
mild cognitive impairment (MCI)
dementia
what are the 4 stages of dementia
mild - BADL intact, minor impairment to IADL
moderate - impaired BADL requiring prompting
severe - BADLs cannot be performed even with prompting
terminal - total care, nonverbal
what distinguishes dementia from MCI?
MCI does NOT interfere with everyday activities - dementia affects memory + one other cognitive ability that interferes with everyday functioning
what are some causes of reversible cognitive impairment
- anemia
- B12 deficiency
- hypothyroidism
- anticholinergic use
- acute delirium
- cerebral hypoperfusion
what is the cutoff for MOCA to diagnose dementia
18
in AD, what is the most common first clinical presentation?
selective memory impairment of RECENT events –> progresses over time to more distant events
T/F: AD has a gradual onset
True
what gene predisposes one to AD?
human apolipoprotein E (APOE) - allele e4
it increases risk by impairing amyloid beta clearance from cerebrum
what are the 2 underlying mechanisms of AD
amyloid beta peptide (form plaques between neuron and disrupts cell function)
Tau protein aggregation that contribute to formation of neurofibrillary tangles in teh neuronal cytoplasm
what causes & risk factors vascular dementia
cerebrovascular or CV illness - 10% of cases are linked to strokes or other issue with blood flow to the brain
risk factors include diabetes, hypertension, high cholesterol, metabolic syndrom, afib, obesity, tobacco smoking, >65yo
what are symptoms of vascular dementia
varies depending on area of brain affected but can include:
deficits in attention
difficulty processing info
decline in executive functioning (flexible thinking, self-control, emotional control)
what causes lewy body dementia?
deposits of alpha-synuclein (Lewy bodies) in the brain
what is the unique characteristic of lewy body dementia
visual hallucinations
LBD is an unbrella term inclusive of what two conditions?
Parkinson’s disease with dementia (PDD) & Dementia with Lewy Body (DLB)
PDD - parkinon’s disease established for at least one year prior to onset of symptoms
DLB - earlier cognitive impairment relative to parkinsonism
What causes fronto-temporal dementia
damage to neurons in the frontal and temporal lobes of the brain
often abnormal amoutns of tau and TDP-43 proteins inside nerve cells
what is common clinical presentation of fronto-temporal dementia
change in personality and behaviour - may embarrass themselves in public
what are causes of delirium? (Iwatchdeath)
I - infection
W - withdrawal
A - acute metabolic disorder
T - trauma
C - cns pathology
H - hypoxia
D - deficiences in vitamins
E - endocinopathies
A - acute vascular insults
T - toxins
H - heavy metals
what are the three types of delirium?
hyperactive, hypoactive, mixed
what test is for delirium?
CAM
must have acute onset or fluctuation course
AND
inattention
AND
disorganised thinking or altered level of consciousness
what are the two large classes of medications for treatment of dementia?
Cholinesterase inhibitors and NMDA Receptor Antagonists
what indications are CIs NOT indicated for?
MCI and FTD
