Dementia

Question 1

5 A’s of Alzheimers?

Answer 1

Apraxia (unable to do things)
Aphasia
Amnesia
Agnosia (recognising faces/objects)

Associated behaviours:
Behaviour (wandering, irritable, aggression, incontinence)
Personality change 
Visual hallucinations (15%)
Delusions (15%)
Depression

Question 2

When should medical treatment for Alzheimer’s be commenced?

Answer 2

If MMSE is <20

1. Moderate = 2nd gen ACh-i - Donepezil (rivastagmine)
2. Moderate-severe = Memantine (NMDA antagonist)
3. 1st gen Ach-i = Tacrine