dementia Flashcards

Question

distinctive features of frontotemporal dementia

Answer 1

* STML not always present, uncontrollable repetition of words, mutism, repetition of words of other people, personality change, decline in personal and social conduct

Answer 2

* Every dementia patient costs the economy ￡27,647 per year: more than the UK median salary (￡24,700). * patients with cancer cost ￡5,999, heart disease ￡3,455, stroke ￡4,770 per year.

Answer 3

* Age * Gender * Genetic background * Medical history * Lifestyle “A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of MCI or dementia in elderly persons.” Roberts et al. (2012) [J](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print)[Alzheimers](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print)[Dis.](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) 2012;32:329-39.

Answer 4

women more commonly than men

Answer 5

2nd most common affects men more * Likely due to men have [high blood pressure](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print), which increases the risk of having a [stroke](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) (a cause of vascular dementia).

Answer 6

* [High blood pressure](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) * [High cholesterol](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) * [Diabetes](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) * Smoking * Being [obese](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print) * Lack of exercise * Irregular heart beat (such as [atrial fibrillation](http://www.guardian.co.uk/lifeandstyle/besttreatments/dementia-risk-factors-for-dementia/print)_)_

Answer 7

* Financial * early diagnosis, better controlled, longer time before needing 24/7 care, * may have domino effect of getting family to be care givers, * better QoL

Answer 8

often misattributed to stress, bereavement or normal ageing. * Loss of short-term memory * Confusion, poor judgement, unwilling to make decisions * Anxiety, agitation or distress over perceived changes * Inability to manage everyday tasks. * Communication problems – a decline in ability or interest in talking, reading * and writing. It currently takes around three years for a person with dementia to get a formal diagnosis and only around a third of sufferers end up properly diagnosed.

Answer 9

* More support required, including reminders to eat, wash, dress and use the lavatory; * Increasingly forgetful and may fail to recognise people; * Distress, aggression, anger, mood changes – frustration; * Risk of wandering and getting lost, leaving taps running, gas unlit, cooking unattended or forgetting to light the gas; * May behave inappropriately e.g. Going out in nightclothes; * May experience hallucinations, throw-back memories Symptoms are progressive and irreversible

Answer 10

* Inability to recognise familiar objects, surroundings or people – but there may be some flashes of recognition. * Increasing physical frailty, may start to shuffle or walk unsteadily, eventually becoming bed/wheelchair confined. * Difficulty eating and sometimes swallowing, weight loss  soft, high calorie - dental * Incontinence and gradual loss of speech. * Symptoms are progressive and irreversible.

Answer 11

Dementia screen to eliminate treatable causes * FBC, U&E's, kidney, liver and thyroid function tests * Glucose, serum B12, Folate and Calcium, C-Reactive Protein and Urinalysis If indicated * Syphilis serology, autoantibody screen, serum cholesterol and CT Neurological examination and detailed cognitive testing (MMSE).

Answer 12

* Mini-mental State Examination MMSE (Folstein) * Blessed Dementia Scale * The Montreal Cognitive Assessment (MoCA) * Single Neuropsychological Tests: * Clock draw, Delayed word recall, Category Fluency * Combined single tests 7 minute screen, IQCODE, AD8 Dementia Screening

Answer 13

* well known * easy to administer * samples range of congnitive functions * test-re-test and inter rate availability

Answer 14

mini-mental state examination

Answer 15

* only 3 words are to be remembered on recall - not sensitive to mild impairment * old - new knowledge? * non standardised time between registration and recall * not sensitive in testing frontal lobe

Answer 16

Category Fluency * You have 1 minute: * Name as many animals as you can………. * Name as many football teams as you can… * Name as many countries as you can….. Delayed Word Recall * 10 words * Make up a sentence Castle Bottle Anchor Plane Cat Queen Book Hat Cloud Green e.g. The QUEEN sat in her CASTLE wearing a GREEN HAT made of CAT whilst she read a BOOK about a PLANE which dropped from a CLOUD an ANCHOR smashing a BOTTLE.

Answer 17

There is no pharmacological, surgical or behavioural cure * Counselling may delay residential care by up to 1 year Aspirin and reducing cardiac risks (control of BP, weight, exercise etc..) may halt deterioration of vascular type dementias. *Lower co-morbidities* * Non-Steroidal Anti Inflammatory Drugs (NSAIDs) may slow progression. * Vitamin E and Ginko Biloba may slow progression

Answer 18

Treatment should continue until the patient, carer, and/or specialist decide it is the right time to stop, if it is not working, or if the person's MMSE score falls below 10. [http://www.nice.org.uk/guidance/cg42/chapter/1-recommendations#/interventions-for-cognitive-symptoms-and-maintenance-of-function-for-people-with-demen](http://www.nice.org.uk/guidance/cg42/chapter/1-recommendations#/interventions-for-cognitive-symptoms-and-maintenance-of-function-for-people-with-demen)

Answer 19

* Anticholinesterases: Donepezil (Aricept®), galantamine, rivastigmine (Exelon®) for mild/moderate Alzheimer’s * May delay admission to residential care, assist in behavioural difficulty, defer deterioration in cognition * Adverse effects nausea, vomiting, diarrhoea, 29% left studies * Specialist instigation and review. 1 in 3 on these drugs?

Answer 20

In a review of six RCTs involving 597 people, *Cerebrolysin* significantly improved cognitive function compared to standard care alone or placebos. It had a small positive effect on patients' overall clinical state. * Some evidence that long-term treatment may give greater benefits, although only two trials looked at long-term effects. This was assessed with scales testing recall, arithmetic or other cognitive abilities. *Chen N et al; Cerebrolysin for vascular dementia; Cochrane Database of Systematic Reviews 2013, Issue 1*

Answer 21

* Walls, floor coverings, skirting boards and doors are all different colours – provides good visual contrast to aid wayfinding * Fix labels and images to drawers to help let people find what they need without assistance * A bedroom WC should be visible from the bed on sitting and when lying down * Position personal pictures and items with personal relevance * Radiators should be low temperature heating * Furniture traditional and domestic

Answer 22

* Reception desk visible from the entrance door * Ceilings, floors and floor coverings should be acoustically absorbent to support audible communication * Colour and tone of walls should be distinctive from the flooring * Colour and tone of furniture should be distinctive from the flooring * Avoid non-essential signs * Any signage should be at eye level with simple clear use of text and colour. Use pictorial elements * Ensure good levels of natural light to minimise artificial light * Any staff only or locked rooms should be coloured the same as the walls to avoid attention

dementia Flashcards

(46 cards)