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Elaina: IGEP Final > Dementia > Flashcards

Flashcards in Dementia Deck (52)
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1
Q

Is dementia an inherent aspect of aging?

A

no!

2
Q

what percentage of patients over 65 years old have alzheimer’s dementia?

A

6-8 percent

3
Q

after the age of 65, at what rate does the prevalence increase every 5 years?

A

doubles every 5 years after 65

4
Q

what percentage of people over the age of 85 have alzheimers dementia?

A

45 percent

5
Q

what percentage of vascular dementia cases co-occur with AD?

A

15-20 percent

6
Q

what is the second most common cause of dementia?

A

lewy body dementia

7
Q

what percentage of caregivers suffer psychological distress (esp. depression)

A

nearly half

8
Q

what will you see on imaging of an alzheimer’s dementia brain?

A

amyloid plaques/oligomers

tau neurofibrillary tangles

9
Q

cytoplasmic alpha-synuclein inclusion bodies should make you think of which two diagnoses?

A

lewy body dementia

parkinsons dementia

10
Q

tau or ubiquitin proteins should make you think of what type of dementia?

A

frontotemporal

11
Q

what are the four DEFINITIVE risk factors for developing alzheimer’s dementia?

A

1) age
2) family history
3) APOE4 allele
4) down syndrome

12
Q

what are four POSSIBLE risk factors for developing alzheimer’s dementia?

A

1) head trauma
2) fewer years of formal education
3) late onset MDD
4) cardiovascular RF (HTN, DM, etc)

13
Q

the presence of amyloid precursor proteins (APP) and presenilin proteins (PS1 and PS2) should make you think what?

A

early onset alzheimers

diagnosed usually before 60

14
Q

APOE 2/3/4 on chromosome 19 should make you think of what?

A

late onset alzheimers

APOE4 carries greatest risk

15
Q

APOE2 is considered to be what in terms of dementia?

A

protective!

16
Q

what is the highest score you can get on the MMSE? what areas of functioning does the MMSE address?

A

highest score = 30

orientation, registration, attention, recall, naming, repetition, 3-step command, language, visuospatial

17
Q

how many items are on the mini-cog? whats the highest score?

A

2 items (score = 5)

assesses visuospatial, executive functions, recall

18
Q

besides the MMSE and the minicog, what are two other commonly used assessments?

A

SLUMS and MoCA

19
Q

when should you consider brain imaging in your patient who is presenting with dementia-like symptoms?

A

1) age less than 65
2) neurologic signs are asymmetric or focal
3) clinical picture suggests normal-pressure hydrocephalus
4) patient has had recent fall or head trauma

20
Q

normal aging is characterized by what type of performance on memory tests?

A

no evidence consistent, progressive deviations

some decline in processing and recall of new information (slower, harder)

21
Q

will a patient with normal aging have difficulty on their ADLs due to cognition?

A

no

weird question

cognition remains mostly intact just slow

22
Q

subjective complaint of decline in at least ONE domain that is noticeable and measurable but NO impairment in independent living is considered what level of cognitive impairment?

A

mild

23
Q

what percentage of people with amnestic mild cognitive impairment maintain a stable level of impairment or return to normal cognitive status in 3-5 years?

A

50 percent

24
Q

what are the 4 distinguishing signs of delirium?

A

1) ACUTE onset
2) cognitive fluctuations over hours or days
3) impaired consciousness and attention
4) altered sleep cycles

25
Q

once delirium has cleared in your otherwise healthy patient, what is the first thing you should start working up?

A

dementia

26
Q

the symptoms of ______ and _____ often overlap and can be hard to differentiate

A

depression and dementia

27
Q

what are some overlapping symptoms between depression and dementia?

A

impaired concentration, lack of motivation, loss of interest, apathy, psychomotor retardation, sleep disturbance

28
Q

what are three key findings that will clue you into depression over dementia?

A

depressed people:

1) demonstrate decreased motivation during cognitive testing
2) express cognitive complaints that exceed measured deficits
3) maintain language and motor skills

29
Q

what percentage of people presenting with reversible dementia and depression progress to true dementia within 5 years?

A

50 percent

30
Q

memory impairment and difficulty learning new information is the core feature of this disease

A

alzheimer’s

31
Q

are motor symptoms common in alzheimer’s disease?

A

rare early

apraxia later (difficulty performing purposeful actions)

32
Q

what will lab tests of a person with alzheimers look like?

A

normal

33
Q

what will imaging of a person with alzheimer’s brain look like?

A

possible global atrophy

small hippocampal volumes

34
Q

what about onset will help you differentiate between alzheimer’s dementia and vascular dementia?

A

alzheimers dementia = insidious onset

vascular dementia = sudden or stepwise

35
Q

what are the cognitive symptoms of vascular dementia?

A

depend on the anatomy of the ischemia

dysexecutive syndrome common (cognitive, behavioral, emotional disturbances occurring together)

36
Q

what will a person with vascular dementia’s motor skills be like?

A

depends on location of ischemia

37
Q

what is the prognosis of vascular dementia?

A

it is a stepwise progression with further ischemia

38
Q

labs of a person with vascular dementia?

A

normal

39
Q

imaging of a person with vascular dementia?

A

cortical or subcortical changes on MRI

40
Q

onset of lewy body dementia? how do these patients typically progress?

A

onset is gradual

memory and visuospatial difficulties, hallucinations

41
Q

will a person with lewy body dementia have symptoms throughout the day? what is a hallmark of this disease?

A

NO

fluctuations of are common

42
Q

which progresses faster, lewy body dementia or alzheimers?

A

both are quite gradual, but lewy body dementia is faster than AD

43
Q

what will labs and imaging of lewy body dementia look like?

A

normal labs

imaging = possible global atrophy

44
Q

motor symptoms of lewy bodydementia?

A

parkinsonism

45
Q

for a diagnosis of lewy body dementia, both dementia and at least one of the these symptoms must be present (4):

A

1) detail visual hallucinations
2) parkinsonian signs
3) changes in alertness or attention
4) poor visuospatial abilities often out of proportion to other cognitive deficits

46
Q

if parkinson’s disease has been diagnosed or present for over 2 years before cognitive symptoms are seen, is the person’s dementia more likely alzheimer’s dementia or parkinson’s dementia?

A

parkinson disease dementia

47
Q

if parkinsonian symptoms are present at the same time as cognitive symptoms, what diagnosis should we consider?

A

lewy body dementia

48
Q

this type of dementia is characterized by executive, language, and behavioral dysfunction

A

frontotemporal dementia

49
Q

this type of dementia is characterized by disinhibition and hyperorality

A

frontotemporal dementia

50
Q

what are the motor symptoms of frontotemporal dementia?

A

none; but may be associated with ALS in rare cases

51
Q

is the onset of frontotemporal dementia gradual or sudden?

A

gradual, usually under 60 years old!

52
Q

what will imaging of a person with frontotemporal dementia’s brain look like?

A

atrophy in frontal and temporal lobes