Dementia and alzheimers

• What is the most common neurodegenerative disease of the brain?

  Dementia
• What are the two most common neurodegenerative diseases mentioned?

  Dementia and Alzheimer’s disease
• What are the cognitive functions involved in neurocognition?

  • Language
  • Perception
  • Thinking
  • Judgment
• What are the executive functions of cognition?

  1. Impulse control
  2. Emotional control
  3. Problem solving capabilities
  4. Memory
  5. Self Awareness
  6. Planning and Prioritizing
  7. Task initiation
  8. Organization
• What is dementia an umbrella term for?

  Memory loss and other cognitive problems
• What are the types of dementia pathology?

  • Vascular dementia
  • Lewy body dementia
  • Frontotemporal dementia
  • Alzheimer’s disease
• What is the etiology of vascular dementia?

  Atherosclerosis and multiple infarct
• What is CADASIL?

  Cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy
• What is the common age group affected by vascular dementia?

  65 years old and above
• What are the risk factors for vascular dementia?

  • Smoking
  • High blood pressure
  • High cholesterol
  • Homocysteine
  • Triglycerides
  • Familial history
  • Overweight
  • Lack of physical activity
  • Metabolic syndrome
  • Diabetes mellitus
  • Heart disease and stroke
• What is the etiology of Lewy body dementia?

  Abnormal deposition of alpha-synuclein in the brain
• What is the common age group affected by Lewy body dementia?

  65 years old and above
• What is a differential diagnosis for Lewy body dementia?

  Parkinson’s disease
• What is the etiology of Alzheimer’s disease?

  Idiopathic
• What are the clinical features of Alzheimer’s disease?

  • Brain atrophy
  • Irreversible cognitive impairment and decline
  • Higher cognitive mental processes decline
  • Altered behavior (aggressions, irritability, agitation, psychosis)
  • Mood disturbances
  • Significant decline in social and occupational functioning
  • Gait and balance problems
• What is the most common age group affected by Alzheimer’s disease?

  65 years and above
• What are the risk factors for Alzheimer’s disease?

  • Age
  • Genetic mutations (Chromosomes 1, 14, 21 for early onset; Apolipoprotein E-4 of chromosome 19 for late onset)
  • Head trauma
  • Use of estrogens, NSAIDs
  • Presence of heart disease, high blood pressure, obesity
• What is the pathophysiology of Alzheimer’s disease?

  1. Neuroanatomic:

  • Progressive and diffuse neural loss in cerebral cortex and hippocampus
  • Neurons die and lose connections
  • Accumulation of amyloid in the space between neurons
  • Increased neuritic plaques and neurofibrillary tangles (beta amyloid) in temporal and parietal lobes
  • Loss of neural connections

  
  

  1. Neurochemical:

  • Affects neurotransmission leading to neuron death
  • Cholinergic markers in the brain with enlarged ventricles
  • Abnormal tau protein that leads to loss of neuronal synapses and brain volume in cortical and limbic system regions
  • Seen in diagnostic imaging: PET scan, CT scan, MRI
• What clinical assessments are used for dementia?

  • Global Deterioration Scale (GDS)
  • Disability Assessment for Dementia (DAD)
  • Allen Cognitive Level Test (ACL Test)
  • Assessment of Motor and Process skills (AMPS)
  • Functional Behavior Profile
  • Activity Profile
  • Caregiver’s Strain Questionnaire
  • Katz Activities of Daily Living Scale
  • Instrumental Activities of Daily Living Scale
• What are some physical and cognitive deficits associated with dementia?

  • Sensory loss
  • Arthritis and other orthopedic conditions
  • Heart disease, diabetes mellitus, chronic obstructive pulmonary disease
  • Depression and anxiety
• What are the goals of setting initiatives for dementia patients?

  • Minimize behavioral disturbances
  • Maximize function and independence
• What is the Tailored Activity Program (TAP) for dementia patients?

  • Evaluates the interests and capabilities of the client with dementia
  • Offers customized activities
• What are seizures?

  • Interruption of neural connections in the brain
  • May be caused by specific disorder, brain injury, or medication
  • Can cause rigidity or convulsions
  • May stop breathing for 50-70 seconds
  • May void urine or feces involuntarily
• What defines epilepsy?

  Two or more seizures with no known causes
• What are the clinical seizure subtypes?

  • Petit mal
  • Grand mal
• What is the difference between focal and generalized seizures?

  • Focal seizure: affects one side of the cerebral hemisphere
  • Generalized seizure: affects both sides of the cerebral hemispheres
• What are common seizure triggers?

  1. Not taking medications
  2. Not sleeping well or fatigue
  3. Stress
  4. Alcohol beverage
  5. Flashing and flickering lights
• What are the steps for managing seizures in a clinical setting?

  1. Place the person in a safe location, away from injury.
  2. Loosen clothing around the neck to keep the airway open.
  3. Do not insert objects into the mouth.
  4. Remove sharp objects to prevent injury.
  5. Lay the person on their side after convulsions subside.
  6. Allow the person to rest after convulsions cease.
  7. Get medical help.