Flashcards in the ageing brain and dementia REVISE Deck (41)
what is the cost of dementia to the UK economy?
bigger than cancer and heart disease combined
in which sort of countries are the vast majority of new dementia cases recorded?
low/middle income countries
is dementia a disease?
it is an overall term describing a group of symptoms (e.g memory loss) associated with decline in cognitive functioning leading to an increasing inability to cope
a major neurocognitive disorder
how many types of demetia are there?
over 100 types
what are the 2 main criteria for dementia diagnosis?
decline in cognitive functioning
leading to an increase in inability to cope and independetly function
what is the difference in the diagnostic criteria for those with a mild or major neurocognitive disorder?
mild - modest cognitive decline but doesn't interefere with capability for independence
modest - significant cognitive decline leading to lack of ability to act independently and to cope
what is dementia more feared than?
heart disease, stroke, diabetes and cancer
what is the prevalence of dementia in england in 2011?
compared to estimated 884 000
what are the percentage probabilities that a randomly seleceted elderly person will have dementia?
6.5% england, 2011
8.3% england, 1991
40% Torbay memory clinic, 2015
65% england care homes, 2011
what is the biological process cause of dementia?
misfolded proteins accumulate into amyloid plaque (either producing too much or unable to clear it)
which can occur both inside and outside neurons in the cerebral cortex and certain subcortical regions (occurs in everyone but some bodies better at breaking this down)
when this occurs inside neurons, they will die as do the synapses connected between them
the rate of neuronal loss can cause the onset of dementia after 10-20 years (middle age wen develop)
what are tell tale signs that someone has dementia from looking at the brain?
brain shrinkage (atrophy) and gapping due to neuronal loss, especially in memory and language areas and hippocampus
reduction of brain activity due to neuronal loss which has occured (detected predominantly by a CT scan but MRI scans can also be used)
what percentage of dementia patients have Alzheimer's disease?
(most common form)
what are some early signs and symptoms of Alzheimer's disease?
problems with language
changes in mood or behaviour
changes in personality
what is the second most common form of dementia?
what is the cause of vascular dementia?
series of strokes (ischemic) causing clot
impairs circulation of blood to the brain
causes cell death
what 3 elements is cognition made up of?
thinking, memory and reasoning
what are the 2 main continuums for types of dementia
alzheimers - vascular (can be a combination of the 2 known as 'mixed dementia')
dementia with Lewy Bodies - Parkinson's
what is the cause of dementia with Lewy Bodies?
results from clumps of alpha-synuclein and ubiquitin protein
what are some of the symptoms of dementia with Lewy Bodies?
what differentiates dementia with Lewy Bodies from Parkinson's?
if there are more cogntive components of parkinson's than motor then diagnosed with dementia with Lewy Bodies
why is frontotemporal dementia easy to misdiagnose as a psychiatric disorder?
due to mood and behaviour disturbances
display 'odd' social behaviour
euphoria and apathy
repetitive compulsive behaviour
which brief cognitive assessments are there for assessing dementia?
the Mini Mental State Examination (MMSE)
the Montreal Cognitive Assessment (MOCA)
what are the main cognitive assessments used by GPs and why
have only around 8 mins to see a patient
Memory Impairment Screen (MIS)
GPCOG Screening Test
why is it hard to accurately measure cognition in cognitive assessments?
testing effects e.g tired and also no comparison to previous cognition so might normally be lower and therefore no change
what is the most telling cognitive test at the beginning of dementia?
delayed recall and also clock drawing
what is an issue with cognitive assessments?
in some there are cultural and educational biases within the questions and tasks
how often is the GPCOG used by GPs
50% of referrals as takes less than 10 mins
drug treatments available
medication which reduces numbers of plaque don't improve symptoms
medications mainly used to treat psychological symptoms
3 types of medication:
NMDA receptor antagonsists
antipsychotics (only used with severly distressed patients or those at risk of harm to themselves or others)
best treatment for dementia as identified by NICE?