Alzheimer's Disease and Dementia Overview
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Questions and Answers

What is the primary distinction between primary and secondary dementias?

  • Primary dementias result from an underlying disease or injury, whereas secondary dementias do not.
  • Secondary dementias are more common than primary dementias.
  • Primary dementias are more severe than secondary dementias.
  • Primary dementias do not stem from another disease or condition, whereas secondary dementias do. (correct)
  • Approximately what percentage of dementia cases in Canada are attributed to Alzheimer's Disease and Related Dementias (ADRD)?

  • 64% (correct)
  • 25%
  • 42%
  • 88%
  • Which of the following is a distinguishing characteristic found by Dr. Alois Alzheimer in 1906?

  • Mood and behaviour changes
  • Impaired judgement and abstract thinking
  • Memory loss and disorientation
  • Plaques and tangles (correct)
  • Which of these is NOT a typical warning sign of dementia?

    <p>Sudden increase in physical strength (B)</p> Signup and view all the answers

    Which of these best describes the current treatment options for ADRD?

    <p>The condition can be managed, but there is no cure. (D)</p> Signup and view all the answers

    What is a known risk factor for developing Alzheimer's Disease and Related Dementias (ADRD)?

    <p>A family history of ADRD (B)</p> Signup and view all the answers

    Why is it useful for caregivers to know more about the person with dementia?

    <p>To build relationships and provide personalized care. (C)</p> Signup and view all the answers

    What is the typical progression of ADRD described as?

    <p>A series of three clear stages (B)</p> Signup and view all the answers

    What is a critical responsibility of Health Care Assistants (HCAs) to ensure a safe environment for clients with conditions like vascular dementia?

    <p>Minimizing hazards such as blocked pathways. (C)</p> Signup and view all the answers

    Vascular dementia is commonly caused by what type of interruption to the brain's blood supply?

    <p>Chronic, reduced blood flow to the brain, often due to strokes. (B)</p> Signup and view all the answers

    What are 'silent strokes' or TIAs, in the context of vascular dementia?

    <p>Strokes so small that they are often not immediately noticeable. (A)</p> Signup and view all the answers

    How does vascular dementia typically progress?

    <p>A stepwise decline with periods of stability followed by further decline. (B)</p> Signup and view all the answers

    Which of the following is NOT identified as a direct cause of vascular dementia?

    <p>Vitamin deficiency (B)</p> Signup and view all the answers

    Which of the following symptoms is MOST characteristic of vascular dementia, particularly after a stroke or TIA?

    <p>Sudden confusion (A)</p> Signup and view all the answers

    Which of the following is a typical physical sign associated with vascular dementia, particularly after a stroke?

    <p>Weakness or paralysis on one side of the body (B)</p> Signup and view all the answers

    What is a key aspect of managing vascular dementia, given that there is no known cure?

    <p>Preventing strokes through practical strategies and lifestyle changes. (C)</p> Signup and view all the answers

    Which of the following is NOT a typical method to honor a person's individuality when they have dementia?

    <p>Administering cognitive tests to monitor deterioration. (A)</p> Signup and view all the answers

    Which of the following factors are associated with a higher risk of developing dementia?

    <p>Older age, specific genetic factors, and chronic brain inflammation. (C)</p> Signup and view all the answers

    Which of the following best describes a common early sign of Alzheimer's?

    <p>Forgetting recent events and struggling with conversations or names. (B)</p> Signup and view all the answers

    Which of the following are considered typical behavioral symptom of dementia?

    <p>Increased agitation, wandering, and inappropriate social behavior. (B)</p> Signup and view all the answers

    Which symptom is most directly related to 'sundowning'?

    <p>Increased confusion and agitation in the evening. (A)</p> Signup and view all the answers

    Which communication challenge is NOT mentioned as a common problem for people with ADRD?

    <p>Enhanced verbal communication abilities. (B)</p> Signup and view all the answers

    When supporting a client with ADRD, what does not contribute to improved interaction?

    <p>Avoiding eye contact to reduce overstimulation. (B)</p> Signup and view all the answers

    What is a key aspect of person-centered care for someone with Alzheimer's disease?

    <p>Considering the person's history, preferences and emotional state. (A)</p> Signup and view all the answers

    Which of the following is NOT a core characteristic of Dementia with Lewy Bodies (DLB)?

    <p>Consistent memory loss, more pronounced than in early Alzheimers (C)</p> Signup and view all the answers

    What is the underlying cause of symptoms in Dementia with Lewy Bodies (DLB)?

    <p>Accumulation of Lewy bodies in specific brain areas. (A)</p> Signup and view all the answers

    Why is diagnosing DLB often a challenge for physicians?

    <p>Its' symptoms overlap with those of Parkinson’s and Alzheimer’s diseases. (C)</p> Signup and view all the answers

    What is the most common way DLB develops in people?

    <p>DLB typically occurs sporadically with no known family history of the disease. (A)</p> Signup and view all the answers

    Which symptom is most specifically associated with DLB and is less common in Alzheimer's disease?

    <p>Frequent visual hallucinations. (C)</p> Signup and view all the answers

    Which of the following is NOT considered a typical communication challenge for someone with DLB?

    <p>Consistent and predictable difficulty in understanding complex instructions, even in early stages. (B)</p> Signup and view all the answers

    Which is the recommended approach when communicating with someone experiencing hallucinations due to DLB?

    <p>Acknowledge the hallucinations calmly but gently redirect their focus to the present. (A)</p> Signup and view all the answers

    Which of these is a motor symptom associated with DLB?

    <p>Muscle rigidity, slowed movement, tremors, and a shuffling gait. (D)</p> Signup and view all the answers

    Which communication approach is most suitable for patients with severe language deficits?

    <p>Focus on non-verbal cues and visual aids to facilitate understanding. (C)</p> Signup and view all the answers

    What is a crucial care priority for HCAs when working with patients with dementia?

    <p>Maintain structure and routine to reduce behavioral triggers. (D)</p> Signup and view all the answers

    Which of the following is a known cause of secondary dementia?

    <p>The physical effects of a disease process or injury. (B)</p> Signup and view all the answers

    How does Parkinson's Disease Dementia (PDD) typically develop in relation to motor symptoms?

    <p>PDD develops after motor symptoms have been present for some years. (A)</p> Signup and view all the answers

    What is the key difference between Parkinson's Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB)?

    <p>In PDD, motor symptoms occur first, while in DLB, cognitive symptoms appear earlier or concurrently. (C)</p> Signup and view all the answers

    What causes Creutzfeldt-Jakob Disease (CJD)?

    <p>Prions, which trigger normal proteins in the brain to fold abnormally. (B)</p> Signup and view all the answers

    What is a characteristic of the later stages of Creutzfeldt-Jakob Disease (CJD)?

    <p>A mute, rigid state, potentially comatose. (C)</p> Signup and view all the answers

    What is the typical progression of Creutzfeldt-Jakob Disease (CJD) once symptoms become noticeable?

    <p>The disease is often rapidly fatal. (B)</p> Signup and view all the answers

    What is the typical survival timeframe for a patient diagnosed with Creutzfeldt-Jakob Disease (CJD)?

    <p>Roughly 1 year from the onset of symptoms (B)</p> Signup and view all the answers

    What is a primary focus for HCAs when caring for a patient with rapidly progressing Creutzfeldt-Jakob Disease (CJD)?

    <p>Maintaining safety, providing comfort, and supporting the family (C)</p> Signup and view all the answers

    What causes Substance-Induced Persisting Dementias?

    <p>Long-term cognitive impairments due to chronic substance abuse or toxic substance exposure (B)</p> Signup and view all the answers

    Which vitamin deficiency is primarily associated with Wernicke-Korsakoff Syndrome (WKS)?

    <p>Vitamin B1 (D)</p> Signup and view all the answers

    What is a characteristic symptom of the acute phase of Wernicke’s Encephalopathy?

    <p>Unsteady gait and difficulty walking (D)</p> Signup and view all the answers

    Which term describes the action of fabricating memories to fill gaps in memory, often seen with Korsakoff Syndrome?

    <p>Confabulation (B)</p> Signup and view all the answers

    What is a significant difference between Wernicke's encephalopathy and Korsakoff syndrome?

    <p>Wernicke's encephalopathy is an acute and potentially reversible condition, often leading to Korsakoff syndrome which is chronic. (C)</p> Signup and view all the answers

    Which symptom is most prevalent with Korsakoff syndrome?

    <p>Inability to make new memories (B)</p> Signup and view all the answers

    Flashcards

    Secondary Dementia

    Dementia that develops as a result of another medical condition or injury. Examples include dementia caused by head trauma or HIV infection.

    Primary Dementia

    Dementia that is not a result of another condition. For example, Alzheimer's disease.

    ADRD

    Alzheimer's disease and related dementias, affecting over 64% of Canadians with dementia.

    Alzheimer's Disease

    Characterized by plaques and tangles in the brain. There is no cure, but medications can slow its progression.

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    Mild Neurocognitive Disorder

    The first stage of ADRD, characterized by mild memory loss, difficulty with tasks, and language problems.

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    Major Neurocognitive Disorder

    The more advanced stage of ADRD, characterized by significant memory loss, disorientation, and personality changes.

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    Loss of Initiative

    Losing interest in activities, friends, and family. It could indicate a change in personality or behavior.

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    Problems with Abstract Thinking

    Cognitive challenges include difficulty understanding numbers, using calculators, or recognizing medical emergencies.

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    Person-centered Care

    A person with Alzheimer's disease should be treated as an individual with unique preferences, history, and feelings.

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    Simple Communication

    A helpful communication strategy involves using clear, simple language and short sentences for individuals with Alzheimer's disease.

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    Early Signs of Alzheimer's

    Signs of Alzheimer's disease may include initial forgetfulness, trouble with daily activities, and difficulty finding words.

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    Communication Challenges

    Communication challenges in Alzheimer's can include difficulty finding words, understanding conversations, and repeating questions.

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    Causes of Alzheimer's Disease

    Factors influencing the development of Alzheimer's include genetics, age, lifestyle, and brain changes.

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    Symptoms of Alzheimer's Disease

    Symptoms of Alzheimer's can include impaired judgment, difficulty learning new information, and changes in sleep patterns.

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    Supporting Individuals with ADRD

    Techniques to support individuals with Alzheimer's disease include using clear language, maintaining eye contact, and providing non-verbal cues.

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    Vascular Dementia

    A common dementia type caused by reduced blood flow to the brain, often due to strokes, leading to gradual cognitive decline.

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    Silent Strokes

    Small, silent strokes that may not cause noticeable symptoms but contribute to brain damage over time.

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    Small Vessel Disease

    A type of vascular dementia caused by narrowing of blood vessels in the brain, impacting blood flow.

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    TIAs (Transient Ischemic Attacks)

    Temporary blood flow disruptions to the brain, often a precursor to stroke, causing brief neurological symptoms.

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    Atherosclerosis

    Atherosclerosis is characterized by the buildup of plaque inside arteries, narrowing them and potentially blocking blood flow.

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    Stepwise Progression

    A hallmark of vascular dementia, this refers to a step-by-step progression of cognitive decline, with periods of stability followed by deterioration.

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    Slowed Thinking

    The ability to think clearly and solve problems, affected by vascular dementia, causing slowed response times and difficulty with complex tasks.

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    Weakness or Paralysis

    A common symptom of vascular dementia, particularly following a stroke, where one side of the body experiences weakness or paralysis.

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    What is Dementia with Lewy Bodies (DLB)?

    A brain disorder characterized by progressive cognitive decline, fluctuating alertness, visual hallucinations, and Parkinson's disease-like motor symptoms.

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    What are Lewy bodies?

    Abnormal protein deposits found in the brains of people with DLB, Parkinson's disease, and Alzheimer's disease.

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    What is the typical cause of DLB?

    DLB usually develops without a family history, but a genetic link to dementia or Parkinson's disease might increase the risk.

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    What is a common symptom of DLB?

    Frequent, detailed hallucinations of people or animals, often occurring early in the disease.

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    What are Parkinsonism symptoms in DLB?

    Slowed movement, muscle stiffness, tremors, and a shuffling gait, similar to Parkinson's disease.

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    What is a hallmark symptom of DLB?

    Fluctuations in awareness and alertness, including drowsiness, lethargy, and periods of staring into space.

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    How can you support someone with DLB?

    Adapt communication based on the patient's changing abilities. Acknowledge hallucinations and gently redirect focus.

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    Why is diagnosing DLB difficult?

    The symptoms of DLB can overlap with Alzheimer's disease and Parkinson's disease, making diagnosis challenging.

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    Parkinson's Disease Dementia (PDD)

    A type of dementia that affects people with Parkinson's disease, characterized by motor symptoms like tremors and stiffness followed by cognitive decline.

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    Prions

    Abnormal proteins that can cause normal proteins in the brain to fold abnormally, leading to brain damage and dementia.

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    Creutzfeldt-Jakob Disease (CJD)

    A rare, fatal brain disorder caused by prions, leading to rapid cognitive and motor decline.

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    Communication Approach for Severe Language Deficits

    A pattern of communication where non-verbal cues and visual aids are emphasized for people with significant language difficulties.

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    Care Priority: Structure and Routine

    Maintaining a structured environment and routines to reduce behavioral triggers in people with dementia.

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    Care Priority: Meaningful Engagement

    Offering opportunities for meaningful engagement to combat apathy and foster connection in individuals with dementia.

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    Difference between PDD and DLB

    The key difference between PDD and DLB is the order of symptom onset: PDD starts with motor problems, while DLB has cognitive symptoms first or concurrently.

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    Substance-Induced Persisting Dementias

    Cognitive impairment caused by prolonged substance abuse or exposure to toxic substances, even after stopping the substance use.

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    Wernicke-Korsakoff Syndrome (WKS)

    A severe thiamine deficiency (Vitamin B1) that causes neurological damage, often linked to chronic alcohol abuse.

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    Wernicke's Encephalopathy

    The acute phase of WKS characterized by confusion, unsteady gait, and eye problems.

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    Korsakoff Syndrome

    The chronic phase of WKS with persistent memory loss and inability to form new memories.

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    Anterograde Amnesia

    The inability to form new memories, a hallmark of Korsakoff Syndrome.

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    Confabulation

    The fabrication of memories to fill gaps in memory, often seen in Korsakoff Syndrome.

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    Wernicke's Encephalopathy Progression

    Untreated Wernicke's Encephalopathy progresses into Korsakoff Syndrome.

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    Study Notes

    Types of Dementia

    • Dementia is a general term for a disease or condition where dementia is the main illness.
    • Primary dementia does not result from any other disease.
    • Secondary dementia occurs as a result of a physical disease or injury.
    • ADRD is the most common form of dementia, accounting for over 64% of all dementias in Canada.
    • ADRD can be categorized as either minor or major neurocognitive disorder.
    • Dr. Alois Alzheimer identified Alzheimer's disease in 1906, noting plaques and tangles as distinguishing characteristics.
    • Currently, no cure exists, but some medications can slow its progression.
    • A family history of ADRD is a known risk factor.

    Warning Signs

    • Memory loss affecting daily abilities: forgetting things often or struggling to retain new information.
    • Difficulty performing familiar tasks: forgetting how to do everyday activities.
    • Difficulties with language: forgetting words or substituting words that don't fit.
    • Disorientation in time and space: not knowing the date or place.
    • Impaired judgment: not recognizing a medical issue or inappropriate clothing choices.
    • Problems with abstract thinking: not understanding concepts like numbers.
    • Misplacing things: putting objects in unusual places.
    • Changes in mood and behavior: sudden shifts from easygoing to quick-tempered.
    • Changes in personality: behaving differently than usual, for instance, feeling paranoid.
    • Loss of initiative: losing interest in activities and relationships.

    Tips from the Alzheimer's Society of Canada

    • Knowing more about a person with dementia helps staff understand their values, preferences, and life stories.
    • Support workers and staff can develop individualized care plans.

    Causes of Dementia

    • Genetic Factors: Inherited predisposition
    • Older Age: Increasing risk with advancing years
    • Lifestyle and Environmental Factors: Lifestyle choices affecting health
    • Brain Changes: Physical changes in brain structure and function
      • Plaques (protein buildup)
      • Tangles (protein fibers)
      • Chronic Brain Inflammation

    Signs of Dementia

    • Initially forgetting recent events, conversations, or names.
    • Trouble handling routine activities.
    • Increased agitation, wandering, or inappropriate social behavior.
    • Trouble finding the right words or forming sentences.

    Symptoms of Dementia

    • Impaired judgment and decision-making.
    • Difficulty learning new information or skills.
    • Repeated questioning.
    • Sundowning: increased confusion and agitation in the evening.
    • Loss of coordination and mobility in later stages.
    • Changes in sleep patterns, such as insomnia or excessive sleeping

    Specific Communication Challenges

    • Word-finding difficulties
    • Comprehension issues
    • Repetition
    • Agitation-triggered miscommunication
    • Non-verbal dependence
    • Progressive decline

    Supporting Clients with ADRD

    • Use simple, clear language and short sentences.
    • Maintain eye contact.
    • Employ nonverbal cues to aid comprehension.

    Key Takeaways about Dementia

    • Alzheimer's disease primarily affects memory, cognition, and behavior, leading to dependency on care.
    • Early recognition of signs and symptoms allows for more effective care routines.
    • Effective communication is vital for maintaining dignity and reducing agitation.
    • Person-centered care is crucial: acknowledging the patient's history, preferences, and emotional state.
    • HCAs should make the environment safe to prevent accidents or wandering.

    Vascular Dementia

    • A form of dementia resulting from reduced blood flow to the brain, often due to strokes or TIAs.
    • It leads to chronic reduced blood supply in the brain, causing progressively declining cognitive functions.
    • Causes include strokes, small vessel disease, TIAs, and atherosclerosis.
    • Symptoms can include slowed thinking and problem-solving, difficulty walking or balancing, frequent mood swings, and cognitive/physical abilities worsening after a stroke.

    Dementia with Lewy Bodies (DLB)

    • Progressive dementia characterized by fluctuating alertness/awareness, visual hallucinations, and parkinsonian motor symptoms.
    • Lewy Bodies accumulation of a protein inside brain regions affects memory and motor control.
    • Symptoms can include fluctuating levels of awareness, recurrent detailed visual hallucinations, Parkinsonism (slowed movement, tremors), and cognitive dysfunction.
    • Difficulties can include fluctuating awareness, difficulty with speech, and delusions.

    Frontotemporal Dementia (FTD)

    • Changes in personality and behavior are a major characteristic, which can include disinhibition, apathy, social withdrawal, mouthing of objects, and compulsive/ritualistic behaviors.
    • Frequently associated with memory problems in the earlier stages.
    • The front and side parts of the brain are affected by abnormal proteins, leading to personality, behavior, and language dysfunction.
    • Symptoms can include loss of social filters, apathy, compulsive behaviors, lack of empathy, and poor judgment.

    Substance-Induced Persistent Dementias

    • Long-lasting cognitive impairments following chronic substance abuse or exposure to toxic substances.
    • Problems are present even after stopping the substance.
    • These impair memory, thinking, and behavior.

    Wernicke-Korsakoff Syndrome (WKS)

    • Neurological disorder from thiamine (Vitamin B1) deficiency, often linked to chronic alcohol abuse.
    • Wernicke's encephalopathy (acute phase) presents with confusion, ataxia (unsteady gait), and eye problems.
    • Korsakoff's syndrome (chronic phase) is characterized by severe memory loss, fabrication of memories, and cognitive problems.
    • Treatment involves thiamine replacement along with nutrition and hydration.

    Other Causes of Secondary Dementia

    • Acquired Immune Deficiency Syndrome (AIDS)
    • Huntington's Disease
    • Multiple Sclerosis

    Parkinson's Disease Dementia (PDD)

    • Dementia develops after Parkinson's disease symptoms like tremors and stiffness.
    • Main difference with Lewy Body dementia is motor symptoms appearing first.

    Creutzfeldt-Jakob Disease (CJD)

    • Rare, degenerative, and fatal brain disorder caused by abnormal proteins (prions).
    • Rapidly fatal, involving brain damage affecting cognitive and motor functions.
    • Symptoms include balance issues, muscle stiffness, spasms, involuntary movements, leading to a comatose state.

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