Dementia and Cognitive Communication

Study Notes

Acquired global loss of brain function, slow onset
Caused by various diseases, not a disease itself
DSM-5 defines dementia as memory loss and deficits in verbal/written communication, object recognition, motor skills, abstract thought, and complex task execution.
Not due to delirium or another mental disorder.

Assess and treat cognitive-communication deficits arising from dementia or related illnesses.
Diagnose and treat cognitive, communication, and swallowing problems.

Changes in cognition significant enough to be outside the typical aging range but not severe enough to interfere with daily activities (ADLs).
Symptoms include decreased concentration, word-finding difficulties, short-term memory problems, and inability to follow detailed conversations.

Language remains largely intact, with minor declines in word-finding abilities.
Attention is mostly stable, with some decline in selective attention and divided attention abilities, especially in complex tasks.
Long-term and procedural memory are unaffected; episodic and short-term memory may be slightly reduced.

Degenerative frontal and temporal lobes.
Includes Pick's disease, progressive nonfluent aphasia, and semantic dementia.
Initial symptoms are predominantly language deficits, progressing to include cognitive decline.

Language deficits are the initial and main symptoms, occurring before broader cognitive decline.
Typically diagnosed before age 65; life expectancy is 7-10 years.
Characterised by changes in motor skills, episodic memory, behaviour, and personality.
PPA has three variants.

Progressive degeneration of frontal and temporal lobes.
Characterized by personality changes, inappropriate social behavior, and memory problems that do not involve language deficits.

Subcortical dementia, progressive, and terminal.
Defined by involuntary, erratic movements (chorea).
Can cause changes to personality, cognition, language, and emotional well-being.

Mixed dementia caused by small strokes in the brain, affecting multiple cognitive domains like memory, language, and executive functioning.
Symptoms include aphasia, apraxia and difficulties with planning.

Neuropathological changes due to Lewy bodies in neurons (cell body).
Subcategorized as Parkinson's disease and dementia with Lewy bodies.
Parkinson's disease: motor issues (rigidity, tremors, slow movements), cognitive deficits, and in some cases problems with swallowing or speech.

Arizona Battery for Communication Disorders of Dementia: to improve quality of life.
Cognitive Stimulation: Improved cognitive skills and quality of life.
Reality Orientation Therapy: Engaging individuals with their immediate surroundings and current situations to improve context.
Validation Therapy: Validate the individual's feelings and experiences, even if the feelings do not make logical sense to an outside observer.
Reminiscence Therapy: Semi-cued conversations about past events and experiences to increase orientation and recall.
External memory aids: tools that aid in retaining factual information.

Modifiable risk factors including diabetes management, cholesterol control, smoking cessation, physical activity, alcohol moderation, and preventing head injuries.

Brief Cognitive Status Exam (BCSE): assess global cognitive functioning.
Quick Cognitive Functioning Screener.
Standardized Mini-Mental State Examination (MMSE): evaluates cognitive impairment.
Family Confusion Assessment Method (FAM-CAM): used to assess everyday cognitive skills.
Everyday Memory Survey (EMS): evaluates memory function in daily living situations.