46 Questions
What percentage of dementia cases are caused by Alzheimer's disease?
60-70%
What is the primary goal of the World Health Organization's Integrated Care for Older People (ICOPE) guidelines?
To prioritize cognitive decline in older adults
What led to Daphne's relapse of depressive illness?
Tom's diagnosis of Alzheimer's disease and associated carer stress
What type of assessment is recommended for older adults identified as living with frailty?
Comprehensive geriatric assessment (CGA)
What was the outcome of Daphne's relapse of depressive illness?
She was admitted to a psychiatric hospital
What triggered Tom's hospital admission?
A fall and associated injury
What is a characteristic of REM sleep behavior disorder in people with Lewy body dementia?
They move, make gestures, and/or speak during REM sleep
Which part of the brain is related to language in frontotemporal dementia?
Left frontal lobe
What is the average lifespan from the onset of symptoms for frontotemporal dementia?
6-8 years
What is a common complication of frontotemporal dementia when associated with ALS?
A shorter lifespan of around 2 years
What is the name of the disease that causes memory loss, uncontrolled body movements, and mood and behavior changes?
Huntington's disease
What is the name of the condition that affects balance, movement, vision, speech, and swallowing?
Progressive supranuclear palsy
What is the most common combination of dementias in mixed dementia?
Alzheimer's disease and vascular dementia
Which age group is most affected by mixed dementia?
People over 75
What is the term for the death of brain cells and atrophy or shrinkage of the cerebral cortex and basal ganglia?
Corticobasal degeneration
What is the name of the disease that causes nerve cell death and atrophy or shrinkage of the cerebral cortex and basal ganglia?
Corticobasal degeneration
What percentage of Tom's income and assets were diverted to fund his nursing home care?
Eighty percent
What is the projected cost of dementia globally by 2030?
$2 trillion
What is the primary way to differentiate between the different forms of dementia?
Clinical evaluation
What is the defining pathologic hallmark of Alzheimer's disease?
Tangles and plaques in the brain
Which part of the brain is affected first by Alzheimer's disease?
Hippocampus
What is the primary difference between dementia with Lewy bodies and Parkinson's disease dementia?
Timing of dementia onset
Which symptom is a primary distinguishing feature of Lewy body dementia?
Visual hallucinations
What is the most common cause of dementia in older adults after Alzheimer's disease and vascular dementia?
Lewy body dementia
What is the primary risk factor for developing Lewy body dementia?
Old age
What is a common cognitive feature of Lewy body dementia?
Fluctuating cognition
What is the primary cause of cognitive impairment in Normal Pressure Hydrocephalus?
Build-up of cerebrospinal fluid in the brain's ventricles
What is the recommended approach to obtain a comprehensive picture of cognitive impairment?
Using cognitive tests and information from a caregiver or spouse
What is the percentage of the world's elderly population affected by dementia in 2015?
5%
What is the primary goal of a comprehensive geriatric assessment?
To formulate a comprehensive management plan
What is the recommended approach to diagnosing dementia?
Conducting a comprehensive medical history and cognitive assessment
What is the primary benefit of using a selective serotonin reuptake inhibitor (SSRI) in Ahmed's treatment?
Improvement in mood
What is the recommended approach to managing Ahmed's care after his fall?
Referring him to a memory clinic for further evaluation
What is the primary goal of the MMSE test?
To assess cognitive impairment
What is the primary risk factor for cognitive impairment in Ahmed's case?
Cerebrospinal fluid build-up in the brain's ventricles
What is the primary purpose of a Zarit Burden interview?
To evaluate the caregiver's burden
What is the significance of a patient's companion providing their medical history?
It suggests memory impairment.
What is the characteristic progression of neurodegeneration?
Delayed onset and advancement.
What is the purpose of evaluating all prescription, over-the-counter, and non-traditional drugs?
To identify potential causes of dementia.
What is the significance of vascular disease risk factors in the medical history?
They are a risk factor for cerebrovascular disease.
What is the purpose of the cognitive assessment?
To determine the severity and type of cognitive impairment.
What is the significance of unusual behaviors in the neurological assessment?
They are a sign of frontotemporal dementia.
What is the purpose of laboratory testing in the diagnosis of dementia?
To rule out other potential causes of dementia.
What is the significance of a history of cognitive decline in highly educated, high-functioning people?
It may be a sign of dementia despite normal results on a short screening cognitive test.
What is the purpose of functional neuroimaging, such as positron emission tomography (PET)?
To show changes that point to Alzheimer's disease.
What is the significance of amyloid PET in the diagnosis of Alzheimer's disease?
It is a highly sensitive and specific test for Alzheimer's disease.
Study Notes
Dementia: Definition and Impact
- Dementia is a syndrome characterized by progressive cognitive impairment affecting functional abilities, memory, personality, communication, and spatial awareness.
- It impairs functional abilities, causes behavioral and psychological problems, and may cause mood and personality changes.
- Alzheimer's disease causes 60-70% of dementia cases.
Types of Dementia
- Alzheimer's disease: characterized by plaques and tangles in the brain, leading to nerve cell death and brain shrinkage.
- Lewy body dementia: characterized by parkinsonism, cognitive impairment, and visual hallucinations.
- Frontotemporal dementia: affects behavior and language, causing changes in personality, behavior, and language.
- Mixed dementia: a combination of two or more types of dementia, such as Alzheimer's disease and vascular dementia.
Dementia Epidemiology and Cost
- Around 47 million people worldwide had dementia in 2015, which is 5% of the world's elderly population.
- The global cost of dementia was estimated to be $818 billion in 2015, which is 1.1% of the global GDP.
Diagnosis and Management of Dementia
- Dementia cannot be diagnosed with a single test; it requires a combination of medical history, cognitive and neurological assessment, and laboratory testing.
- Cognitive assessment tools include AD8 screening, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Addenbrooke's Cognitive Examination-III (ACE-III).
- Neurological assessment looks for signs of neurocognitive problems, such as aphasia, apraxia, and agnosia.
- Laboratory testing includes blood tests, such as B12 and thyroid stimulating hormone (TSH), and imaging tests, such as MRI or CT scans.
Advanced Diagnostic Techniques
- Functional neuroimaging, such as positron emission tomography (PET), can show changes indicating Alzheimer's disease.
- Specific tracers for amyloid (amyloid PET) are highly sensitive and specific for Alzheimer's disease.
- Lumbar puncture can detect amyloid beta 42 and tau in the cerebrospinal fluid (CSF), aiding in the diagnosis of early Alzheimer's disease.
- Research is ongoing for the development of blood tests to detect early markers of Alzheimer dementia.
This quiz assesses your understanding of dementia, a syndrome characterized by progressive decline in cognitive function, and its symptoms. Learn about the impact of Alzheimer's disease on dementia cases and the importance of identifying frailty in older adults.
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