Dementia

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Questions and Answers

What is the primary goal of cognitive stimulation therapy for dementia patients?

To achieve set cognitive goals (correct)

To reduce medication side effects

To improve physical health

To prevent protein buildup in the brain

Which type of dementia is the most common?

Alzheimer's disease (correct)

Lewy body dementia

Frontotemporal dementia

Vascular dementia

What is a common cause of dementia related to protein buildup in the brain?

Severe head trauma

Chronic inflammation

Abnormal deposits of amyloid and tau (correct)

Increased blood flow to the brain

What medication is given to patients with severe Alzheimer's who cannot tolerate acetylcholinesterase inhibitors?

Memantine Signup and view all the answers

What effect does Donepezil have on the brain?

Slows down the breakdown of acetylcholine Signup and view all the answers

How many sessions of cognitive stimulation therapy do patients usually attend?

14 or more Signup and view all the answers

What is a potential side effect of using Memantine?

Headaches Signup and view all the answers

What happens to nerve cells in the brain when proteins build up abnormally?

They begin to die Signup and view all the answers

What is the primary role of acetylcholine in the brain?

To send messages between brain cells Signup and view all the answers

Which of the following describes the state of brain cells in individuals with Alzheimer's disease?

Brain cells are damaged and killed Signup and view all the answers

What are the possible side effects of Donepezil treatment?

Trouble sleeping and nausea Signup and view all the answers

What characterizes vascular dementia?

Caused by blockages or reduced blood flow to the brain Signup and view all the answers

What is one of the benefits of reminiscence therapy for dementia patients?

Improves cognitive functioning Signup and view all the answers

Why is early dental intervention important for dementia patients?

It allows for early detection and treatment of issues Signup and view all the answers

How does cognitive decline in dementia patients affect dental procedures?

Makes procedures less tolerable Signup and view all the answers

What challenge might arise from cognitive decline in dementia patients during dental visits?

Inability to recognize dental equipment Signup and view all the answers

What might patients face when dealing with particular teeth as dementia progresses?

Declining communication abilities affecting care Signup and view all the answers

How might advancing dementia symptoms affect dental appliances like dentures?

Lead to misplacement and frustrations Signup and view all the answers

What can result from a patient's inability to cope with dental appointments due to dementia?

Need for sedation if special care is delayed Signup and view all the answers

What principle does the Mental Capacity Act 2005 establish regarding decision making?

Patients are presumed to have decision-making capacity Signup and view all the answers

What difficulties might arise during dental appointments for patients with dementia?

Distress or confusion due to unfamiliarity Signup and view all the answers

What is a potential consequence of long waiting lists for special care dentistry?

Higher likelihood of requiring sedation Signup and view all the answers

Why is it important to consider the implications of different stages of dementia for dental care?

Patients may require varying levels of support Signup and view all the answers

What association has been shown regarding periodontal disease?

It is associated with Alzheimer's disease Signup and view all the answers

Study Notes

Dementia Definition and Cause

Dementia is a general term for conditions impacting nerve cells and their connections in the brain.
It involves significant loss of cognitive functions (thinking, remembering, reasoning).
It disrupts daily life and activities.
Dementia isn't a single disease but a collection of diseases.
Many types involve abnormal protein buildup in the brain, such as amyloid plaques and tau tangles (common in Alzheimer's).
Build-up causes nerve cells to function poorly.
Nerve cell death leads to brain shrinkage.
Reduced neurotransmitters (e.g., acetylcholine) affect communication between brain cells.
Vascular dementia is linked to reduced blood flow damaging brain cells due to narrowed or blocked blood vessels, or a single stroke.
Alzheimer's disease, is the most common type and is caused by abnormal build-up of amyloid and tau proteins.

Treatment

Cognitive stimulation therapy/rehabilitation helps patients improve memory, language, and problem-solving skills.
This involves group activities with professionals, typically 14+ 1-hour sessions for mild or moderate dementia.
Medication:
- Memantine: for patients who can't tolerate acetylcholinesterase inhibitors; it prevents excessive glutamate effects and is suitable for moderate/severe Alzheimer's.
- Donepezil: a type of acetylcholinesterase inhibitor that slows down a chemical breakdown of acetylcholine used in treatment of Alzheimer's symptoms; side effects include trouble sleeping, nausea, and appetite changes.

Reminiscence Therapy

Structured or unstructured therapy method involving props and discussion of past events.
Benefits may include improved cognition, reduced depression, and improved mood.

Dementia and Dental Implications

Dementia can make dental procedures less tolerable, and stages of progression significantly impact tolerance.
Requires varying support levels for dental hygiene, from prompting to full support.
As dementia worsens, communication skills decrease.
Misplacement of dental appliances, like dentures, may result in difficulty eating and communicating
A decline in patient's behavior, like frustration and discomfort.
The Mental Capacity Act 2005 states that everyone should be presumed capable of making decisions, including accepting or refusing medical treatment.
Periodontal disease and Alzheimer's disease may be linked in some studies (Kamer et al., 2020).
Early dental appointments are advised after diagnosis for prevention and early intervention as dementia progresses.
Complications (e.g., premature extractions) may arise as patients' capabilities change.
Patients in later stages can be distressed or confused during a dental visit.
Possible referrals to special care dentistry, but waitlists can lead to sedation.
Lasting power of attorney holders can make decisions for patients lacking capacity.
Out-patient dental services in care facilities are a viable option.

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