Dementia: Definition and Types

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What characterizes dementia as a syndrome?

Acute confusion and disorientation

Temporary forgetfulness

An enhancement of learning capacity

A disturbance of multiple higher cortical functions (correct)

At what age group is the prevalence of dementia 1 in 20?

40 – 65

70 – 80 (correct)

80+

65 – 70

What does the national diagnostic rate of 62% represent?

The yearly increase in new dementia cases

The efficiency of dementia diagnosis relative to the benchmark (correct)

The number of diagnosed cases compared to potential cases

The percentage of diagnosed cases in the entire population

Which of the following terms is synonymous with dementia within the context of neurocognitive disorders?

Chronic cognitive decline Signup and view all the answers

Based on the content, how many subtypes of dementia have been identified?

200+ Signup and view all the answers

What is one of the criteria for diagnosing Vascular Dementia according to NINDS-AIREN?

Evidence of relevant cerebrovascular disease on CT/MRI Signup and view all the answers

Which feature is NOT typically associated with Dementia with Lewy bodies?

Gradual onset and progression Signup and view all the answers

According to the Lund-Manchester Criteria, which is an early sign of Frontotemporal Dementia?

Early decline in social interpersonal conduct Signup and view all the answers

Which of the following is a characteristic of the cognitive decline in Alzheimer's disease over time?

Gradual deterioration in cognitive functions Signup and view all the answers

What is one requirement for diagnosing Vascular Dementia after a stroke?

Onset of dementia within three months of stroke Signup and view all the answers

What is the primary function of episodic memory?

Remembering events and experiences Signup and view all the answers

Which of the following is NOT one of the 'Big Four' types of dementia?

Parkinson’s Disease Signup and view all the answers

What is a key characteristic of probable Alzheimer's Disease according to the NINCDS/ADRDA criteria?

Intact level of consciousness Signup and view all the answers

Which type of memory involves short-term retention and is critical for tasks like dual-task performance?

Working Memory Signup and view all the answers

What percentage of dementia cases are represented by Dementia of the Alzheimer’s type (DAT)?

62% Signup and view all the answers

Study Notes

Dementia: Definition and Prevalence

Dementia is a syndrome caused by brain disease, usually chronic or progressive.
It involves the disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning, language, and judgment.
Consciousness remains unaffected.
Cognitive impairment is often accompanied by deterioration in emotional control, social behavior, or motivation (WHO 1992, ICD-10).
Prevalence significantly increases with age: 1 in 1000 (40-65 years), 1 in 50 (65-70 years), 1 in 20 (70-80 years), and 1 in 5 (80+ years).
A 2022 national diagnostic rate for dementia was 62%, compared to a benchmark of 66.7%.

Types of Dementia

Alzheimer's Disease (AD) accounts for up to 62% of dementia cases.
Vascular Dementia (VaD) accounts for 17%.
Dementia with Lewy Bodies (DLB) accounts for 4%.
Frontotemporal Dementia (FTD) accounts for 10-15%.
Other types account for a small percentage (2-5%).

Diagnostic Criteria for Dementia Types

Alzheimer's Disease: Uses NINCDS/ADRDA criteria, including dementia, gradual progression, intact consciousness, onset after age 40, and absence of other causes.
Vascular Dementia: Uses NINDS-AIREN criteria, requiring dementia, cerebrovascular disease, focal stroke signs, impairment in memory and one other cognitive domain, and evidence of relevant cerebrovascular disease (CT/MRI).
Dementia with Lewy Bodies: Requires progressive cognitive decline and two of the following: fluctuating cognition, recurrent visual hallucinations, or spontaneous motor features of Parkinsonism. Supportive features include falls, syncope, neuroleptic sensitivity, paranoid delusions, and other hallucinations.
Frontotemporal Dementia: Uses Lund-Manchester criteria, requiring insidious onset, gradual progression, early decline in social conduct, impairment in personal conduct regulation, emotional blunting, and loss of insight.

Cognitive Decline in Alzheimer's Disease

Cognitive decline in AD progresses over time, impacting memory, judgment, personality, sleep, and eventually leading to loss of reasoning and physical function.
Progression can take 4-8 years or even up to 20 years.
A model by Sperling et al. (2011) outlines the preclinical stages of AD

Causes of Dementia

Biological factors: include genetic predisposition (chromosomes linked to dementia) and altered brain pathology affecting various lobes (frontal, parietal, temporal, occipital) impacting cognitive functions like planning, language, memory, perception, and attention.
Psychosocial factors: encompass "malignant social psychology," including intimidation, disempowerment, and other negative interactions that detract from psychological needs like comfort, occupation, identity, inclusion, and attachment (Kitwood, 1997).
Environmental factors: lifestyle choices (alcohol, smoking, diet) and physical environment (floor patterns, lighting, overstimulation) may play a role.

Therapeutic Implications

Prevention of dementia onset is crucial.
Strategies to slow progression are important.
Effective management of symptoms and slowing decline are key therapeutic goals.

Case Study: Diane Mensha

75-year-old woman who got lost and forgot her way home, highlighting the impact of dementia on daily life and the need for medical intervention.

Memory Types

Different types of memory are affected in dementia, including perceptual representation memory, working memory (short-term memory), semantic memory (facts and knowledge), episodic memory (events and experiences), and procedural memory (motor and cognitive skill learning). There is interplay between these types.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the definition and prevalence of dementia, a syndrome characterized by cognitive decline. It also explores different types of dementia, including Alzheimer's Disease, Vascular Dementia, and Frontotemporal Dementia. Test your knowledge on the various forms and statistics related to this condition.