Dementia: Definition and Types
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Questions and Answers

What defines dementia in terms of cognitive functioning?

  • Only short-term memory is affected.
  • Consciousness is usually clouded.
  • It includes disturbances in multiple higher cortical functions. (correct)
  • Emotional disturbances are the main symptoms.
  • What is the prevalence of dementia for individuals aged 80 and above?

  • 1 in 10
  • 1 in 5 (correct)
  • 1 in 20
  • 1 in 50
  • According to the information, how many subtypes of dementia are estimated to exist?

  • Around 100 subtypes
  • About 10 subtypes
  • Approximately 70 subtypes
  • Over 200 subtypes (correct)
  • What was the national diagnostic rate for dementia recorded on 31st July 2022?

    <p>62%</p> Signup and view all the answers

    What is a common misconception about dementia?

    <p>It only affects older adults.</p> Signup and view all the answers

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

    <p>After age 40</p> Signup and view all the answers

    Which type of memory is responsible for recalling facts and general knowledge?

    <p>Semantic memory</p> Signup and view all the answers

    What percentage of dementia cases does Vascular Dementia account for according to the Dementia UK Report (2007)?

    <p>17%</p> Signup and view all the answers

    Which of the following criteria is an alternative diagnostic criterion for Frontotemporal Dementia (FTD)?

    <p>Lund-Manchester criteria</p> Signup and view all the answers

    Which type of memory is associated with motor and cognitive skill learning?

    <p>Procedural memory</p> Signup and view all the answers

    Study Notes

    Dementia: Definition and Types

    • Dementia is a syndrome caused by brain disease, usually chronic or progressive.
    • It affects multiple higher cortical functions: 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).
    • Many subtypes exist (70+, 100+, 200+ reported in different studies).
    • Different types of memory are impacted: perceptual representation, working memory, semantic memory, episodic memory, and procedural memory.
    • The "Big Four" dementia types are: Alzheimer's Disease (AD), Vascular Dementia (VaD), Dementia with Lewy Bodies (DLB), and Frontotemporal Dementia (FTD).
    • Diagnostic criteria vary depending on the type of dementia, with preferred criteria differing from those used in ICD and DSM systems.

    Dementia Prevalence and Statistics

    • Prevalence rates increase significantly with age.
    • Rates are: 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 study showed a national diagnostic rate of 62% versus a benchmark rate of 66.7%.
    • Dementia UK (2007) reported the following percentages for dementia types: DAT (62%), VaD (17%), DLB (4%), FTD (10-15%), and others (2-5%).

    Alzheimer's Disease (AD)

    • Characterized by dementia, gradual progression, intact consciousness, onset after age 40, and absence of other causes (NINCDS/ADRDA criteria).
    • Cognitive decline progresses over time.

    Vascular Dementia (VaD)

    • Involves dementia, cerebrovascular disease, focal stroke signs, impairment of memory and at least one other cognitive domain, and evidence of relevant cerebrovascular disease (NINDS-AIREN criteria).
    • Onset often within three months of a stroke, or may present with abrupt deterioration or fluctuating, stepwise progression.

    Dementia with Lewy Bodies (DLB)

    • Features progressive cognitive decline impacting daily functioning.
    • Requires two of the following: fluctuating cognition, recurrent visual hallucinations, spontaneous Parkinsonism motor features.
    • Supportive features include: falls, syncope, neuroleptic sensitivity, paranoid delusions, and hallucinations in other modalities (McKeith et al., 1996).

    Frontotemporal Dementia (FTD)

    • Characterized by insidious onset, gradual progression, early decline in social conduct, impairment in self-regulation, emotional blunting, and early loss of insight (Lund-Manchester criteria).

    Dementia Progression and Outcomes

    • Progression stages include mild, moderate, and severe, with a typical lifespan of 4-8 years (though it can be up to 20).
    • Death often results from pneumonia or other comorbidities.

    Dementia: Causes and Models

    • Causes include biological factors (chromosomes, altered brain pathology), psychosocial factors (malignant social psychology), and environmental factors (lifestyle, physical environment).
    • Kitwood's (1997) model emphasizes psychological needs: comfort, occupation, attachment, identity, and inclusion.
    • "Malignant social psychology" describes harmful behaviors and attitudes that negatively impact people with dementia.

    Therapeutic Implications

    • Focus on prevention of onset, slowing progression, and treating symptoms to manage decline. Prevention is emphasized.

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