Dementia Syndrome Overview (L.5.10)

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Questions and Answers

What is a defining characteristic of dementia syndrome?

Sudden cognitive decline due to a single traumatic event

Substantial cognitive decline from a previous level of performance (correct)

Cognitive deficits must occur in the context of delirium

Cognitive deficits are solely attributable to another mental disorder

Which age group has a prevalence of dementia syndrome of 5-7%?

60 years and older (correct)

40-49 years

30-39 years

50-59 years

During which stage of Alzheimer's disease do neuropsychiatric symptoms such as visual hallucinations typically emerge?

Final, severe stage

Initial, mild stage

Pre-diagnostic stage

Moderate stage (correct)

What occurs during the final, severe stage of Alzheimer's disease?

Motor rigidity and prominent cognitive decline are present Signup and view all the answers

What is the recommended specialist for the investigation if dementia syndrome is suspected?

Neurologist, Psychiatrist, Geriatrician Signup and view all the answers

What is a key feature of the clinical course of late-onset dementia?

Worsening motor function over time Signup and view all the answers

What is the estimated number of individuals worldwide with dementia as of 2017?

Approximately 50 million Signup and view all the answers

What is a common behavioral issue that appears during the moderate stage of Alzheimer's disease?

Reversal of sleep patterns Signup and view all the answers

What is the primary purpose of assessing regional cerebral blood flow (CBF) in diagnosing Alzheimer’s Disease (AD)?

To compare with normal aging patterns Signup and view all the answers

Which diagnostic tool is primarily used to evaluate cognitive functions in patients suspected of having dementia?

Clock drawing test (CDT) Signup and view all the answers

Which of the following treatments focuses on increasing cholinergic synaptic transmission?

Cholinergic augmentation therapy Signup and view all the answers

What is a common feature of neuropathology in Alzheimer’s Disease?

Amyloid plaques and neurofibrillary tangles Signup and view all the answers

What role does simplification of the patient’s environment play in dementia care?

Facilitates orientation and safety Signup and view all the answers

Which of the following is NOT part of the laboratory tests for dementia assessment?

Electrocardiogram (ECG) Signup and view all the answers

Which technique shows higher diagnostic accuracy when assessing abnormalities associated with dementia?

Longitudinal assessment Signup and view all the answers

Which approach is recommended for family support in dementia care?

Provide educational resources and group therapy Signup and view all the answers

Study Notes

Definition of Dementia

Dementia is a neurocognitive disorder characterized by significant cognitive decline in one or more areas: complex attention, executive function, learning and memory, language, perceptual-motor skills, praxis, and social cognition.
Cognitive deficits must interfere with the ability to perform daily living activities independently.
Symptoms must not occur in the context of delirium or be attributed to another mental disorder.

Prevalence of Dementia

Prevalence in individuals aged 60 years and older is approximately 5-7%.
One in five individuals aged 85 and older has dementia.
In Europe, around 5 million people are affected by dementia.
Globally, approximately 50 million people were reported to have dementia in 2017.

Causes of Dementia

Numerous potential causes lead to chronic cognitive impairment with variations in pathology and presentation.

Clinical Course of Dementia

Dementia can be classified into two types: early onset (before 65 years, rare) and late onset (after 65 years, more common).
Key features include short-term memory impairment (later affecting long-term memory), increasing dependence, declining motor function, and behavioral issues.

Stages of Alzheimer's Disease

Mild Stage: Lasts 2-3 years; characterized by short-term memory loss and anxiety/depression symptoms.
Moderate Stage: Symptoms may improve gradually, but neuropsychiatric manifestations like visual hallucinations and sleep pattern changes emerge.
Severe Stage: Motor rigidity and substantial cognitive decline are evident; linear decline across stages occurs with caregiver burden peaking when neuropsychiatric symptoms appear.

Investigation for Suspected Dementia

A comprehensive evaluation includes assessments by neurologists, psychiatrists, and geriatricians.
Physical Assessment: Thorough examination required.
Laboratory Tests: Essential tests include complete blood count, liver enzymes, renal function tests, thyroid assessment, glucose, calcium, Vitamin B12, and folic acid levels.
Instrumental Investigations: CT scans may reveal various abnormalities; MRI may correlate with dementia severity. PET and SPECT are used for assessing cerebral blood flow changes.
Cognitive Function Assessment: Tools such as the Clock Drawing Test (CDT), Mini-Mental State Examination (MMSE), and the Blessed Dementia Scale are utilized.
Evaluation of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) as well as co-morbidities are critical for comprehensive assessment.
Neuropathology: Key signs include amyloid plaques and neurofibrillary tangles, with loss of specific neurotransmitters in Alzheimer’s disease.

Non-Medicamental Treatment

Strategies focus on simplifying and familiarizing the patient's environment, preventing isolation, and ensuring safety with tools like night lamps and gas monitors.
Memory support tools include digital clocks, calendars, day planners, and item locators.
Physical therapy, occupational therapy, art therapy, and group therapy provide support.
Family counselling services and utilization of gerotechnology enhance patient care.

Medicamental Treatment

Cholinergic augmentation therapy aims to enhance cholinergic transmission by inhibiting acetylcholinesterase, which increases acetylcholine availability in the synaptic cleft.
Different drugs within this class vary in their mechanisms of inhibiting acetylcholinesterase.

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Description

This quiz covers the definition, prevalence, and causes of dementia syndrome, specifically focusing on its impact on cognitive functions. It includes various domains affected by cognitive decline and how these deficits can interfere with daily living activities. Test your understanding of this crucial neurocognitive disorder.