Understanding Dementia: Causes and Types

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Questions and Answers

Which type of memory is involved in learning motor skills and cognitive tasks?

Perceptual representation memory

Episodic memory

Semantic memory

Procedural memory (correct)

What percentage of dementia cases is accounted for by Vascular Dementia (VaD)?

62%

50-75%

17% (correct)

Which of the following is NOT one of the preferred diagnostic criteria for Frontotemporal Dementia (FTD)?

ICD criteria

Lund-Manchester criteria

NINDS criteria

International Consensus Criteria for DLB (correct)

Which cognitive deficit is required for the diagnosis of Probable Alzheimer’s Disease according to NINCDS/ADRDA criteria?

Deficits in two or more areas of cognition Signup and view all the answers

At what age must Alzheimer's Disease onset occur to meet the specific criteria laid out by NINCDS/ADRDA?

At age 40 or older Signup and view all the answers

What is the estimated prevalence of dementia in individuals aged 80 and older?

1 in 5 Signup and view all the answers

Which of the following accurately describes dementia according to its definition?

It is a syndrome resulting from a chronic or progressive disease of the brain. Signup and view all the answers

Which statement regarding recorded dementia diagnoses is correct?

The National Diagnostic Rate was 62% as of July 2022. Signup and view all the answers

What age range has the highest prevalence rate of dementia according to the provided statistics?

80 years and older Signup and view all the answers

What aspect of function is not directly disturbed by dementia?

Physical strength Signup and view all the answers

What criterion must be met for a diagnosis of Vascular Dementia according to the NINDS-AIREN criteria?

Impairment of memory and another cognitive domain Signup and view all the answers

Which symptom is NOT explicitly listed as a requirement for the diagnosis of Dementia with Lewy bodies?

Severe memory loss Signup and view all the answers

In order to meet the criteria for Frontotemporal Dementia, which of the following is not required?

Severe impairment in memory retention Signup and view all the answers

Which feature is supportive but not required for a diagnosis of Dementia with Lewy bodies?

Syncope/transient loss of consciousness Signup and view all the answers

Which combination is a hallmark indicator of Vascular Dementia progression?

Stepwise progression accompanied by fluctuation Signup and view all the answers

Study Notes

What is Dementia?

Dementia is a syndrome caused by brain disease, usually chronic or progressive.
It involves multiple higher cortical function disturbances, including memory, thinking, orientation, comprehension, calculation, learning, language, and judgment.
Consciousness remains unaffected.
Cognitive impairment is often accompanied or preceded by emotional control, social behavior, or motivational deterioration. This definition is based on the WHO 1992 (ICD 10).
Different types of memory are affected: perceptual representation memory, working memory, semantic memory, episodic memory, and procedural memory.

Prevalence Rates

Dementia prevalence increases significantly with age.
Prevalence: 1 in 1000 (40-65 years), 1 in 50 (65-70 years), 1 in 20 (70-80 years), 1 in 5 (80+ years).
Higher prevalence rates in women compared to men across all age groups.

Types of Dementia

Alzheimer's Disease (AD): Accounts for 62% of dementia cases (Dementia UK Report 2007). Preferred diagnostic criteria include NINCDS/ADRDA.
Vascular Dementia (VaD): Accounts for 17% of dementia cases (Dementia UK Report 2007). Preferred diagnostic criteria include NINDS-AIREN.
Dementia with Lewy Bodies (DLB): Accounts for 4% of dementia cases (Dementia UK Report 2007). International consensus criteria are used for diagnosis.
Frontotemporal Dementia (FTD): Accounts for 10-15% of dementia cases (Dementia UK Report 2007). The Lund-Manchester criteria or NINDS criteria are used for diagnosis.
Other types of dementia make up a small percentage of cases.

Alzheimer's Disease (AD)

Characterized by dementia, gradual progression, intact consciousness, onset after age 40, and no other identifiable cause (NINCDS/ADRDA Criteria).
Cognitive decline progresses over time, eventually leading to severe impairment and death.

Vascular Dementia (VaD)

Dementia is present, along with cerebrovascular disease, focal stroke signs (neurological exam), and impairment in memory and at least one other cognitive domain.
Evidence of relevant cerebrovascular disease (CVD on CT/MRI scans) is also required.
Onset may be within three months of a stroke, or progression may be abrupt or stepwise.

Dementia with Lewy Bodies (DLB)

Shows progressive cognitive decline affecting daily functioning.
Requires two of the following: fluctuating cognition, recurrent visual hallucinations, spontaneous Parkinsonism (motor features).
Supportive features are repeated falls, syncope, neuroleptic sensitivity, paranoid delusions, and hallucinations in other senses.

Frontotemporal Dementia (FTD)

Characterized by insidious onset and gradual progression with early decline in social interaction, personal conduct regulation, emotional blunting, and loss of insight.

Progression of Alzheimer's Disease

Progression spans a typical 4-8 years (up to 20 years in extreme cases).
Stages progress from mild (loss of recent memory, faulty judgment) to moderate (personality changes, aggression, agitation, sleep disturbances, delusions) to severe (loss of all reasoning, bedridden, incontinence).
Death typically results from pneumonia or other comorbidities.

Causes of Dementia

Biological factors: Chromosomes linked to dementia, altered brain pathology.
Psychosocial factors: Malignant social psychology.
Environmental factors: Lifestyle (alcohol, smoking, diet), physical environment (floor patterns, lighting, overstimulation).

Kitwood's Psychological Needs

Emphasizes the importance of comfort, occupation, attachment, identity, and inclusion in dementia care.

Describes negative interpersonal interactions that can negatively affect individuals with dementia.
Examples include intimidation, disempowerment, withholding, imposition, outpacing, disruption, infantilisation, objectification, labelling, stigmatisation, disparagement, ignoring, banishment, accusation, mockery, treachery, and invalidation.

Therapeutic Implications of Alzheimer's Disease

Focuses on preventing onset, slowing progression, and treating symptoms to slow decline.

Prevention of Dementia

Prevention is better than cure. Lifestyle choices heavily influence the risk.

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Description

This quiz explores the definition of dementia, its prevalence rates, and the various types of dementia, including Alzheimer's Disease. It covers key cognitive impairments and social behaviors associated with this syndrome, as well as statistics related to age and gender. Test your knowledge on this important health topic.