mental deterioration in adults. Characteristics include loss of intellectual function
loss of cognitive function
loss of social function
loss of motor function
true or false – a patient that suffers from dementia will have a lifespan that is about 10 years shorter and death is usually caused by something else
true
what is the incidence of severe dementia in the USA
2 million
what is the incidence of moderate dementia in the USA
5 million adults
true or false – 5-10% of people over 65 years have some manifestation of dementia
true
name some of the behavioral changes that occur in patients that suffer from dementia
fearful/anxious
inattentive
irritable
lack of interest in typical activities
silence or very talkative
inappropriate dress
lack of discretion – profanity
what are some of the intellectual/cognitive changes?
forget where they are/what happened
forget appointments, people, names
cannot follow directions
cannot do ordinary math
judgment flawed
abstract thinking loss
easily confused in conversation
what are some of the causes of potentially reversible dementia
drug and toxic agents
lead – also produces peripheral neuropathy
magnesese – also produces parkinsonian syndrome
Mercury – "mad as a Hatter" - the top hats that are made of felt
carbon tetrachloride
alcohol – also may produce a peripheral neuropathy, over a long period of time
what two vitamins deficiencies can cause potentially irreversible dementia
thiamine – B1
vitamin B12
what is Wernicke Korsakoff syndrome
includes ataxia, confusion, and paralysis of extraocular muscles, and is associated with vitamin deficiency of thiamine B1
what are some of the signs and symptoms of a vitamin deficiency of vitamin B 12
anemia that may produce confusion
what is Korsakoff psychosis
patient can't form new memories, also related to vitamin deficiency of thiamine B1
what are some of the metabolic causes of potentially irreversible dementia
myxedema (hypothyroidism) – slow mentation
renal failure – dialysis dementia
hypoglycemia
Cushing's syndrome
hypoxia, COPD, heart failure
Is Alzheimer's dementia classified as nonreversible dementia or potentially reversible dementia?
nonreversible dementia
what are some of the characteristics of Alzheimer's dementia
insidious, progressive
cause uncertain
begins middle-age, 50 – 60
memory loss first symptom
may develop repetitive behaviors
diffuse cerebellar dysfunction
neurofibrillary tangles, cerebral atrophy
not normal aging
what chromosome is affected in Huntington's disease
chromosome 4, autosomal dominant
when do symptoms present in Huntington's disease
midlife
how many people out of 10,000 will suffer from Huntington's disease?
Is it more common in male or female?
1
equally common in male and female
how soon after the symptoms of Huntington's disease present will a patient lose all function?
10 – 15 years
what are some of the infectious diseases that can cause nonreversible dementia
AIDS dementia– late stages
Jakob Creutzfeldt disease – mad cow disease
neurosyphilis – has pretty much vanished because of penicillin, caused by sexual contact by infected person, slowly reaches nervous system
true or false – dementia is easily diagnosed by one universal test
false
what are the requirements for a diagnosis of dementia
complete medical exam
evidences several cognitive deficits, including memory impairment of at least one of; aphasia, apraxia, agnosia, decreased need for sleep, cognitive deficits severe enough to interfere with occupational and/or social activities.
define aphasia
problems with language (receptive and expressive)
define apraxia
inability to carry out purposeful movements even though there is no motor or sensory impairment
define agnosia
failure to recognize, especially people
what is the treatment for dementia
correct underlying medical issues
control behaviors – antipsychotics, antidepressants, sleep aids
reduce speed of degeneration – antioxidants, cholinesterase inhibitors (aricept)
