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Cognitive and Behavioral Disorders in the Geriatrics

Is Dementia part of the normal aging process? * no
Diagnostic criteria of Dementia ? *Impairment of Memory and one of the following severe enough to interfere with daily functioning: -Aphasia -Apraxia -Agnosia -Impaired executive function
Alzheimer’s Disease patho ? * Extracellular deposition of amyloid-beta protein producing neuritic plaques ----*Development of neurofibrillary tangles----* narrow gyri and widened sulci
At least two physiological impairments may contribute to AD ? * reduced cerebral production of acetylcholine transferase....* Excessive NMDA receptor stimulation
Alzheimer’s Treatment ? *Cholinesterase Inhibitors - to keep ACh ....* NMDA Receptor Antagonists...* Vit. E
Alzheimer’s Disease-Diagnosis ? * no confirmatory test besides brain biopsy after death.... * DSM-IV Diagnostic Criteria: -Impairment of recent memory -Gradual onset and continued decline of cognitive ability ..At least one of the following: -Aphasia -Apraxia -Agnosia
Best test for Alz ? * Slums test...not mmse
Dementia with Lewy Bodies (DLB)Dx Criteria ? * you see Lewy Bodies.... * Dx = Dementia criteria, Plus At least two of the following three clinical features: -Cognitive fluctuations -Visual hallucinations -Parkinsonism (Dementia preceding motor symptoms)
Good Dx tool ? * mini mental cog status test...tests cognitive issues, not memory
DLB Tmt ? *Nonpharmacological therapy is first choice...* cholinesterase inhibitors , atypical psychotics, and levodopa
Vascular Dementia how to Dx ? * imaging (CT/MRI)...* vascular issues
Vascular Dementia Tmt ? * control vascular risk factors
Parkinson’s Disease with Dementia (PDD)criteria ? * criteria states that with PDD, the motor symptoms occur at least 1 year prior to the cognitive symptoms
Tmt of PDD ? * cholinesterase inhibitors
Frontotemporal Dementia basics ? * Characterized by focal atrophy of the frontal and temporal lobes.......* Progresses more rapidly than AD, onset to death is 8.7 years versus 11.8 years in AD
Reversible Dementia (Delirium) basics ? * meds induced, alcohol, metabolic disorders, depression, etc.
Top Diagnosis tool? * history
Mini Mental Status Exam scores ? * 26-30 is normal ....20-25 mild deficit ....10-19 moderate deficit ....<10 severe deficit
Depression masquerading as Dementia ? * History of becoming lost and disoriented, w/ a history of depressed mood.......So ask if they are ever depressed or feel sad.....* antidepressive drugs have been shown to bring them out of depression, which brings them out of their dementia state
Created by: thamrick800