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OPTA 222 (Dementia)

What is Dementia?

Dementia is a umbrella term used for diseases that cause cortical and sub cortical degeneration. It is fatal and irraversable.

What decreased functions happens in the cortical.

Memory, Cognitive skills, Behavior, and Personality

What decreased functions happens in the subcortical.

Changes in personality, Temperature dysregulation, Appetite dysfunction, Growth abnormalities, Emotional abnormalities

What is Alzheimers Disease

Actual cause is unknown but it is thought to be due to amyloid plaques and misformed tau (protein found in the brain)

Symtoms of Mild/Early Stages of Alzheimers

Misplacing objects, Forgetting names when introduced to new people, Difficulty performing tasks, Forgetting things just read or seen, Issues with planning/organization

Symtoms of Moderate/Intermediate Stages of Alzheimers

Moody or withdrawn, Can’t remember own demographic information, Confusion with orientation, Difficulty dressing for season, Wandering/getting lost, Personality changes/behaviors such as suspicious, delusions, repetitive behaviors, Sleep issues, Sundowning

Symtoms of Severe/Late Stages of Alzheimers

24 hour care required, Bowel/bladder control lost, Lose awareness immediate surrounding environment, Lose physical capabilities (walking, sitting, swallowing), Poor communication

Treatment for Alzheimers

Memory: Aricept
Behaviors: Treating symptoms, Antidepressants, anxiolytics (decrease anxiety), antipsychotics

Sleep changes: Treating symptoms, Sleeping pills, benzodiazepines (relaxants)

Agnosia

Impaired ability to identify objects despite intact sensory function

Apraxia

Impaired ability to do previously learned motor activities despite intact motor function

Aphasia

Impaired ability to comprehend or use language

Orientation

Person, Place and Time. Can either be O x 1,2 or 3 (scoring 1⁄3, 2⁄3, or 3/3)

Sundowning

Behavioural issues around the time the sun is setting

What is Vascular Dementia?

It is a type of dementia classified as resulting from limited blood flow to the brain due to a variety of reasons.

What condition can cause vascular dementia?

Small vessel disease (ex: atherosclerosis),Heart conditions, Stroke, Vascular brain changes

Risk Factors for Vascular Dementia

Smoking, High Cholesterol, High alcohol intake, Obesity

Signs and Symptoms of Vascular Dementia

Memory loss, impaired planning and judgment, uncontrolled laughing and crying, declining ability to pay attention, impaired function in social situations, and difficulty word finding

Treatment for Vascular Dementia

Can see improvements from treating the underlying disease, treatment that may improve blood flow

What is Lewy Body Dementia

One of the most common types of dementia associated with protein deposits (lewy bodies) in the brain

Risk Factors of Lewy Body

Age, Certain health conditions: Somewhat associated with Parkinson’s Disease, and REM sleep behavior disorder[No lifestyle factors have been linked]

Signs and symptoms of Lewy Body

Hallucinations, Unpredictable changes in concentration and attention, Poor cognitive function, Movement problems (look similar to Parkinson’s Disease), Malfunctions in the autonomic nervous system

Treatment and Rehab role for Lewy Body

Medications help for short periods of time (can not permanently change symptoms), Rehab to maintain safety and function for as long as possible

What is Korsakoff Syndrome

Chronic memory disorder caused by severe thiamine (vitamin B1) deficiency

Risk factors for Korsakoff Syndrome

Anything that causes Vit B1 (thiamine) deficiency, Alcoholism, Malnutrition, Eating disorders, Cancer, Stomach disorders

Signs and Symptoms in Wernicke Syndrome. and Korsakoff Syndrome:

● Wernicke Syndrome:Mental status change, Ataxia (coordination), Eye abnormalities,Nystagmus (eyes jumping back and forth – usually horizontal), Loss of ocular (voluntary) motory control
● Korsakoff Syndrome:Memory impairment, thinking skills, social & attention behaviors are preserved,Poor muscle coordination, Unsteady gait, Paralysis of eye muscles (loss of ocular control), Rapid eye movements (nystagmus), Decreased fine motor skills

Treatment for Korsakoff Syndrome

Treating the underlying condition. Still has an eventual decline, Thiamine replacement therapy (IV), Abstaining from alcohol consumption, Rehab – cognitive rehabilitation

What is Pick’s Disease

An umbrella term for a group of disorders that primarily affect the frontal and temporal lobes of the brain, Has a younger age of onset, often occurring between the ages of 40-60

Signs and Symptoms of Pick's Disease

● Behavioral changes (frontal lobe):Inappropriate social behavior (more common), Apathy, Lack of inhibition,Decline in personal hygiene
● Speech and language problems (temporal lobe): No longer knowing word meanings, Difficulty using language appropriately, Difficulty forming sentences with proper structure

● Motor disorders: Tremor, Rigidity, Poor coordination, Difficulty swallowing, Muscle weakness

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