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Dementia - Coggle Diagram
Dementia
Risks of developing dementia
Increasing age
Family hx/genetics
Smoking/alcohol use/abuse
Atherosclerosis
High cholesterol
Diabetes
Mild cognitive impariment
Stroke
Lower physical activity
Treatments
Treatment for depression symptoms
Anti depressants
Mindfulness/meditation
Counselling/psychotherapy
Rehabilitation
Occupational rehab
Exercise programs
Cognitive rehab
Nutrition
Controlling vascular risk
Managing pharmacological side effects
Specialist referalls
OT
PT
Dietitian
Psychologist/Psychiatrist
Managing alcohol use
Advanced-care-planning
Main Types
Lewy Body
Types
Parkinson's Disease w/ (Lewy Body) Dementia (PDD)
Later onset (ie; 10 years after Parkinson's Dx)
Dementia w/ Lewy bodies (DLB)
Early onset, and rapid progression
Aggregated proteins
Alpha-synuclein
Deep w/in cortical layers through out the brain
Dx
Clinical Fx of Dementia
2 of Core Clinical Fx's
Visual Hallucinations
Cognitive Fluctuations
Parkinsonism
REM sleep behaviour disorder
Tx
Cholinesterase inhibitors
Antipsychotics
Safe sleeping environment (REM SBD)
Melatonin
Tx of Parkiinsonian Sx's
Physical Therapy
Levadopa
Lifestyle interventions
Frontal Temporal
Group of neurodegenerative disorders
Degeneration of Frontal and/or Temporal lobes
One of most common early onset dementias
DX
Evaluation
Family member informant (behavioural problems)
Behavioural changes (ie: impulsivity)
Clinical assessment
CT/MRI to exclude structural pathology. Temporal/frontal atrophy may be present
Tx
Safety mgt
Exercise & Mobility
Speech Therapy
Behavioural Modifications
Manage Neurtransmitters
Serotonin activity
Dopaminergic function
Vascular
Cause
Impaired Cerebral Blood Flow
Cerebral Vascular Disease
2nd Most Common Dementia
Dx
Neuro-immaging + Clinical features
Cognitive Screening Test
Lab results (to exclude other causes)
Alzheimer's
Most Common Dementia
Types
Early onset AD
Inherited AD (rare)
AD associated w/ Down Syndrome
Typical AD
S/SX's
Impairments in other cognitive domains
Behavioural/psychological sx's
Decline in executive function
Memory impairment
Apraxia
Sleep distrubances
Seizures
Dx
Clinical assessment
Cognitive testing
Neuroimaging
FDG-PET (Flurodeoxyglucose)
Distinct regions of hypometabolism
MRI
Generalized/Focal Atrophy
Reduced Hippocampal volume
Amyloid-PET
Tracers indicate amyloid lesions
Biomarkers
Cerebral Spinal Fluid
AB protein deposition
Increased CSF total Tau
Tx
Cholinesterase Inhibitors
Antioxidants
Vascular risk manaagment
Prevalence/incidence
55 million ppl living with dementia world wide
10 million new cases/year
7th leading cause of death among all diseases globally
Major factor of dependency and disability among older adults
Signs and Symptoms
Middle Stage
Confused while at home
Forgetful of recent events and peoples names
Increasing struggles with communication
Needing assistance with personal grooming and care
Behavioural changes
Late Stage
Total dependence
Inactivity
Lack sense of time and place
Problems recognizing friends/relatives
Escalation in behavioural changes
difficulty walking
Early Stage
Loosing track of time
Becoming lost in familiar places
Forgetfullness
Impacts
Societal
Institutional costs
societies out of pocket expenses
Direct/indirect costs
Ageing population = increase incidence of dementia
Patient
Loss of identity
Loss of independence
Insidious decline leading to death
Loss of being contributing member
Family
Society
strain on personal resources
Sense of stigma (particularly in early stage)
Caregiver/family
Social
Loss of friends/support
Lost opportunity for social engagement
Personal Health
Stress, anxiety, depression
Poorer self-reported health
Increased need for health services
Financial changes
out of pocket expenses
lost wages
Common Factors
Higher cortical disturbances
Calculations
Thinking
Orientation
Judgement
Memory
Learning capacity
Comprehensions
Language
Other deteriorations/factors
Social behaviour
Motivation
Emotional Control
Depression
Capacity
Decision-making capacity
Financial capacity
Advanced-Care Planning