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Dementia - Coggle Diagram
Dementia
Differential Diagnosis
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- Functional psychosis / depression
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- Drugs / medication effects
- Vascular events / post traumatic encephalopathy
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Management Principles
- Be honest about diagnosis
- Cure isn't possible - emphasize potential to delay progression
- Support and educate carers intensively
- Promote indepedence - avoid failure
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- Treat co-morbidity and avoid extra disability
- Plan ahead - define risk and minimise
Top Causes
- Alzheimer's disease (60%)
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- Mixed alzheimers / vascular dementia
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Diagnostic Criteria
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- Decline in other cognitive functions (judgement / planning)
- Aware of environment (not delirium)
- Decline in emotional control / motivation
- 6 month duration at least
Investigations
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Specialised Lab Tests
- Drug screen / heavy metal screen
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(CNS infection, MS, beta amyloid (reduced in AD)
and tau (increased in AD)
Imaging
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- PIB scanning / Amyloid imaging
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Dementia =diffuse slowing, increased delta and
theta-
note CJD =triphasic waves / periodic complexes
Alzheimer's Disease
Definition
Chronic progressive neurodegenerative disorder with 3 symptom groups - cognitive dysfunction (memory / language / excutive), BPSD-depression / psychosis / agitation and ADL impairement
Hallmarks
- Neuritic (extracellular amyloid) plaques
- Neurofibrillary tangles (intracellular phsophorylated tau)
Risk Factors
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- Learning disability
Downs syndrome
- Gender - higher in woman, vascular higher in men
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Aetiology
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- Low physical and cognitive activity
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Epidemiology
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4,000 newly diagnosed each year
Disease burden
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Anual care 17 bil in UK - more than heart disease, stroke, cancer combined
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Definition
Progressive and largely irreversible syndrome that is characterised by a widespread impairement of mental function