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17 Cards in this Set
- Front
- Back
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Types of Chronic Dementia (3)
-Which is the most common |
Alzheimer's Disease: 50%
Multi-Infarct (vascular) dementia (20%) Lewy-Body Disorder (Smaller prevalance) |
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1) Definition of Dementia
2) Causes (2) |
1) Loss/impairment of cognitive fx --> later results in decrease in physical function
2)Frontal Lobe Disorder- Initially has personality changes Chronic Neurologic Dz: PD (Dementia is later) : Huntington's Chorea (Personality/cog changes seen first) :H.I.V- 2ndary to switching meds (antiviro medication) |
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Reversible causes of Dementia (4) -DAMP
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1) Polypharmacy- Major cause of cog changes in adults; Pain meds (oxy)
2)Acute infections: UTI, pneumonia 3)Depression: Pseudodementia- Cog change not due to cog conditions 4) Medications: Anticholinergics- Decreases already low Ach Levels |
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Delirium
1)Definition 2)Accompanied by... 3)Often caused by... 4) How is it different than dementia? |
1) Mental status characterized by confusion
2)Lethargy 3) Febrile condition (pneumonia, conditions that causes drowsiness 4)Reversible- Tends to wax and wane |
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Alzeihmer's Disease
1)Type of disease 2)Life expectancy after Dx 3)Out of 10, how may live at home? |
1)Chronic Degenerative Disease
2)8-11 years 3)7/10 |
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Alzheimer's Disease: Brain Changes (4)
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1)Massive brain atrophy: Cortex and hippocampal regions- Shrinking of gyri, widening of sulci
2)Amyloid plaques: Decrease neuronal transmission w limbic system hit the worse 3)Neurofibrillary tangles 4)Loss of cholinergic neurons |
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Read about clinical progression of AD and MCI; and Clock Drawing scoring
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READ
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AD: Stages (3)
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Stage 1: Loss of STM (i.e. balancng checkbook)
Stage 2: Apraxia (motor planning), Agnosia (recognize objects/person), Aphasia (word finding) Stage 3: Worsening mobility and cognitive fx, death from 2ndary causes |
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Severe AD
1)Brain changes 2)Level of dependence 3) Sx (3) 4) How does death usually occur |
1) Extreme brain shrinkage
2)Completely dependent 3)Weight loss, Increased sleeping, Loss of bladder/bowel control 4)Pneumonia or oyher infections |
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What did the Nun Study say about AD?
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Inverse relationship in regards to education and AD (i.e. better education decreases risk of AD)
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Medications (6)
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1) Cholinesterase inhibitors- Ach Important for learning and memory- Delays worsening of Sx for 6-12 months for 50% of pts
2) Cognex: ->33% of patients; Can be toxic (need liver fx test) 3) Aricept- Less toxic 4) Exelon 5) Razadyne 6) Memantine- Mod -> severe dz; Regulation of glutamate |
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Multi-Infarct/ Vascular Dementia
1)Type of progression 2)Implications for rehab |
1)Step-down progression on the arterial and venous side
2)Monitor the progression |
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Lewy-Body Disease
1) Characterized by... 2)How fast is the progression 3)Unique Sx 4) Have to be cautious with... |
1) Dementia c extrapyramidal Sx (i.e. shuffles, shakes)
2)Rapid, fulminating 3) Prominent visual hallucinations (Not seen with AD) 4)Narcoleptic meds |
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Cognition Outcome Measures (3)
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1) 6-item screener for cog impairment
2) Month, year, day of week 3) Apple, table, penny |
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Physical Performance Outcome Measures (2)
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1) 6MWT: 33.5m =MDC 2) TUG: 4.09s= MDC |
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There is an statistical significant difference in fast gait speed when performing resistance training in patient's with cog impairments
Key point is... |
Keep someone as active as possible through mobility
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Intervention Considerations (2)
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1) Falls Management
--Need bed alarm, watch fluid intake --Eradicate any potential causes of falls 2)Activities --Catastrophic Reactions Minimized: Can over react to minor stress; family education is key --Outcome Measure Utilized --Gait/Walking Regimens |
