Common Forms of Dementia Handout Package
Common Forms of Dementia 1 Learning Objectives As a result of working through this module, you should be better able to: 1. Describe clinical features of 4 major types of Dementias: Alzheimer s Disease, Lewy Body Dementia, Frontotemporal Dementia, and Vascular Dementia; 2. Identify commonalities and differences in treatments for these common forms of Dementia. 2 Dementia Dementia is the permanent loss of mental abilities caused by damage to brain cells that is not a normal part of the aging process. (Smith 2003) 3 1
There are many types of dementia and therefore each person will have slightly different symptoms and behaviours. Dementia is a progressive loss of ability and the most common lost ability is memory. (Smith 2003) 4 Areas of Brain Damage Frontal Lobe Damage Personality change Ability to plan and make judgments are effected Temporal Lobe Damage Memory problems 6 2
Areas of Brain Damage Parietal Lobe Damage Affects visiospatial skills Ability to orientate oneself Occipital Lobe Damage Affect the ability to see Brain is unable to decipher messages from the brain 9 Four Common Types of Dementia Alzheimer Disease Diffuse Lewy Body Dementia Frontotemporal Dementia Vascular Dementia 11 Alzheimer Disease Most common form of dementia Slowly progressive Degenerative Affects women more often than men Progressive loss of memory, judgment, impulse control, language and abstract thought Cause is unknown Characterized by atrophy of the brain 12 3
Clinical Hallmarks of Alzheimer Disease Amnesia Agnosia Apraxia Aphasia Anosognosia Altered Perception Apathy 13 Alzheimer Disease Risk Factors Genetic component Families with an early age of onset People with Down s Syndrome Treatment Cholinesterase inhibitors Meds slow the progression of the disease Education of the family and care givers is important 14 Diffuse Lewy Body Dementia Progressive disease Occurs more often in men than women Lewy Body Dementia is identified by abnormal structures in the brain called Lewy Bodies Lewy Bodies are distributed in various areas of the brain Mechanism is unknown 16 4
Clinical Hallmarks of Diffuse Lewy Body Dementia Progression of the disease is usually more rapid Fluctuating cognition Marked variations in attention Hallucinations are also common Some features of Lewy Body Dementia can resemble Parkinson s Disease 17 Diffuse Lewy Body Dementia Risk Factors No known cause LBD risk factors have not been identified Treatment Symptomatic treatment is available Cholinesterase inhibitors Caregiver support and education Neuroleptics should be avoided 18 Frontal Temporal Dementia Insidious onset, progresses slowly More common in women than in men Clinical syndrome that involves progressive atrophy of the frontal and temporal lobes of the brain 20 5
Clinical Hallmarks of Frontal Temporal Dementia Personality changes and language difficulties Poor hygiene Lack of social tact Sexual disinhibition Hyperorality Apathy Speech impairment As the disease progresses, general symptoms of dementia arise, such as confusion and forgetfulness 21 Frontal Temporal Dementia Risk Factors Younger age group More common among women than men Treatment No known treatment or cure Care giver support 22 Vascular Dementia Prevalence increase with age Affects both sexes equally Onset is usually abrupt Progression is stepwise Result from lack of blood supply to the brain related to thromboembolism, hemorrhage or ischemia 23 6
Clinical Hallmarks of Vascular Dementia Mental abilities fluctuate as short episodes of confusion generally follow small strokes Slowness in mental process Problems with decision making Poor organizational ability Alterations in the person s ability to walk, weakness if the limbs, or slurred speech, due to the stroke 24 Vascular Dementia Risk Factors Hypertension Heart disease Diabetes Age > 65 years Treatment Treatment of the cardiovascular Meds are also given to improve blood flow 25 Other Dementias Dementia due to Parkinson s Disease Depressive symptoms Impaired executive functions Hallucination and delusions HIV/AIDS Dementia May affect one third of the patients with AIDS Clients will exhibit a progressive cognitive decline 26 7
Other Dementias Creutzfeld-Jacob Disease Is a form of progressive dementia Rapidly progressive Four forms of the disease sporadic, familial, transmissible and variant Dementia due to Huntington s Disease An inherited disease Physical symptoms include involuntary movements and clumsiness Cognitive symptoms include loss of ability to recall information Loss of attention and difficulty with decision making 27 Reversible Dementia Medical and health conditions that cause confusion D E M E N T I A -Drugs -Emotional Disorders -Metabolic Disorders -Eyes and ears -Nutritional deficiencies -Tumors and traumas -Infections -Alcoholism 29 Case Study 72 year old married man Retired from his job as an Accountant Decline in memory Stuttering Slow gait Requires assistance with bathing and grooming Reports to be seeing children hiding in the bedroom closet 30 8
Case Study Muscle rigidity Slow, shuffling gait, but no tremor Parkinsonian features Aggressive On Risperidone Difficulty swallowing and drooling Hallucinations 31 9