Dementia and Dysphagia Vocabulary

Vocabulary flashcards covering dementia definitions, cognitive reserve, risk factors, and dysphagia assessment/management techniques based on the lecture material.

Dementia (Medical Perspective)

An umbrella term describing a collection of acquired, progressive conditions caused by various brain diseases that impair cognition, behavior, and the ability to perform everyday tasks.

Cognitive Domains

The five core areas of cognitive function that can be impaired in dementia: attention, memory, language, visuospatial skills, and executive functioning.

Acquired (in Dementia)

Refers to a disease process or cognitive impairment that was not present at birth, but developed at some point during a person's life.

Progressive (in Dementia)

Refers to a condition where the underlying disease process and associated cognitive, behavioral, and functional declines continuously worsen over time.

Modifiable Risk Factors for Dementia (2024 Lancet Update)

Fourteen potentially modifiable lifestyle, social, and physiological risk factors—including high LDL cholesterol and vision loss added in 2024—that account for approximately $45\%$ of dementia cases worldwide.

Cognitive Reserve

The brain's resilience or capacity to cope with neuropathological damage without demonstrating overt clinical expression or symptoms of cognitive decline.

Accumulated Deficit Syndrome

An alternative theory viewing dementia as a complex, multidetermined outcome of aging resulting from accumulated neuropathology, diminished cognitive reserve, increasing frailty, and advancing age.

Frailty

A state of heightened vulnerability and risk characterized by multidomain decline, as evaluated by tools like the Edmonton Frailty Scale across cognition, general health, functional independence, mood, and mobility.

Mild Cognitive Impairment (MCI)

A stage characterized by self-reported and objectively measurable changes in one or more cognitive domains that are atypical for age, but do not significantly interfere with independent daily activities.

Dysphagia in Alzheimer's Disease

Swallowing impairment occurring in $84\text{--}93\%$ of individuals with moderate-to-severe Alzheimer's disease, significantly increasing the risk of aspiration pneumonia, which accounts for $70\%$ of deaths in this population.

Oral-Stage Dysfunction in Dementia

Swallowing difficulties involving volitional motor control, such as prolonged meal duration, lack of swallow initiation, holding bolus in the mouth, reduced oral coordination, oral residue, and tactile or oral agnosia.

Clinical Swallow Examination (CSE)

A non-instrumental assessment performed by a speech pathologist encompassing background history, cognitive-communication, physical, oral sensorimotor, and oral intake observations to evaluate swallow safety and guide management.

Cervical Auscultation (CA)

An adjunct clinical assessment technique where a clinician places a stethoscope over the lateral aspect of the larynx or trachea to listen to respiratory and swallowing sound patterns before and after swallowing.

Pulse Oximetry (in Dysphagia Assessment)

An adjunct clinical assessment measuring peripheral blood oxygen saturation ($\text{SpO}_2$); while normal ranges are $95\text{--}100\%$, drops in $\text{SpO}_2$ are not directly correlated with aspiration events.

Videofluoroscopic Swallow Study (VFSS)

An instrumental diagnostic procedure (also known as a Modified Barium Swallow) using dynamic x-ray imaging to visualize bolus movement and anatomical structures across oral, pharyngeal, and esophageal stages of swallowing.

Flexible Endoscopic Evaluation of Swallowing (FEES)

An instrumental assessment using a flexible nasendoscope passed through the nasal cavity to directly visualize pharyngeal and laryngeal structures, mucosal health, secretion management, and airway protection.

Whiteout (in FEES)

The transient loss of visual field during the pharyngeal swallow in endoscopic evaluation caused by epiglottic inversion and pharyngeal wall contraction, preventing direct observation during the exact moment of swallow.

Eating and Drinking with Acknowledged Risk (EDAR)

A person-centered framework where an individual or their medical decision-maker makes an informed choice to continue oral intake despite identified safety risks, following multidisciplinary consultation and risk-mitigation planning.