7. Mental Health Part 1 - Dementia and AD

Statistics

• Percentage Americans of geriatrics

• Percentage w mental health disorder

• Annual cost of treatment

• Baby Boomers

Behavioral and Mental Health Management

Where do Pharmacists fit in?

Dementia pathophysiology

Dementia preventative treatment approaches

When does it go from Confusion → Dementia

Dementia

• Causes

• Differential diagnosis

• even if a patient has a diagnosis of dementia, you cannot default that what you are seeing is signs of dementia. You have to make sure that other things are not causing it, and that is one of the biggest issues that makes Jerry Care so hard, because confusion can be, like, 82 different things, and you have to figure out what's going on

• Magnesium is not typically checked, so be sure to check for this specifically

  • if too low, can cause dementia-like symptoms

Dementia in the news

• Lewy Body Dementia

• Frontotemporal demential (FTD)

• Parkinson’s dementia

• two types of FTD

What is AD

MMSE Scoring

• Exam Question: If a patient has an MSSE Score of 25, is that impairment or not.

• It is NOT a diagnostic tool

• 25 is no cognitive impairment; recall LESS than 24 is impairment

Treatment options

• Acetylcholinesterase inhibitors

  • Donepezil

  • Rivastigmine (Exelon)

  • Galantamine (Razadyne)

• NMDA Blockers

  • Memantine (Namenda)

• AChE-i/NMDA Combo

  • Memantine + Donepezil (Namzaric)

• Unconventional - taken b/c these are “natural medicines”

  • Vitamin E

  • Ginkgo biloba

  • A-phosphatidylserine

  • L-carnitine

  • Huperzine A

• Controversial

  • Aducanumab (Aduhelm)

  • Lecanemab (Leqembi) and Donanemab (Kisnula)