PRAXIS: DEMENTIA

dementia

significant decline in one or more areas of complex attention, EF, learning and memory, language, perceptual motor, or social cognition

decline must not be to other mental disorders

classified as major/mild neurocognitive disorder

Alzheimer’s

most common form of dementia

early onset before 60 and late onset after 60

POS features: neurofibrillary tangles, tau pathology, and depletion of other neurochemicals

NEG features: neuronal loss/depletion of neurochemicals

neurofibrillary tangles

pathologies of brain proteins in axons and dendrites that increase memory loss/cog decline

amyloid (neuritic) plaques

abnormal deposits of amyloid protein that can cause (sub)cortical degeneration. esp in cerebral cortex and hippocampus

granulovacuolar degeneration

neurons in hippocampus are esp susceptible to these membranous fluid-filled cavities containing granular debris

neuronal loss (neuronal atrophy)

pretty straightforward. Results in a shrinking brain

Neurochemical change

these are depleted in Alzheimer’s dementia:

acetylcholine, somatostatin, vasopressin, and corticotropin

early signs of AD

small memory problems

some issues with new learning and visuospatial problems, behavior changes, mood change, poor judgement

mid signs of AD

intensified early stage problems, intellectual deterioration, profound disorientation to place/time/etc., lack of judgement, delusions, hallucinations, agnosia, sundowning, seizures

language problems with AD

naming, word finding, comprehending the abstract, echolalia, meaningless (empty) speech, pragmatic issues, reading/writing issues

frontotemporal dementia

caused by degeneration in frontal and temporal lobes with degeneration of cells in these regions, signs of Pick’s disease, presents of Pick bodies,

Huntington’s related dementia

loss of neurons at BG, caudate nucleus, putamen, and substantia nigra, possible atrophy of prefrontal/temporal/parietal lobes, and reduced inhibitory neurotransmitters GABA and acetylcholine

symptoms of HD

chorea, uncontrollable tic movements, progressively reduced voluntary movements, behavioral disorders

deterioration in memory, attention, concentration, EF skills, naming problems, dysarthria

Vascualr dementia

vascular diseases can cause bilateral (sub)cortical or mixed damage resulting in dementia. like multiple mini strokes.

Lewy body dementia

caused by lewy bodies (excessive protein deposits) in neuronal cell bodies causing dementia like symptoms and degeneration of (sub)cortex. can also have hallucinations