Dementia Diagnosis and Treatment

Flashcards covering the diagnosis, cognitive testing, medications, and side effects associated with dementia and Alzheimer's disease.

CT Scan

A diagnostic imaging tool used to identify brain shrinkage and rule out tumours or haemorrhages; it is more cost-effective than MRI.

Complete blood count (CBC)

A blood test used in dementia diagnosis to check for anaemia or infections that might impact cognitive function.

Thyroid function tests

Diagnostic tests measuring TSH and $\text{free T4}$ to rule out hypothyroidism, which presents symptoms similar to dementia.

Vitamin B12 and folate levels

Measurements used to identify deficiencies that can lead to cognitive decline and dementia-like symptoms.

Electrolyte panel

A test to identify imbalances in sodium, potassium, or calcium that can cause confusion and cognitive issues.

MMSE (Mini-Mental State Examination)

A $30\text{-point}$ questionnaire used for cognitive screening and monitoring that evaluates domains such as orientation, registration, and recall.

Orientation (MMSE Domain)

Questions within the MMSE regarding time (date, day, week, year) and place (country, city, building).

Registration (MMSE Domain)

The cognitive assessment of the ability to repeat named prompts, such as repeating $3$ unrelated words.

Attention and calculation (MMSE Domain)

A section of the MMSE involving serial events like mathematics or spelling a word backward.

Recall (MMSE Domain)

The evaluation of memory by asking for previously given words after a short delay.

Visuospatial skills (MMSE Domain)

A cognitive task involving the copying of a complex figure.

GPCOG

A reliable screening tool for detecting cognitive impairment in older adults, often used before referral to a memory clinic.

Antihistamines

First-generation versions like diphenhydramine and chlorpheniramine block acetylcholine receptors, causing temporary dementia-like symptoms.

Acetylcholine

A neurotransmitter essential for learning, memory, and cognitive functions.

Cholinesterase Inhibitors

Medications that stop acetylcholinesterase from breaking down acetylcholine, increasing its availability in the synapse and slowing disease progression.

Donepezil

A cholinesterase inhibitor given daily that requires re-titration if doses are missed for more than $1\text{ week}$; used with caution in asthma or COPD.

Galantamine

A cholinesterase inhibitor derived from daffodils used for mild-moderate disease; requires re-titration if missed for more than $5\text{ days}$.

Rivastigmine

A twice-daily medication available as a capsule, liquid, or transdermal patch, useful for patients requiring slow titration.

Memantine

An NMDA receptor antagonist that targets the excitatory amino acid glutamate for the treatment of moderate-severe Alzheimer's.

Glutamate

An excitatory amino acid thought to be chronically raised in dementia, potentially destroying neuronal cells.

Detrusor muscle

The muscle in the bladder wall that contracts to expel urine; its overstimulation by increased acetylcholine can cause urinary urgency.

Bradycardia

A slow heart rate caused by increased parasympathetic activity through the vagus nerve, a side effect of cholinesterase inhibitors.

Nitric oxide

A chemical released in blood vessels due to acetylcholine that promotes vasodilation and can contribute to low blood pressure.

Disease modifying immunotherapies

New drugs such as Donanemab, Lecanemab, and Remternetug that target and break down amyloid plaques in the brains of Alzheimer's patients.