Dementia and PPA

dementia

an acquired and persistent impairment of multiple cognitive domains severe enough to limit competence in activities of daily living, occupation, and social interaction

alzheimer’s

lewy body dementia

vascular dementia

parkinson’s

frontaltemporal lobar degeneration

mixed

irreversible dementias (6)

severe vitamin deficiencies

medications

UTIs

reversible dementias (3)

delirium

where a client has changing cognitive states (drowsy, hyper, etc.)

beta amyloid plaques, neurofibrillary tangles

alzheimer’s is characterized by the accumulation of _______and ________ leading to neuronal damage and cell death

astrocytes

what cleans your brain while you are sleeping

acetylcholine

glutamate

2 neurotransmitters that play a critical role in alzheimer’s

learning, memory, and attention

acetylcholine and glutamate are neurotransmitter that plays a critical role in ______, ______, and ______

preclinical

mild cognitive impairment

dementia due to AD

3 stages of AD

preclinical

persons are asymptomatic yet have measurable changes in brain, blood, and cerebrospinal fluid biomarkers

mild cognitive impairment

may have difficulties with memory loss, language, and problems with spatial awareness but symptoms are not severe enough to interfere significantly with their ADLs

dementia due to AD

significant memory loss, difficulty with language and communication, and problems with executive functioning affecting their ADLs

PET scan

insert radioisotope bound by sugar (carbohydrate isotope) sent to your brain, a person asks you to perform tasks (speech, motor) and you are able to see where the activity is in the brain when performing the activity

MRI

looks at structural anomolies

insidious onset

refers to the gradual and progressive decline in cognitive abilities over time

clear history of worsening cognition

the individual must have a documented history of cognitive decline that has been getting progressively worse over time

amnestic

single domain

multiple domain

MCI subtypes (3)

amnestic

most common subtype, memory is affected

single domain

affecting language ability, executive function or visuospatial function

multiple domain

involving multiple cognitive domains and may occur with memory impairments or without them

logopenic

semantic

non-fluent

3 types of PPA

logopenic

anomia and impaired repetition of phrases and sentences

working memory is their biggest challenge

pauses in speech

limited spoken language

semantic

impaired object knowledge, anomia, and single word comprehension

difficulty forming semantic memory/images

phonemic cues will be more helpful instead of categorical cues/associations

non-fluent

non-fluent speech and agrammatism

frustration due to effortful speech

cause, lead

PPA is not the ______ of dementia but could _____ to dementia

PPA

neurodegenerative disease cause by the development of plaque in the speech and language neural network

frontal

temporal

parietal

lobes affected in PPA (3)

non-verbal, voice bank

some patients with PPA may eventually become _____ which is why it would be a good idea to ____ early on if an AAC device could be used

working, episodic

patients with AD demonstrate early and severe impairments of _____ and ____ memory that worsen at the disease progresses

working memory

these memory deficits have significant negative impact on auditory comprehension of language at the discourse level

simple

patients with AD often understand _____ directions and respond appropriately to ____ concrete questions until the middle stages of the disease

depression

this is a common symptom associated with PWD and often contributes to poorer performance on testing affecting their willingness to participate

could impede successful outcomes of intervention programs

Mini Mental State Examination (MMSE-2)

Montreal Cognitive Assessment (MoCA)

Saint Louis University Mental Status Exam (SLUMS)

Cognitive screening tests (3)

SLUMS

this cognitive screener has a story recall section

Arizona Battery for Communication Disorders of Dementia (ABCD)

this assessment quantifies different aspects of linguistic communicating, including the ability to understand and produce speech as well as read and write

can be used to identify areas of strength and weakness in LANGUAGE abilities and develop targeted intervention strategies

Rivermead Behavioral Memory Test-3 (RBMT-3)

Wechsler Memory Scale (WMS-IV)

Memory tests (2)

Rivermead Behavioral memory test

this assessment looks at everyday memory of the patient and is typically already performed by the psychologist or OT but you can utilize the data to appropriately chose your tests/goals

Functional linguistic communication inventory (FLCI)

assess functional language that begins with evaluating greetings, signs, and symbols, and social conversations

Environment and communication toolkit (ECAT)

helps clinicians and caregivers identify and modify environmental factors that may be impacting communication abilities in PWD

spared cognitive abilities

treatment capitalizes on ________ and reducing demands on impaired ones

positive

treatment including stimuli that evoke ______ emotion, action, and fact memory; individualized specific treatment stimuli and activities to ensure meaninfulness

Reminiscence therapy

structured review of the past meant to stimulate recall

topics illustrated using pictures, clothes, props, and are associated with meaningful life themes

memory books and wallets

written and graphic cues

contain factual information that is personally relevant, important, and likely to be used regularly by the individual with dementia

montessori-based interventions

snoezelen therapy

environmental consideration for therapy (2)

spaced retrieval training

used to improve memory in PWD involving teaching individual to recall information at increasingly longer intervals of time, with the goal of retaining information for longer periods of time

snoezelen therapy

to explore and relax

stimulates the primary senses

montessori

promotes social interaction based on independence and self-esteem

their environment is set up to create independence and autonomy

giving more choices

having activities based on hobbies and interests