Dementia and Encephalopathy Flashcards

Flashcards covering key vocabulary and concepts related to dementia and encephalopathy.

Dementia

A syndrome characterized by a constellation of symptoms that is progressive and debilitating affecting memory, language, visual spatial skills, executive functioning, and more.

Declarative (Explicit Memory)

Facts - Long Term

Episodic Memory

Events for autobiographical experiences

Procedural Memory

Motor skills that become automatic – tying shoe, shaving, etc.

Semantic Memory

Conceptual knowledge for understanding and organizing world

Procedural VC Memory

Verbal & cognitive learned skills that occur without conscious awareness – using phone, mailing a letter, etc.

Lexical Memory

Words and meanings and spelling including linguistic representations

Priming Memory

Associations with earlier experiences that trigger memories – dog invokes bark & tail wag, etc.

Conditioned Responses Memory

Reaction to previous similar stimulus – habits – door knock means someone is there, etc.

Major neurocognitive disorders

Interferes with ability to function independently

Mild neurocognitive disorder

Person can engage in independent functioning, but represents a significant decline from previous functioning.

Electrical Alzheimer’s Test

Detects the earliest signs before symptoms of cognitive decline appear by placing electrodes on the head and spine to detect changes in the brain’s electrical activity.

Early Stage Dementia Symptoms

Difficulty handling finances, disorientation to time and place, and episodic and working memory difficulties - recalling personal information.

Early Stage Treatment Focus

Restore functions as possible, help patient compensate for deficits, and provide caregiver with environmental adaptations for patient.

Middle Stage Dementia Symptoms

Disoriented to time and place, restlessness and distractibility, and poor episodic memory.

Middle Stage Treatment Focus

Help patient compensate for deficits and provide caregiver with environmental adaptations for patient.

Late Stage Dementia Symptoms

Disoriented to person, place, and time with severe-profound cognitive deficits noted.

Late Stage Treatment Focus

Help patient compensate for deficits, provide caregiver with environmental adaptations for patient, and assist caregiver in anticipation of patient’s wants and needs.

Diagnosing Alzheimer’s disease

Measuring levels of the amyloid beta protein in the CSF (cerebral spinal fluid).

Cholinesterase inhibitors and memantine

Given to treat the cognitive symptoms (memory loss, confusion, and problems with thinking and reasoning) of Alzheimer's disease.

Mini-Mental State Exam (MMSE)

Screens attention, concentration, language, and memory.

Treatment Suggestions for Dementia

Interview family/caregivers and provide counseling to family.

Treatment for Dementia

Manipulate the patient’s environment, i.e., eliminate barriers to full societal integration.

Spaced Retrieval Training (SRT)

The clinician gives pieces of important information or shows a behavior and then asks the patient to recall the information over time.

FOCUSED Caregiver Training Program

Face-to-face communication, orient to topic, continue with concrete topics, resolve any communication blocks, structure with yes/no and choice questions, encourage exchange conversation, and use direct, simple, short sentences

Common Etiologies of Encephalopathy

Infection, dehydration, metabolic deficiency, hypoglycemia, drug intoxication, and anoxia

Presenting Features of Encephalopathy

Acute change in mental state, change in personality and behavior, change in cognitive functioning, and altered level of alertness

Early stage encephalopathy

Patient lacks insight and judgment to recognize symptoms and is usually initially inattentive to the changes and alterations in his or her memory

Late stage encephalopathy

Chronic confusion, hyper-somnolence (excessive sleepiness), chronic confusion and delirium (more often unpleasant hallucinations), and possible coma

Role of Speech-Language Pathologist in ICU with Encephalopathy

Determine attentional abilities, assess functional communication needs and develop a communication modality for use in that context.

Screening tools for encephalopathy

Montreal Cognitive Assessment (MoCA), The Mini Mental Status Exam (MMSE), and St. Louis University Mental Status Exam (SLUMS)