Dementia

DSM 5 - major neurocognitive disorders

Interferes with independence, significant acquired cognitive decline in one or more of attention, executive function, learning and memory, language, perceptual motor, social cognition, deficits are not due to another disorder

DSM 5 - mild neurocognitive disorder

Modest acquired decline in one or more domains, do not impact independence

Structural changes in Alzheimer’s

Cortical atrophy, reduced size of hippocampus, enlarged ventricles

Pathology of AD

Amyloid plaques and neurofibrillary tangles or Tau that interfere with communication between neurons

Common memory symptoms of AD

Primary deficit of episodic memory, persistent short term memory loss, repeatedly saying the same time, difficulty learning new information

Common impairments of AD

Language and word finding, visuospatial perception, executive functioning, abstract thinking, disorientation to person, place, time

Other potential symptoms of AD

Changes in behaviour and mood, delusions or paranoia, aggression and agitation, reduced motivation and difficulty initiating tasks

Frontotemporal dementia

Group of neurodegenerative diseases characterised by progressive deficits in behaviour, executive function or language, commonly diagnosed in patients under 65

Structural changes in frontotemporal dementia

Progressive atrophy of frontal and temporal brain regions

Behavioural variant of FT dementia

Bilateral frontal lobe atrophy - personality changes, apathy, impulsive actions, socially inappropriate behaviour

Non fluent variant progressive aphasia - FT dementia

Atrophy in left anterior temporal areas

Impairments of Non fluent variant progressive aphasia

non fluent effortful speech with relatively preserved cognition, inconsistent speech sound errors, anomia or inability to name objects

Semantic variant progressive aphasia - FT dementia

Atrophy of anterior temporal lobe, amygdala and insular cortex

Impairments of Semantic variant progressive aphasia

Impairment of word meaning and finding, selective impairment of semantic memory, fluent but empty speech, may show some behavioural changes

Lewy body dementia

Umbrella term that includes clinically diagnosed dementia with lewy bodies and parkinsons disease dementia

Lewy bodies

Abnormal deposits of alpha synuclein in the brain

Accumulation of lewy bodies

Associated with neuronal loss in substantia nigra and reduced production of ACh and dopamine

Common symptoms of Lewy Body dementia

Executive dysfunction, difficulties with selective attention visuospatial function and episodic memory, verbal recall difficulty, apathy, depression, hallucinations, delusions

Vascular dementia

Cognitive loss associated with cerebrovascular damage such as strokes or transient ischaemic attacks, abrupt onset

Common symptoms of vascular dementia

Attention deficits, executive dysfunction, deficits in working, procedural and episodic memory, gait abnormalities, exaggerated reflexes