Health '20 17 Module 3 Section 2: Dementia and the Three D’s

This set covers the core terminology from the lecture on dementia, including definitions of various types, the three stages of progression, specific pathological markers like plaques and tangles, and the clinical distinctions between the 'Three D's': delirium, dementia, and depression.

Dementia

A collection of symptoms caused by various neurological disorders resulting in the deterioration of brain function, affecting memory, thinking, and daily activities.

Neurodegeneration

The process involving the loss of cells in the brain and the breakdown of important nerve connections.

Frontotemporal Dementia (FTD)

A type of dementia occurring typically between ages $40$ and $60$ characterized by dramatic changes in personality, behavior, and social conduct rather than initial memory loss.

Aphasia

A symptom where a person loses the ability to speak or find the right words, often seen as dementia progresses.

Global Deterioration Scale

Also known as the Reisberg Scale, a system used by medical professionals that divides the dementia process into seven distinct stages.

Early Stage Dementia

The phase where a client experiences mild forgetfulness and communication difficulties but is usually still aware of their diagnosis.

Middle Stage Dementia

The phase where memory continues to deteriorate, the client may fail to recognize family, and behaviors like wandering or sundowning become common.

Sundowning

An increase in agitation, aggression, or disorientation that specifically occurs in the evening or night.

Late Stage Dementia

The final phase where the client is bedridden, requiring $24$-hour care, and loses control of all body functions and verbal communication.

Primary Dementia

Dementias that are irreversible and not caused by another disease, such as Alzheimer's disease and Related Dementias (ADRD).

Secondary Dementia

Dementia resulting from physical effects of other diseases, such as substance abuse, injury, or nutritional deficiencies, which can sometimes be reversible.

Alzheimer's Disease and Related Dementias (ADRD)

The most common form of dementia, accounting for $64\%$ of all cases in Canada, identified by the presence of plaques and tangles in the brain.

Plaques

Toxic deposits in the brain consisting of beta amyloid that interfere with brain cell function at excessive levels.

Tangles

Neurofibrillary tangles made of tau protein that accumulate inside neurons, eventually choking off living cells.

Vascular Dementia

The second most common form of dementia, caused by chronic reduced blood flow to the brain, often following strokes or transient ischemic attacks (TIAs).

Transient Ischemic Attacks (TIAs)

Often called silent strokes, these are brief interruptions in blood flow that can lead to gradual, stepwise cognitive decline.

Dementia with Lewy Bodies (DLB)

A type of progressive dementia characterized by fluctuations in alertness, recurring visual hallucinations, and Parkinson-like motor symptoms.

Pick's Disease

A specific type of Frontotemporal Dementia marked by the presence of Pick bodies in the brain, often causing gluttony and compulsive behavior.

Mixed Dementia

A condition where a client exhibits characteristics of both Alzheimer's disease and vascular dementia simultaneously.

Creutzfeldt-Jakob Disease (CJD)

A very rare and rapid fatal brain disorder believed to be caused by proteinaceous prions, with $90\%$ of patients dying within one year of the first symptom.

Normal Pressure Hydrocephalus

A potentially reversible form of dementia caused by poor reabsorption of cerebral spinal fluid, resulting in fluid buildup in the brain.

Wernicke-Korsakoff Syndrome

A brain disorder caused by a lack of thiamine ($vitamin\,B_1$), often associated with heavy alcohol consumption and characterized by fabrication of stories to cover memory gaps.

Confabulation

The creation of false memories to fill in memory gaps without the intent to deceive, common in certain types of dementia.

Delirium

A medical emergency involving a sudden onset of severe confusion and rapid changes in brain function, often reversible if the underlying cause is treated.

Depression

A treatable mood disorder that can represent with similar symptoms to dementia, sometimes referred to as pseudodementia.

Pseudodementia

A term used when depression mimics the signs and symptoms of dementia.

Cholinesterase Inhibitors

A class of medications, including donepezil, galantamine, and rivastigmine, that slow cognitive decline by preventing the breakdown of acetylcholine.

NMDA Receptor Antagonists

A type of medication, such as memantine, used to help improve cognition and manage symptoms in clients with Alzheimer's.

Anosmia

The loss of the sense of smell, which can occur as far as $10$ years before the clinical signs of dementia appear.

Time Shifting

A late-stage dementia symptom where patients believe they are in an earlier time in their lives and may ask for relatives who are no longer alive.