MCI and Dementia

T/F An MCI is severe enough to impact ADLs

False

What is a hallmark of an MCI for diagnostic criteria?

difficulty in at least one cognitive process

everything else normal (ADLs, no dementia, cognitive functioning)

Amnestic MCI vs Non-Amnestic MCI

Amnestic- memory deficits

Non-amnestic- no memory deficits

Single domain MCI

Deficits in one NON-MEMORY cognitive process

ex. executive functions

Multiple domain MCI

multiple cognitive processes deficits w/ or without memory deficits

DSM-V criteria: mild and major

mild: does not interfere with ADLs; MCI

major: can interfere with ADLS; dementia

Normal Aging vs Abnormal aging: Memory example

Normal: what you were going to say

Abnormal aging: forgetting the steps to a common task

What are some premorbid levels of functioning that I should consider?

education

SES

employment

information from spouse/family

What are the typical assessments you could use for a MCI?

MOCA, SLUMS, MMSE, CLQT

T/F People with MCI are MORE likely to develop dementia

True

T/F MCI always leads to dementia

False

Can some individuals with mild cognitive impairment (MCI) revert to normal cognition or remain stable throughout their lives?

Yes

What is the typical reversion rate for an MCI patient? Which subtype is most likely to revert?

15-22%; amnestic MCI

What are common language deficits with MCI?

(naming and word retrieval has two subtypes)

Naming and word retrieval

-verbal fluency

-confrontation naming

Discourse processing

What are three ways to prevent MCI?

1. physical activity

2. diet

3. cognitive activity

Altered Mental Status (AMS) can range from...

slight confusion to coma

What is the onset of dementia?

Sneaky

What are some other criteria of dementia?

Acquired

Persistent

Affects several areas of mental function

Severe

What are the 4 cortical dementias?

Alzheimer's

Frontotemporal

Pick's

Primary prog. aphasia

What percent of dementia is accounted for by Alzheimer's?

50-60%

Alzheimer's Early stage: length, impairments, motor function

-lasts 2 years

-motor function spared

-cognitive impairments: working memory, prospective memory, word finding, language comprehension

-personality changes

Alzheimer's middle stage: length, impairments, motor function

-lasts 4-10 years

-greater impact on ADLs

-sundowning

-decline in executive function

Alzheimer's late stage: length, impairments, motor function

-motor dysfunction

-unresponsive

-profound cognitive and ADL deficits

Frontotemporal

-hallmark of language deficits

-due to accumulation of proteins

What are the subcortical dementias?

-Parkinsons

-Huntington's

-AIDS dementia complex

Huntington's Disease

-dance like movement (choreic)

-progressive and terminal

-speech, lang, swallowing, and cognition impaired

Mixed dementias

-multi-infarct

-vascular

-lewy body disease

Vascular dementia aka ...

multi-infarct dementia

vascular dementia onset and prevalence?

2nd leading cause of all dementias

sudden onset

Lewy body is caused due to..

abnormal deposits of protein

What are the two types of lewy body dementias

1. Parkinsons

-lewy bodies in substantia nigra

2. Lewy body

-Alzheimer's and Parkinsons symptoms

What are some symptoms of lewy body dementias?

Attention and EF deficits

What is normal pressure hydrocephalus?

excess cerebrospinal fluid accumulates in the brain's ventricles

Polypharmacy is ?

drug induced deficits

Delerium is defined as

an acute confusional state

Pseudodementia

"false dementia"

-can be caused by depression

Early stage dementia symptoms

1. memory

2. disorientation

3. ADLs

4. difficulty performing mentally challenging tasks

What is the hallmark of dementia?

Acquisition of new information

Middle stage deficits

Semantic memory (naming)

Visual-deficits deficits (prosopagnosia)

Late stage deficits

1. Semantic memory (all paraphasias)

2. Memory of routine programs

3. Mutism

Aphasia vs dementia pts

Aphasia patients can do well on nonverbal and problem solving tests while dementia patients will do bad on both

What are typical assessments for dementia patients?

MMSE, MOCA, CLqT, ABCD