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Which Of The Following Statements Is True Regarding Dementia

What Are The Warning Signs Of Alzheimers Disease

CampER_Acute Geriatric Abdomen (Session 9 of 12)

Watch this video play circle solid iconMemory Loss is Not a Normal Part of Aging

Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.

In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:

  • Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
  • Trouble handling money and paying bills.
  • Difficulty completing familiar tasks at home, at work or at leisure.
  • Misplacing things and being unable to retrace steps to find them.
  • Changes in mood, personality, or behavior.

Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .

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Medications To Treat The Underlying Alzheimers Disease Process

Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.

Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.

Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.

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What Is The Burden Of Alzheimers Disease In The United States

  • Alzheimers disease is one of the top 10 leading causes of death in the United States.2
  • The 6th leading cause of death among US adults.
  • The 5th leading cause of death among adults aged 65 years or older.3

In 2020, an estimated 5.8 million Americans aged 65 years or older had Alzheimers disease.1 This number is projected to nearly triple to 14 million people by 2060.1

In 2010, the costs of treating Alzheimers disease were projected to fall between $159 and $215 billion.4 By 2040, these costs are projected to jump to between $379 and more than $500 billion annually.4

Death rates for Alzheimers disease are increasing, unlike heart disease and cancer death rates that are on the decline.5 Dementia, including Alzheimers disease, has been shown to be under-reported in death certificates and therefore the proportion of older people who die from Alzheimers may be considerably higher.6

Aging

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Drugs To Treat Alzheimer Disease

Cholinesterase inhibitors modestly improve cognitive function and memory in some patients. Four are available. Generally, donepezil, rivastigmine, and galantamine are equally effective, but tacrine is rarely used because of its hepatotoxicity.

Donepezil is a first-line drug because it has once-a-day dosing and is well-tolerated. The recommended dose is 5 mg orally once a day for 4 to 6 weeks, then increased to 10 mg once a day. Donepezil 23 mg once a day may be more effective than the traditional 10 mg once-a-day dose for moderate to severe Alzheimer disease. Treatment should be continued if functional improvement is apparent after several months, but otherwise it should be stopped. The most common adverse effects are gastrointestinal . Rarely, dizziness and cardiac arrhythmias occur. Adverse effects can be minimized by increasing the dose gradually .

Memantine, an N-methyl-d-aspartate receptor antagonist, appears to improve cognition and functional capacity of patients with moderate to severe Alzheimer disease. The dose is 5 mg orally once a day, which is increased to 10 mg orally twice a day over about 4 weeks. For patients with renal insufficiency, the dose should be reduced or the drug should be avoided. Memantine can be used with a cholinesterase inhibitor.

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How Does Alzheimers Disease Progress

PPT

The rate of progression of the disease varies from person to person.

However, the disease does lead eventually to complete dependence and finally death, usually from another illness such as pneumonia. A person may live from three to twenty years with Alzheimers disease, with the average being seven to ten years.

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Vitamins And Supplements Can Prevent Dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report some general limitations of the evidence, they conclude:

We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions.

Differences Between Delirium And Dementia

Delirium and dementia are conditions that can be confusing, both to experience and to distinguish. Both can cause memory loss, poor judgment, a decreased ability to communicate, and impaired functioning. While the question of delirium vs dementia may seem difficult to answer, there are many differences between the two, including the following:

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Although There Is No Cure For Dementia Scientists And Researchers Are Working Hard To Find One

Until that day comes, support and treatments are available that can help with symptoms and managing daily life. These can allow people with dementia to lead active, purposeful lives and carry on doing the things that matter to them most.

Treatments

There are drugs available that may help with some types of dementia and stop symptoms progressing for a while. This is one reason why its important to go to the GP as soon as you suspect theres a problem.

Other things that can help with symptoms of dementia include:

  • cognitive stimulation, which might involve doing word puzzles or discussing current affairs
  • life story work, sharing memories and experiences with a carer or nurse to create a life story book
  • keeping as active as possible physically, mentally and socially which can boost memory and self esteem, and help avoid depression.

Our research

Through research, were learning more about dementia every day. Researchers are working with people with dementia and their families to look into the causes of dementia.

Theyre looking at how it might be prevented and diagnosed earlier, and how to improve quality of life for people living with the condition. The more we understand, the more we can do to help people stay independent and live the life they want for as long as possible.

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Treatment For Moderate To Severe Alzheimers

A medication known as memantine, an N-methyl D-aspartate antagonist, is prescribed to treat moderate to severe Alzheimers disease. This drugs main effect is to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer’s and caregivers.

Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.

The FDA has also approved donepezil, the rivastigmine patch, and a combination medication of memantine and donepezil for the treatment of moderate to severe Alzheimers.

Drug NameFor More Information
Aducanumab
  • Intravenous: Dose is determined by a persons weight given over one hour every four weeks most people will start with a lower dose and over a period of time increase the amount of medicine to reach the full prescription dose
  • Tablet: Once a day dosage may be increased over time if well tolerated
  • Orally disintegrating tablet: Same dosing regimen as above

How Is Alzheimer’s Disease Diagnosed

Doctors use several methods and tools to help determine whether a person who is having memory problems has possible Alzheimers dementia , probable Alzheimers dementia , or some other problem.

To diagnose Alzheimers, doctors may:

  • Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality
  • Conduct tests of memory, problem solving, attention, counting, and language
  • Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem
  • Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to rule out other possible causes for symptoms

These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time. They can also help diagnose other causes of memory problems, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, mild cognitive impairment, or a non-Alzheimers dementia, including vascular dementia. Some of these conditions may be treatable and possibly reversible.

People with memory problems should return to the doctor every 6 to 12 months.

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Signs And Symptoms Of Alzheimers Disease

Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers. Some people with memory problems have a condition called mild cognitive impairment . With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimers, but not all of them do so. Some may even revert to normal cognition.

The first symptoms of Alzheimers vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimers. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimers in a health care providers office.

Fda Approves New Medication For Alzheimer’s

PPT

In June 2021, the U.S. Food and Drug Administration approved Aduhelm for treating patients with Alzheimers disease. Aduhelm is the first new drug approved to treat the disease since 2003 as well as the first to specifically target amyloid-beta – the protein researchers widely believe to play a role in the development of Alzheimer’s.

Delirium: Delirium requires immediate treatment by a physician. Since it’s usually caused by a physical illness or infection, medications such as antibiotics often resolve the delirium.

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Neurological Disorders Practice Test Questions

1. Amyloid plaques and neurofibrillary tangles are the hallmarks of:
  • Alzheimers disease
  • 2. Difficulty speaking and understanding speech is termed:
  • Apnea
  • 3. The most common form of transient facial paralysis is:
  • Alzheimers disease
  • Bells palsy
  • Erbs palsy
  • 4. Gradually increasing pain and weakness and numbness in the hand or wrist that radiates up the arm suggest:
  • Amyotrophic lateral sclerosis
  • 5. All of the following may be associated with Guillain-Barre Syndrome except:
  • Weakening or tingling sensation in the legs
  • Weakness in the arms and upper body
  • Nearly complete paralysis
  • First symptom is altered mental status
  • 6. Which of the following statement about herpes zoster is not true?
  • It is caused by the varicella-zoster virus
  • It causes burning, tingling pain and lesions, generally on one side of the body
  • Anyone who has had chickenpox is at risk of postherpetic neuralgia
  • It is a sexually transmitted disease
  • 7. Diagnostic tests for epilepsy include all of the following except:
  • Simple blood tests
  • Brain scan
  • Wada test
  • 8. Treatment for epilepsy to eliminate or sharply reduce the frequency of seizures may involve all of the following except:
  • Cognitive-behavioral therapy
  • Narrow-spectrum and broad-spectrum antiepileptic drugs
  • Vagus-nerve stimulation
  • 9. The most common inherited neurological disorder is:
  • Bloch-Sulzberger Syndrome
  • Alpers disease
  • Asperger Syndrome
  • 10. A severe form of epilepsy that appears during the first year of life is called:
  • Dandy-Walker syndrome
  • Fahrs syndrome
  • How Does Alzheimers Disease Affect The Brain

    Scientists continue to unravel the complex brain changes involved in Alzheimers disease. Changes in the brain may begin a decade or more before symptoms appear. During this very early stage of Alzheimers, toxic changes are taking place in the brain, including abnormal buildups of proteins that form amyloid plaques and tau tangles. Previously healthy neurons stop functioning, lose connections with other neurons, and die. Many other complex brain changes are thought to play a role in Alzheimers as well.

    The damage initially appears to take place in the hippocampus and the entorhinal cortex, which are parts of the brain that are essential in forming memories. As more neurons die, additional parts of the brain are affected and begin to shrink. By the final stage of Alzheimers, damage is widespread and brain tissue has shrunk significantly.

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    Dementia Is Inevitable With Age

    This statement is not true. Dementia is not a normal part of aging.

    According to a report that the Alzheimers Association published, Alzheimers disease, which is the most common form of dementia, affects 3% of people aged 6574 years in the U.S.

    As a result of the risk increasing as we age, 17% of people aged 7584 years and 32% of people aged 85 years and older have a dementia diagnosis.

    This is not quite correct. Alzheimers is a type of dementia, accounting for 6080% of all dementia cases. Other types of dementia include frontotemporal dementia , vascular dementia, mixed dementia, and Lewy body dementia.

    The define dementia as the loss of cognitive functioning thinking, remembering, and reasoning and behavioral abilities to such an extent that it interferes with a persons daily life and activities.

    Although dementias share certain characteristics, each type has a distinct underlying pathology.

    Alzheimers disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

    FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

    We All Forget A Name Or A Face Sometimes Especially As We Get Older But Dementia Is Something Different

    My Response Video

    Memory problems are one of a number of symptoms that people with dementia may experience. Others include difficulties with planning, thinking things through, struggling to keep up with a conversation, and sometimes changes in mood or behaviour.

    Dementia is not a natural part of ageing and it doesnt just affect older people. Over 40,000 people under 65 in the UK have dementia. This is called early-onset or young-onset dementia.

    Help and support

    If youre worried about your memory, or about someone else, the first thing to do is make an appointment with the GP.

    There are lots of reasons someone may show symptoms similar to dementia. These include depression, chest and urinary tract infections, vitamin and thyroid deficiencies and brain tumours.

    Your GP can check for most of these and take the next steps to find out whats causing your memory problems.

    We know it can feel daunting, but the quicker you talk to your GP, the sooner you can get the information, advice and support you need.

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    What Is Known About Alzheimers Disease

    Scientists do not yet fully understand what causes Alzheimers disease. There likely is not a single cause but rather several factors that can affect each person differently.

    • Age is the best known risk factor for Alzheimers disease.
    • Family historyresearchers believe that genetics may play a role in developing Alzheimers disease. However, genes do not equal destiny. A healthy lifestyle may help reduce your risk of developing Alzheimers disease. Two large, long term studies indicate that adequate physical activity, a nutritious diet, limited alcohol consumption, and not smoking may help people. To learn more about the study, you can listen to a short podcast.
    • Changes in the brain can begin years before the first symptoms appear.
    • Researchers are studying whether education, diet, and environment play a role in developing Alzheimers disease.
    • There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. Heres 8 ways.

    Can Dementia Be Inappropriately Diagnosed In A Single Visit

    Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.

    Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.

    But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.

    It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.

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