Mild cognitive impairment and alzheimers disease
10 important questions on Mild cognitive impairment and alzheimers disease
Alzheimers visual and perceptual functions
- environmental information gets lost
- dressing disturbances (failure to locate sleeve)
- impaired contrast and figure background discrimination (missing toilet, misplacing items)
- various visual agnosias
- associated with pathology in visual association cortex
- occurs early but is not clinically apparent until memory ant attention disturbances are fully manifested (failure to copy complex figure of rey, )
Alzheimers executive functioning
- umbrella term for:
-planning
-set shifting
-inhibition
-working memory
-initiation
-etc. - executive functions are mainly for non-routine situations
- impairment in executive functions are already present in early stages
- impairments in executive functions often underlie problems in activities of daily living
Alzheimers neuropsychiatric issues
- core feature of alzheimers
- occur earlier in some patients than others
- once established, some evolve, remain the same, or recede
- behavioural deterioration may occur due to an acute stressor
- changes range from apathy,social withdrawal, disinhibition, agitation, eating disorders, psychosis
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Alzheimers personality and social behaviour
- early stages
-personality and behaviour are broadly preserved
-patients function well socially
Alzhiemers other neuropsychiatric issues
- delusions and hallucinations
-delusions are more common and are often persecutory, theft, or spousal infidelity
-hallucinations are usually visual
-predict more rapid decline - depression
-alzheimers and depression often coexist
-depression often precedes alzheimers - agression and agitation, provoked by:
-confusion
-delusions
-depression
-sleeping problems
-pain
-infections or drugs
-trivial changes in environment
Mild cognitive impairment (MCI)
- subjective and objective cognitive symptoms
- transitional stage between normal aging and dementia
MCI diagnostical criteria
- changes in cognitive status
- impairment in one or more cognitive domains
- preservation of independence in functional abilities
- not demented
MCI differential diagnosis
- Normal aging
- dementia
-alzheimers
-lewy body dementia
-frontotemporal dementia - depression
- delirium
- metabolic factors
Differential diagnosis depression
- depressed patients are impaired in:
-memory
-executive functions
-attention
-psychomotor speed
MCI influence of age, gender and education
- MCI is more common in men
- fewer years of education is associated with a higher prevalence of MCI
- the prevalence of MCI increases with age
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