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NE8 MCI and Dementia

Deleted user 9 questions Updated 11 Oct 2019

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Questions in this quiz (9)

  1. 1Normal advancing age can result in a number of neurophysiological changes. Select the change that is abnormal/not due to aging.
    1. ADeposition of beta-amyloid peptide
    2. BNeurofibrillary tangles
    3. CLoss of synapses and neuronal networks
    4. DExcitotoxicity
  2. 2Subjective Cognitive Decline
    • This is a title given to individuals who [blank_start]report[blank_end] experiencing cognitive change-most typically [blank_start]memory[blank_end] deficits.
    • No impairment shown on cognitive [blank_start]testing[blank_end].
    • There is increasing evidence that this subjectively experienced decline is associated with an [blank_start]increased[blank_end] risk of these patients experiencing [blank_start]future[blank_end] cognitive decline - and having biomarker abnormalities.
    1. Areport
    2. Bmemory
    3. Ctesting
    4. Dincreased
    5. Efuture
  3. 3The DSM-V classifies MCI as “Mild Neurocognitive Disorder”. Their criteria are:
    A. Evidence of modest cognitive decline from a previous level of performance in [blank_start]one or more[blank_end] cognitive domains (e.g. complex attention, executive function, learning and memory, language, perceptual motor, or social cognition) based
    on:
    1. Concern of the [blank_start]individual[blank_end], a knowledgeable informant, or the [blank_start]clinician[blank_end] that there has been a mild decline in functioning; and
    2. A modest impairment in cognitive performance, [blank_start]preferably[blank_end] documented by standardised neuropsychological testing (usually 1-2 standard deviations below the expected range-between the 3rd and 16th percentiles).
    B. The cognitive deficits do not interfere with capacity for [blank_start]independence[blank_end] in
    everyday activities (but greater [blank_start]effort[blank_end], compensatory strategies, or accommodation may be required).
    C. The cognitive deficits do not occur exclusively in the context of a [blank_start]delirium[blank_end]
    D. The cognitive deficits are not better explained by another [blank_start]mental disorder[blank_end]
    1. Aone or more
    2. Bindividual
    3. Cclinician
    4. Dpreferably
    5. Eindependence
    6. Feffort
    7. Gdelirium
    8. Hmental disorder
  4. 4What’s the difference between MCI and Dementia?
    • In MCI there is a preservation of the person’s [blank_start]independence[blank_end] in functional abilities, and [blank_start]lack[blank_end] of significant impairment in [blank_start]occupational or social[blank_end] functioning.
    • A person with a dementia or Major Neurocognitive Disorder (DSM-IV) will display more significant deficits on their cognitive tests (>[blank_start]2 SD from the mean[blank_end]) and their functioning will have [blank_start]significantly[blank_end] declined.
    1. Aindependence
    2. Black
    3. Coccupational or social
    4. D2 SD from the mean
    5. Esignificantly
  5. 5Risk factors for developing MCI:
    • Age
    • Male
    • Lower [blank_start]educational[blank_end] level
    • Presence of [blank_start]apolipoprotein E[blank_end] allele
    • Family [blank_start]history[blank_end] of cognitive impairment
    • Presence of [blank_start]vascular[blank_end] risk factors (hypertension, hyperlipidaemia, coronary artery disease, and stroke)
    • [blank_start]Chronic[blank_end] health conditions e.g. hypertension, hyperlipidaemia, coronary artery disease, osteoarthritis, chronic obstructive pulmonary disease, depression, diabetes mellitus.
    • Those that are cognitively or physically [blank_start]sedentary[blank_end]
    1. Aeducational
    2. Bapolipoprotein E
    3. Chistory
    4. Dvascular
    5. EChronic
    6. Fsedentary
  6. 6Not all cases of MCI are precursors to dementia and not all are [blank_start]progressive[blank_end]. Studies have found quite high [blank_start]reversal[blank_end] rates, with [blank_start]30% to 50%[blank_end] of patients originally diagnosed with MCI reverting back to “normal cognition” or remaining [blank_start]stable[blank_end] at follow-up assessments.
    SOME reversible Causes of MCI:
    • [blank_start]Poly[blank_end]pharmacy
    • Hypotension/Orthostatic [blank_start]Hyper[blank_end]tension
    • Depression
    • [blank_start]Hypo[blank_end]thyroidism
    • Vitamin [blank_start]B12[blank_end] Deficiency
    • Hypo/hyper[blank_start]glycemia[blank_end]
    • De[blank_start]hydration[blank_end]
    1. Aprogressive
    2. Breversal
    3. C30% to 50%
    4. Dstable
    5. EPoly
    6. FHyper
    7. GHypo
    8. HB12
    9. Iglycemia
    10. Jhydration
  7. 7Screening for MCI: MoCA (Montreal Cognitive Assessment)
    - Developed in 2005 as a brief [blank_start]screening[blank_end] instrument, not for diagnosis
    - Takes 10 [blank_start]minutes[blank_end] to administer and is scored out of [blank_start]30[blank_end] points. Initial norms recommended a cut off score of 26/25 (<[blank_start]25[blank_end] suspected of having MCI) but studies have shown that a cut off of 23/30 may be better as it allows fewer [blank_start]falsepositives[blank_end].
    - Assesses multiple cognitive domains including attention, concentration, executive functioning, memory, language, visuospatial skills, abstraction, calculation and orientation.
    - The MoCA has excellent [blank_start]sensitivity[blank_end] in identifying MCI and AD (90% and 100% respectively). [blank_start]Specificity[blank_end] = 87% ([blank_start]true positive[blank_end] rate).
    1. Ascreening
    2. Bminutes
    3. C30
    4. D25
    5. Efalse positives
    6. Fsensitivity
    7. GSpecificity
    8. Htrue positive
  8. 8Choose the incorrect statement.
    1. ACurrently there are no pharmacologic treatments that are approved for treatment of MCI.
    2. BPharmacologic treatments have been found to be useful at delaying the onset of dementia.
    3. CThere is no evidence to suggest that vitamins and various supplements help (unless there is a clear vitamin deficiency).
  9. 9Treatments tend to focus on lifestyle modification:
    • Vascular [blank_start]risk[blank_end] factor control
    • Withdrawing and simplifying [blank_start]medication[blank_end] regimes may help
    • Physical [blank_start]exercise[blank_end] is highly protective
    • Engaging in meaningful mental [blank_start]stimulation[blank_end] and intellectual activity
    • Socialising
    • Maximising [blank_start]hearing[blank_end]
    • Ensure people with [blank_start]sleep[blank_end] disorders are assessed and treated
    • Management of depression and/or anxiety
    • Education around [blank_start]external memory aids[blank_end] e.g. diary, calendar, keeping keys/purse in the [blank_start]same[blank_end] spot, reminder notes
    • Trying to minimize risk:
    - driving assessments, [blank_start]occupational therapy assessment[blank_end] around safety in the home, etc
    • Family education
    1. Arisk
    2. Bmedication
    3. Cexercise
    4. Dstimulation
    5. Ehearing
    6. Fsleep
    7. Gexternal memory aids
    8. Hsame
    9. Ioccupational therapy assessment

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User has deleted their subject information Quiz on NE8 MCI and Dementia, created by Deleted user on 11/10/2019.
Author
Deleted user
Language
English
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72
History
Created on 11 Oct 2019 · updated on 11 Oct 2019
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