Dementia Through Clinical Cases, Lecture notes of Reasoning

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Dementia Through Clinical Cases

Fireside Chat – Alzheimer’s Association 7

th

Annual

Kansas Education Conference on Dementia

Ryan W. Schroeder, PsyD, LP, ABPP-CN Board Certified Clinical Neuropsychologist

What is Dementia?

Pathology

Pathology under Microscope

Alzheimer’s Dementia

Alzheimer’s Dementia

Common Sx in Early AD

Primary cognitive change:

• Difficulty learning and remembering new information
  • Able to remember old information Common behavior changes:
• Forget to take medications or pay bills
• Frequently misplace or forget to take items (keys, pursue)
• Seem withdrawn from socially or mentally challenging situations (potentially due to being unable to keep up with information)
• Experience frustration or irritability due to difficulties
• Increase arguing due to not seeing issues that are being pointed out about them

Middle Stage AD

Late Stage AD

Common Sx in Late AD

Cognitive changes:

• Inability learning any new information
• Difficulty remembering long-term information
• Minimal reasoning ability
• Significant reduction in general intellectual functioning Examples of behavior changes:
• Unable to learn any new information
• Might forget family members or call them by wrong name
• Speech might become incomprehensible
• Hallucinations and delusions can occur
• General urinary incontinence
• Require assistance with bathing, grooming, dressing, eating, and toileting
• Require help walking

AD Pathology

Example – Late Stage A male in his early 80s was referred for an evaluation. He had previously been diagnosed with Alzheimer’s dementia. At the time of the evaluation, he was living at home with assistance from his family and paid caregivers. He is now unable to learn most any new information, and long-term memories are also weak (sometimes forgetting who his wife and children are). He is sometimes hard to understand due to slurring of words, and he appears to see people who are not in the room. He is needing help bathing, dressing, cutting his own food, and using the toilet. Due to falls, he is usually transported to appointments in a wheelchair. During the evaluation, he was unable to state his age, the current month, the current year, or the city where he was located. He was read a list of 3 words but could not remember any of them after just 1 minute. His family noted that they are struggling to provide care to him, and they asked whether it would be appropriate to consider moving him to a residence with a memory care unit.

Frontotemporal Dementia

Frontotemporal Dementia