Objectives. Aging and Forgetfulness Define Dementia Types of Dementia Treatment

Size: px
Start display at page:

Download "Objectives. Aging and Forgetfulness Define Dementia Types of Dementia Treatment"

Transcription

1 Dementia David Lam, MD, FRCPC, Psychiatry Assistant Clinical Professor Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton, Ontario

2 Objectives Aging and Forgetfulness Define Dementia Types of Dementia Treatment

3 Aging and Forgetfulness Memory loss is not a normal part of aging Most people remain alert as they age Benign senescent forgetfulness memory loss + other changes in mental powers = dementia Mild cognitive impairment (MCI)

4 Definition of Dementia Latin word Demens Not a disease Umbrella term to describe a group of symptoms Loss of recent memory and other mental abilities which interfere with daily life

5 Definition of Dementia Gradual memory loss Learning problems Problem with daily tasks Confusion Loss of language skills Reasoning and judgement Personality change Behavioural problems

6 Dementia - Epidemiology The 65 and older segment of the Canadian population is quickly growing. The fastest growth is in the 85+ category. By 2021, seniors will constitute about 18% of the Canadian population, projected to be ~ 7 million people. Health Canada. Canada s Aging Population

7 Dementia - Epidemiology Incidence of dementia with age, it doubles every 5 years after age 60. Canadian Study on Health and Aging (CSHA) = Canadians with dementia =

8 Dementia - Epidemiology new cases of AD in 2001, > ½ were women. By 2011, > new cases of AD per year. By 2031, >3/4 million Canadians will be diagnosed with AD or another dementia.

9 Types of Dementia Alzheimer s Disease (AD) Vascular Dementia (VaD) Lewy Body Dementia (LBD) Frontotemporal Dementia (FTD)

10 Alzheimer s Disease Most common form of dementia ~ % First described by Dr. Alois Alzheimer Patient was Auguste D. 51 y.o. woman Decline in mental functions Delusions Hallucinations

11 Alzheimer s Disease Exact cause still unknown Hallmarks of the disease Amyloid plaques Neurofibrillary tangles Brain cells shrink A decrease in brain size A decrease in brain chemicals Inflammation reaction occurs in the brain. To protect the brain - cytokines are released. As brain cells become more impaired, levels of these protective substances increase to toxic levels and damages the brain more than it protects.

12 Alzheimer s Disease Confirmed risk factors: Old age Family history of dementia Risk of developing AD 2-3x if a parent or a sibling has AD. History of vascular disorder ApoE-e4 gene (abnormal genetic variation)

13 Alzheimer s Disease The disease process begins slowly Memory loss Language problems (aphasia) Problems with identifying and recognizing things (agnosia) Problems with activities and coordination (apraxia) Problems with complicated functions (executive functioning)

14 Alzheimer s Disease Mild Problems with: Balancing a cheque book Preparing a complex meal Managing a difficult medication schedule Forgetting appointments Driving

15 Alzheimer s Disease Moderate Problems with: Simple food preparation House hold clean up, yard work (difficulty using common items) Forgetful of personal history (children s names) Personality changes Trouble with directions (can t find their way home) Some aspects of self care

16 Alzheimer s Disease Severe Problems with: Personal care, feeding, grooming, toileting Problems with communicating to others and understanding May have troubles with movement Unable to recognize family Requires regular supervision or care

17 Alzheimer s Disease Profound Largely oblivious to their surroundings Totally dependent on caregivers

18 Alzheimer s Disease Generally bed bound Terminal Require constant care Susceptible to accidents and infectious diseases, such as pneumonia, which often will lead to death

19 Alzheimer s Disease Typical course of Alzheimer's Disease MMSE Score MCI Mild Moderate Severe Alzheimer's Disease The average survival ~ 8 10 years after symptoms start. Years Adapted from Feldman et al., Clinical Diagnosis and Management of Alzheimer s Disease, 1991

20 Lewy Body Dementia May account for 5-10 % and possibly as much as 25 % of dementias Abnormal deposits in the brain, Lewy bodies It shares features of AD and Parkinson s disease Delusions and hallucinations Sensitive to neuroleptic medications

21 Vascular Dementia Third most common form of dementia ~ % Usually affects people between 60 and 75 Occurs in men > women It is caused by a series of strokes in the brain Strokes are due to blocked or burst blood vessels in the brain

22 Vascular Dementia Risk Factors for Stroke High blood pressure Diabetes High cholesterol Heart disease/abnormal heart rhythms

23 Vascular Dementia Symptoms usually occur quickly Symptoms progress in a step-wise pattern Presentation depends on what area of the brain is affected: Confusion/memory loss Abnormal movements/gait/coordination Language problems Inappropriate emotions

24 Vascular Dementia Transient Ischemic Attacks (TIAs) TIAs increase the risk of suffering a stroke VaD is diagnosed through a neurological examination and brain scanning investigations VaD and AD can occur together

25 Frontotemporal Dementia Broad spectrum of disorders, Pick s disease, behavioural variant, Progressive non-fluent aphasia, semantic dementia. Frontal and temporal lobes affected. Symptoms begin gradually and progress slowly. Age of onset between 40 and 60. Usually see behavioural changes first. Disinhibition, impulsivity, impaired social awareness, decline in personal hygiene, and repetitiveness. May also see apathetic type.

26 Treatment Assess for medical and reversible causes Psychosocial and behavioral interventions: Educate patient and family Ensure patient safety, such as driving Address legal issues - POA Regular health monitoring Medications

27 Treatment Medications used to treat mild to moderate cases of AD Acetylcholinesterase inhibitors Prevents breakdown of acetylcholine (Ach) Ach important in mental abilities Medications do not stop AD Medications act to slow the progression Tacrine (Cognex)

28 Donepezil (Aricept) Acetylcholinesterase inhibitor. Once daily dosing. Initiated at 5 mg/day and then increased to 10 mg/day after 4-6 weeks. Clinical trials indicated that the 10 mg/day dose was more effective than the 5 mg/day dose.

29 Rivastigmine (Exelon) Acetylcholinesterase and butyrylcholinesterase inhibitor. Twice daily dosing. Initiate at 1.5 mg bid. It may be increased after 4-6 weeks to 3 mg bid. Subsequently, every 4-6 weeks can be increased to 4.5 mg bid and 6 mg bid. Again, better effects at higher doses but more side effects. Patch 5 and 10. Good kidneys.

30 Galantamine (Reminyl) ER Acetylcholinesterase inhibitor and nicotinic receptor modulator via allosteric potentiation, which enhances cholinergic transmission. Razadyne in the U.S. Starting dose is 8 mg daily. The dosage may be increased to 16 mg daily in 4 weeks, and then 24 mg daily after another 4 weeks.

31 Common Side-effects Nausea, vomiting, diarrhea, anorexia, muscle cramps and fatigue. Caution if there is a history of cardiac conduction defects, history of GI bleeds, asthma.

32 Memantine (Ebixa) FDA approved in October 2003 for the treatment of moderate to advance Alzheimer s disease (Ebixa/Namenda). It works differently than the other medications for Alzheimer s disease (NMDA antagonist). It involves Glutamate, its receptor (NMDA), and calcium in the brain cell. It was approved in Canada at the end of 2004.

33 Memantine (Ebixa) It is for the treatment of moderate to severe Alzheimer s disease. It is not covered by the provincial drug plan. Start at 5 mg daily, and increase by 5 mg every week. The recommended dose is 10 mg twice daily.

34 Memantine (Ebixa) It is well tolerated. Common side-effects may include: dizziness, constipation, headaches, high blood pressure, confusion (rapid ), seizures (rare). Good kidneys.

35 Antipsychotic Medications Non-cognitive symptoms of dementia can include depression, anxiety, hallucinations (hearing voices and seeing things), delusions (believing in something that is untrue), and agitation (verbal aggression, physical aggression). These symptoms can impact care. Behavioural problems are common in people with dementia (about 80%). Difficult behaviours and incontinence are the cause of most admissions to LTC.

36 Antipsychotic Medications Depression can be treated with antidepressants. Anxiety can be treated with antidepressants or benzodiazepines. Delusions and hallucinations are treated with antipsychotic medications. Agitation, particularly physical aggression, has been treated with antipsychotic medications.

37 Antipsychotic Medications All medications have potential for side-effects and adverse effects. Problems with AP medications. They have been associated with an 1.6 x increase risk for death (mainly strokes). Unclear why this may be. More research is needed. These medications are now reserved for patients who s symptoms are very disruptive and debilitating (unsafe to themselves and others). There is often no good alternatives. Keep in mind that these symptoms are also very uncomfortable to patients and can affect their physical health as well. Risk benefit analysis.

38 Take Home Points 1. Dementia is a memory problem plus other cognitive changes that affects a person s functioning that is a decline from their previous level of functioning. 2. Old age is the most consistent risk factor for developing a dementia. 3. Alzheimer s Disease is the most common type of dementia. 4. Medical, psychosocial, safety, and legal issues have to be addressed. 5. Medications available for treatment are not disease modifying.

Primary Care Update January 28 & 29, 2016 Alzheimer s Disease and Mild Cognitive Impairment

Primary Care Update January 28 & 29, 2016 Alzheimer s Disease and Mild Cognitive Impairment Primary Care Update January 28 & 29, 2016 Alzheimer s Disease and Mild Cognitive Impairment Kinga Szigeti, MD Associate Professor UBMD Neurology UB Department of Neurology Questions How do we differentiate

More information

Alzheimer Disease (AD)

Alzheimer Disease (AD) 1 Alzheimer Disease (AD) 2 Alzheimer's disease is a progressive degenerative disease that attacks the brain and results in impaired memory, thinking and behavior. It was first described by Dr. Alois Alzheimer

More information

Cholinesterase inhibitors and memantine use for Alzheimer s disease TOPIC REVIEW

Cholinesterase inhibitors and memantine use for Alzheimer s disease TOPIC REVIEW Cholinesterase inhibitors and memantine use for Alzheimer s disease TOPIC REVIEW Diagnosis of Dementia : DSM-IV criteria Loss of memory and one or more other cognitive abilities Aphasia Apraxia Agnosia

More information

Normal Aging versus Alzheimer Disease Drugs to treat the symptoms that are not due to old age. Leah Wright, HBSc. BSP student June 2006

Normal Aging versus Alzheimer Disease Drugs to treat the symptoms that are not due to old age. Leah Wright, HBSc. BSP student June 2006 Normal Aging versus Alzheimer Disease Drugs to treat the symptoms that are not due to old age. Leah Wright, HBSc. BSP student June 2006 Alzheimer Disease is a form of dementia that affects 5% of men and

More information

Memantine (Ebixa) Drug treatment for Alzheimer s disease

Memantine (Ebixa) Drug treatment for Alzheimer s disease IS 20 October 2011 Information sheet Memantine (Ebixa) Drug treatment for Alzheimer s disease Introduction... 1 How does Ebixa work?... 1 Who might benefit?... 2 What effect might Ebixa have?... 2 How

More information

2012 Medical School for Actuaries Nov. 6-7, 2012 Session #1: Alzheimer s Disease

2012 Medical School for Actuaries Nov. 6-7, 2012 Session #1: Alzheimer s Disease 2012 Medical School for Actuaries Nov. 6-7, 2012 Session #1: Alzheimer s Disease Dylan Wint, M.D. ALZHEIMER DISEASE Dylan Wint, M.D. Lou Ruvo Center for Brain Health DEFINITIONS Cognitive related to thinking,

More information

Pharmacotherapy of BPSD. Pharmacological interventions. Anti-dementia drugs. Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence

Pharmacotherapy of BPSD. Pharmacological interventions. Anti-dementia drugs. Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence Pharmacotherapy of BPSD Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence Pharmacological interventions Reducing medication errors. Reducing potentially inappropriate medication prescription.

More information

MCDB 4777/5777 Molecular Neurobiology Lecture 38 Alzheimer s Disease

MCDB 4777/5777 Molecular Neurobiology Lecture 38 Alzheimer s Disease MCDB 4777/5777 Molecular Neurobiology Lecture 38 Alzheimer s Disease Outline of Today s Lecture Why is Alzheimer s disease a problem? What is Alzheimer s Disease? What causes Alzheimer s disease? How can

More information

Donepezil hydrochloride (Aricept) Drug treatment for Alzheimer s disease

Donepezil hydrochloride (Aricept) Drug treatment for Alzheimer s disease IS 11 October 2011 Information sheet Donepezil hydrochloride (Aricept) Drug treatment for Alzheimer s disease Introduction... 1 How does Aricept work?... 1 Who might benefit from Aricept?... 2 What effect

More information

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa )

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) ESCA: For the treatment of Alzheimer s disease. SECONDARY CARE SECTION TO BE COMPLETED BY INITIATING DOCTOR

More information

Alzheimer s disease. What is Alzheimer s disease?

Alzheimer s disease. What is Alzheimer s disease? Alzheimer s disease What is Alzheimer s disease? What we know about dementia and Alzheimer s disease Alzheimer s disease is the most common of a large group of disorders known as dementias. It is an irreversible

More information

Everyone has mild memory lapses from time to time. You go

Everyone has mild memory lapses from time to time. You go Coping With Memory Loss Everyone has mild memory lapses from time to time. You go from the kitchen to the bedroom to get something, only to find yourself wondering what you needed. You can t find your

More information

Update on Treatment of the Dementias

Update on Treatment of the Dementias Update on Treatment of the Dementias Mark Pippenger, MD Behavioral Neurology Associate Clinical Professor of Neurology University of Arkansas for Medical Sciences Disclosures I will be discussing off-label

More information

Long Term Care Formulary HCD - 09. Anti-Dementia Drugs (e.g. donepezil, galantamine, rivastigmine, memantine)

Long Term Care Formulary HCD - 09. Anti-Dementia Drugs (e.g. donepezil, galantamine, rivastigmine, memantine) 1 of 8 USE OF CHOLINESTERASE (AChE) INHIBITORS The cholinesterase inhibitor anti-dementia drugs are indicated for the symptomatic treatment of patients with mild to moderate dementia of the Alzheimer s

More information

Intellectual Symptoms Amnesia: Loss of memory function

Intellectual Symptoms Amnesia: Loss of memory function Definition of Dementia (de mens) Latin for out of mind Permanent loss of multiple intellectual functions Alois Alzheimer first described this disease in 1906 in a brain specimen from an autopsy. Alzheimer

More information

DRUG APPROVAL PROCESS FOR THE TREATMENT OF ALZHEIMER S DISEASE

DRUG APPROVAL PROCESS FOR THE TREATMENT OF ALZHEIMER S DISEASE Research DRUG APPROVAL PROCESS FOR THE TREATMENT OF ALZHEIMER S DISEASE There are certain principles that should be followed when involving people with Alzheimer s disease in research. For more information,

More information

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late

More information

Staging and Treatment of Dementia

Staging and Treatment of Dementia Staging and Treatment of Dementia Ami Hall DO 10/25/14 1 Objectives What are the two most common types of dementias seen in a primary care office How are they staged What treatments are available Definition

More information

Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia

Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia Shared Care Guideline-Use of Donepezil, Galantamine, Rivastigmine and Memantine in Dementia Version: 3.0 Ratified by: Medicines Committee Date ratified: 16 th November 2011 Name of originator/author: James

More information

Emergency Room Treatment of Psychosis

Emergency Room Treatment of Psychosis OVERVIEW The term Lewy body dementias (LBD) represents two clinical entities dementia with Lewy bodies (DLB) and Parkinson s disease dementia (PDD). While the temporal sequence of symptoms is different

More information

Traumatic brain injury (TBI)

Traumatic brain injury (TBI) Traumatic brain injury (TBI) A topic in the Alzheimer s Association series on understanding dementia. About dementia Dementia is a condition in which a person has significant difficulty with daily functioning

More information

Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer s disease (amended)

Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer s disease (amended) Issue date: November 2006 (amended September 2007, August 2009) Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer s disease (amended) Includes a review of NICE

More information

Meeting the Needs of Aging Persons. Aging in Individuals with a

Meeting the Needs of Aging Persons. Aging in Individuals with a Meeting the Needs of Aging Persons with Developmental Disabilities Cross Network Collaboration for Florida Aging in Individuals with a Developmental Disability Module 3 Based on ADRC training developed

More information

**Form 1: - Consultant Copy** Telephone Number: Fax Number: Email: Author: Dr Bernard Udeze Pharmacist: Claire Ault Date of issue July 2011

**Form 1: - Consultant Copy** Telephone Number: Fax Number: Email: Author: Dr Bernard Udeze Pharmacist: Claire Ault Date of issue July 2011 Effective Shared Care Agreement for the treatment of Dementia in Alzheimer s Disease Donepezil tablets / orodispersible tablets (Aricept / Aricept Evess ) These forms (1 and 2) are to be completed by both

More information

basics of alzheimer s disease What it is and what you can do

basics of alzheimer s disease What it is and what you can do basics of alzheimer s disease What it is and what you can do What is Alzheimer s disease? Alzheimer s (AHLZ-high-merz) is a disease of the brain that causes problems with memory, thinking and behavior.

More information

Technology appraisal guidance Published: 23 March 2011 nice.org.uk/guidance/ta217

Technology appraisal guidance Published: 23 March 2011 nice.org.uk/guidance/ta217 Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease Technology appraisal guidance Published: 23 March 2011 nice.org.uk/guidance/ta217 NICE 2011. All rights reserved.

More information

2016 Programs & Information

2016 Programs & Information Mayo Alzheimer s Disease Research Clinic Education Center 2016 Programs & Information BROCHURE TITLE FLUSH RIGHT for Persons & Families impacted by Mild Cognitive Impairment Alzheimer s Disease Dementia

More information

Galantamine hydrobromide (Reminyl) Drug treatment for Alzheimer s disease

Galantamine hydrobromide (Reminyl) Drug treatment for Alzheimer s disease IS 17 October 2011 Information sheet Galantamine hydrobromide (Reminyl) Drug treatment for Alzheimer s disease Introduction... 1 How does Reminyl work?... 1 Who might benefit?... 2 What effect might Reminyl

More information

NHS ONEL and NELFT Shared Care Guidelines. Management of medications for Alzheimer s disease. Patient Name : Date of Birth: NHS No:

NHS ONEL and NELFT Shared Care Guidelines. Management of medications for Alzheimer s disease. Patient Name : Date of Birth: NHS No: NHS ONEL and NELFT Shared Care Guidelines Management of medications for Alzheimer s disease DOCUMENT TO BE SCANNED INTO ELECTRONIC RECORDS AND FILED IN NOTES Patient Name : Date of Birth: NHS No: Name

More information

Copywrite - Eric Freitag, Psy.D., 2012

Copywrite - Eric Freitag, Psy.D., 2012 Diagnosis, Intervention and Care for Patients With Cognitive Impairment Eric J. Freitag, Psy.D, FACPN Diplomate, American College of Professional Neuropsychology Mt. Diablo Memory Center Founder/Executive

More information

Acetylcholinesterase Inhibitors and Memantine Clinical Indication: Treatment of Dementia in Alzheimer s Disease (AD)

Acetylcholinesterase Inhibitors and Memantine Clinical Indication: Treatment of Dementia in Alzheimer s Disease (AD) SHARED CARE PROTOCOL AND INFORMATION FOR GPS Acetylcholinesterase Inhibitors and Memantine Clinical Indication: Treatment of Dementia in Alzheimer s Disease (AD) Version: 3 Date Approved: June 2011 Review

More information

Alzheimer's: The Latest Assessment and Treatment Strategies

Alzheimer's: The Latest Assessment and Treatment Strategies Questions from chapter 1 Alzheimer's: The Latest Assessment and Treatment Strategies 1) What is a loss of cognitive and intellectual powers without changes in consciousness. a) dementia b) delusions c)

More information

Dementia with Lewy bodies

Dementia with Lewy bodies IS 18 April 2011 Information sheet Dementia with Lewy bodies Introduction... 1 Key points... 1 What is dementia with Lewy bodies?... 1 How many people are affected by DLB?.. 2 What is the cause?... 2 Symptoms...

More information

Prescribing Framework for Donepezil in the Treatment and Management of Dementia

Prescribing Framework for Donepezil in the Treatment and Management of Dementia Hull & East Riding Prescribing Committee Prescribing Framework for Donepezil in the Treatment and Management of Dementia Patients Name:.. NHS Number: Patients Address:... (Use addressograph sticker) GP

More information

Clinical Audit: Prescribing antipsychotic medication for people with dementia

Clinical Audit: Prescribing antipsychotic medication for people with dementia Clinical Audit: Prescribing antipsychotic medication for people with dementia Trust, team and patient information Q1. Patient's DIS number... Q2. Patient s residence: Home Residential Home Nursing Home

More information

Donepezil, galantamine, rivastigmine and memantine for Alzheimer s disease

Donepezil, galantamine, rivastigmine and memantine for Alzheimer s disease Understanding NICE guidance Information for people who use NHS services Donepezil, galantamine, rivastigmine and memantine for Alzheimer s disease NICE technology appraisal guidance advises on when and

More information

N-methyl-D-aspartate (NMDA) Receptor Antagonist Memantine (CWM TAF ONLY)

N-methyl-D-aspartate (NMDA) Receptor Antagonist Memantine (CWM TAF ONLY) Bro Taf Localities Drugs & Therapeutics Committee SHARED CARE Drugs: Acetylcholinesterase inhibitors - Donepezil, Rivastigmine and Galantamine (Cardiff and Vale and Cwm Taf) Protocol No. CV 52 N-methyl-D-aspartate

More information

Essential Shared Care Agreement Drugs for Dementia

Essential Shared Care Agreement Drugs for Dementia Ref No. E040 Essential Shared Care Agreement Drugs for Dementia Please complete the following details: Patient s name, address, date of birth Consultant s contact details (p.3) And send One copy to: 1.

More information

U.S. Scientific Update Aricept 23 mg Tablets. Dr. Lynn Kramer President NeuroScience Product Creation Unit Eisai Inc.

U.S. Scientific Update Aricept 23 mg Tablets. Dr. Lynn Kramer President NeuroScience Product Creation Unit Eisai Inc. U.S. Scientific Update Aricept 23 mg Tablets Dr. Lynn Kramer President NeuroScience Product Creation Unit Eisai Inc. Unmet Need in Moderate to Severe Alzheimer s Disease (AD) Ongoing clinical deterioration

More information

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease.

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Memory loss and changes in mood and behavior are some signs that you or a family member may have Alzheimer s disease. If you have

More information

Underwriting long term care insurance: a primer

Underwriting long term care insurance: a primer By Lori Boyce, AVP Risk Management and R&D Underwriting long term care insurance: a primer Every day Canadians die, are diagnosed with cancer, have heart attacks and become disabled and our insurance solutions

More information

Dementa Formulary Guidance [v1.0]

Dementa Formulary Guidance [v1.0] Dementa Formulary Guidance [v1.0] 1. Introduction These Guidelines are intended for routine use. However there will be instances where they are not suitable for the patient you are managing, where more

More information

Shared Care Protocol for the Prescription of Memantine for Alzheimer s disease

Shared Care Protocol for the Prescription of Memantine for Alzheimer s disease Shared Care Protocol for the Prescription of Memantine for Alzheimer s disease 1. REFERRAL CRITERIA Patients of any age that are suspected to be suffering from moderate to severe Alzheimer s disease will

More information

Lewy body dementia Referral for a Diagnosis

Lewy body dementia Referral for a Diagnosis THE Lewy Body society The more people who know, the fewer people who suffer Lewy body dementia Referral for a Diagnosis Lewy Body Dementias REFERRAL FOR A DIAGNOSIS In the UK people with all forms of dementia

More information

What is vascular dementia?

What is vascular dementia? alzheimers.org.uk What is vascular dementia? Vascular dementia is the second most common form of dementia after Alzheimer s disease. It is caused by problems in the supply of blood to the brain. This factsheet

More information

CEN Outreach Neurological Disorders

CEN Outreach Neurological Disorders CEN Outreach Neurological Disorders Migraine, Mul,ple Sclerosis, Alzheimer s Disease Migraine Migraine is the most common neurological disorder in the developed world Almost 1 in 5 Americans will have

More information

Common causes of dementia

Common causes of dementia Common causes of dementia Alzheimer s disease vascular (multi-infarct etc.) dementia dementia of Parkinsonism Huntington s disease Pick s disease Creutzfeldt-Jacob disease etc. DEGENERATIVE DEMENTIA Pick

More information

Medication for Dementia (Acetylcholinesterase Inhibitors)

Medication for Dementia (Acetylcholinesterase Inhibitors) Older People s Mental Health Service Medication for Dementia (Acetylcholinesterase Inhibitors) August 2011 ^ ãéãäéê çñ `~ãäêáçöé råáîéêëáíó eé~äíü m~êíåéêë What are they? A group of medications used to

More information

Information for Prescribing Anti-dementia Drugs. November 2012

Information for Prescribing Anti-dementia Drugs. November 2012 Information for Prescribing Anti-dementia Drugs The aim of this document is to provide information about the prescribing of anti-dementia medication for adult patients with dementia following an assessment

More information

PARTNERING WITH YOUR DOCTOR:

PARTNERING WITH YOUR DOCTOR: PARTNERING WITH YOUR DOCTOR: A Guide for Persons with Memory Problems and Their Care Partners Alzheimer s Association Table of Contents PARTNERING WITH YOUR DOCTOR: When is Memory Loss a Problem? 2 What

More information

Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole)

Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) EMA/303592/2015 Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) This is a summary of the risk management plan (RMP) for Aripiprazole Pharmathen, which details the measures

More information

Social Security Disability Insurance and young onset dementia: A guide for employers and employees

Social Security Disability Insurance and young onset dementia: A guide for employers and employees Social Security Disability Insurance and young onset dementia: A guide for employers and employees What is Social Security Disability Insurance? Social Security Disability Insurance (SSDI) is a payroll

More information

Alzheimer s disease. Information sheet

Alzheimer s disease. Information sheet IS27 September 2003 Information sheet Alzheimer s disease Introduction This information sheet is for people with early Alzheimer s disease who want to know more about their illness, and for carers of people

More information

Conjoint Professor Brian Draper

Conjoint Professor Brian Draper Chronic Serious Mental Illness and Dementia Optimising Quality Care Psychiatry Conjoint Professor Brian Draper Academic Dept. for Old Age Psychiatry, Prince of Wales Hospital, Randwick Cognitive Course

More information

These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes.

These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes. This is a new guideline. These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes. It incorporates NICE clinical

More information

Electroconvulsive Therapy - ECT

Electroconvulsive Therapy - ECT Electroconvulsive Therapy - ECT Introduction Electroconvulsive therapy, or ECT, is a safe and effective treatment that may reduce symptoms related to depression or mental illness. During ECT, certain parts

More information

NEUROPSYCHOLOGY QUESTIONNAIRE. (Please fill this out prior to your appointment and bring it with you.) Name: Date of appointment: Home address:

NEUROPSYCHOLOGY QUESTIONNAIRE. (Please fill this out prior to your appointment and bring it with you.) Name: Date of appointment: Home address: NEUROPSYCHOLOGY QUESTIONNAIRE (Please fill this out prior to your appointment and bring it with you.) Name: Date of appointment: Date of birth: Age: _ Home address: _ Home phone: Cell phone: Work phone:

More information

Patients with dementia and other types of structural brain injury are predisposed to delirium (i.e., abrupt onset, temporary confusion caused by

Patients with dementia and other types of structural brain injury are predisposed to delirium (i.e., abrupt onset, temporary confusion caused by Dementia is the permanent loss of multiple intellectual functions resulting from neuronal death. Dementia afflicts 10% of individuals over the age of 65 and these patients survive approximately seven years

More information

The Pharmacist s Role in Recognition and Management of Alzheimer s

The Pharmacist s Role in Recognition and Management of Alzheimer s 10:15am - 11:15am: Breakout 2 - Mental Health Option B: The Pharmacist s Role in Recognition and Management of Alzheimer s ACPE UAN 0107-0000-10-013-L01-P 0.1 CEU/1.0 Hr. Activity Type: Application-Based

More information

Dementia. Your medicine. Information for you. Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa

Dementia. Your medicine. Information for you. Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Dementia Your medicine Information for you Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Visit our website: www.nhsaaa.net All our publications are available in other formats

More information

Alzheimer s and Depression: What is the Connection?

Alzheimer s and Depression: What is the Connection? Alzheimer s and Depression: What is the Connection? Ladson Hinton MD Professor and Director of Geriatric Psychiatry Department of Psychiatry and Behavioral Sciences Director, Education Core, Alzheimer

More information

An Introduction to Lewy Body Dementia

An Introduction to Lewy Body Dementia An Introduction to Lewy Body Dementia A special publication for people newly diagnosed with Lewy body dementia and those still seeking answers. You don t have to face LBD alone. Increasing Knowledge Sharing

More information

Dementia & Movement Disorders

Dementia & Movement Disorders Dementia & Movement Disorders A/Prof Michael Davis Geriatrician ACT Health & GSAHS ANU Medical School Eastern Dementia Network Aged and Dementia Care Symposium Bateman s Bay, 22 October 2010 Types of Dementia

More information

Delirium. The signs of delirium are managed by treating the underlying cause of the medical condition causing the delirium.

Delirium. The signs of delirium are managed by treating the underlying cause of the medical condition causing the delirium. Delirium Introduction Delirium is a complex symptom where a person becomes confused and shows significant changes in behavior and mental state. Signs of delirium include problems with attention and awareness,

More information

Depression is a common biological brain disorder and occurs in 7-12% of all individuals over

Depression is a common biological brain disorder and occurs in 7-12% of all individuals over Depression is a common biological brain disorder and occurs in 7-12% of all individuals over the age of 65. Specific groups have a much higher rate of depression including the seriously medically ill (20-40%),

More information

Being an advocate for good care. Useful medications What to expect When to be concerned

Being an advocate for good care. Useful medications What to expect When to be concerned Being an advocate for good care Useful medications What to expect When to be concerned Common Medical Questions 1. What medications are available to help with memory loss? Cholinesterase Inhibitors The

More information

1: Motor neurone disease (MND)

1: Motor neurone disease (MND) 1: Motor neurone disease (MND) This section provides basic facts about motor neurone disease (MND) and its diagnosis. The following information is an extracted section from our full guide Living with motor

More information

Guidelines for Dementia Syndrome

Guidelines for Dementia Syndrome Guidelines for Dementia Syndrome Dementia is the chronic acquired decline in memory and at least one other cognitive function (e.g. language, visual-spatial, executive) sufficient to offset daily life.

More information

Depression in Older Persons

Depression in Older Persons Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression

More information

Disclosures. Case: Ms. K. Case: Ms. K. Dementia: Considering When to Start, Stop, and Continue Medications 4/23/15. * Nothing to disclose

Disclosures. Case: Ms. K. Case: Ms. K. Dementia: Considering When to Start, Stop, and Continue Medications 4/23/15. * Nothing to disclose Dementia: Considering When to Start, Stop, and Continue Medications * Nothing to disclose Disclosures Lianne Hirano, MD UW Division of Gerontology & Geriatric Medicine 4/23/15 Current Concepts in Drug

More information

Parkinson's s disease - a

Parkinson's s disease - a Parkinson's Disease Parkinson's s disease - a progressive disorder of the nervous system that affects movement. The most common perception of Parkinson s is the patient having tremors. Hands shaking, inability

More information

Depression Flow Chart

Depression Flow Chart Depression Flow Chart SCREEN FOR DEPRESSION ANNUALLY Assess for depression annually with the PHQ-9. Maintain a high index of suspicion in high risk older adults. Consider suicide risk and contributing

More information

How to identify, approach and assist employees with young onset dementia: A guide for employers

How to identify, approach and assist employees with young onset dementia: A guide for employers How to identify, approach and assist employees with young onset dementia: A guide for employers What is dementia? Dementia involves the decline of cognitive functions. Young Onset Dementia, also known

More information

Alzheimer s and memory loss

Alzheimer s and memory loss Alzheimer s and memory loss Introduction This introductory leaflet aims to help you understand about memory loss, Alzheimer s disease and other forms of dementia. You can also find out how to get more

More information

JHS Stroke Program. 2016 JHS Annual Mandatory Education

JHS Stroke Program. 2016 JHS Annual Mandatory Education JHS Stroke Program 2016 JHS Annual Mandatory Education Learner Objectives At the conclusion of this module learners will be able to: State the definition of stroke Discuss the pathophysiology of stroke

More information

Cognitive Testing for Underwriting Life Insurance

Cognitive Testing for Underwriting Life Insurance Cognitive Testing for Underwriting Life Insurance Presentation to the Mortality Working Group of the International Actuarial Association Al Klein April 8, 2011 Cognitive function Agenda What is it? What

More information

Alzheimer s disease and diabetes

Alzheimer s disease and diabetes 1007029 CM1053CS Alzheimer s disease and diabetes Nearly 21 million Americans in the United States have diabetes, a disease that makes the body less able to convert sugar to energy. More than 6 million

More information

Alzheimer s and. memory loss

Alzheimer s and. memory loss Alzheimer s and memory loss This leaflet aims to help you understand about memory loss, Alzheimer s disease and other forms of dementia. You can also find out how to get more information. It s for anyone

More information

9/20/2010. The eye doesn t see what the mind doesn t know. Sir William Osler

9/20/2010. The eye doesn t see what the mind doesn t know. Sir William Osler The eye doesn t see what the mind doesn t know. Sir William Osler Lewy Body Dementia Atypical Dementia The Lewy Body Spectrum Patricia J. Gifford, MD Silverado Hospice 2009 Progressive loss of intellectual

More information

INTRODUCTION TO TRAINING

INTRODUCTION TO TRAINING DEMENTIA TRAINING FOR CAREGIVERS BY LINDA THOMSON LPN/ ADMINISTRATOR ALF INTRODUCTION TO TRAINING IDENTIFY WHAT NEUROCOGNITIVE DISORDERS ARE STAGES HOW DO WE COMMUNICATE TO PERSON WITH DEMENTIA BEHAVIORS

More information

Depression in the Elderly: Recognition, Diagnosis, and Treatment

Depression in the Elderly: Recognition, Diagnosis, and Treatment Depression in the Elderly: Recognition, Diagnosis, and Treatment LOUIS A. CANCELLARO, PhD, MD, EFAC Psych Professor Emeritus and Interim Chair ETSU Department of Psychiatry & Behavioral Sciences Diagnosis

More information

Understanding. Brain Tumors. Jana, diagnosed in 1999, with her husband, Paul.

Understanding. Brain Tumors. Jana, diagnosed in 1999, with her husband, Paul. Understanding Brain Tumors Jana, diagnosed in 1999, with her husband, Paul. What Is a Brain Tumor? A brain tumor, like other tumors, is a collection of cells that multiply at a rapid rate. The tumor may

More information

Stephen L. Benson, Psy.D. November 17, 2015

Stephen L. Benson, Psy.D. November 17, 2015 Stephen L. Benson, Psy.D. November 17, 2015 Biomedical view of dementia Lyman (1989) suggested that the biomedical view of dementia includes three features: First, dementia is pathological and individual,

More information

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE 1 DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for depression and any history of depression? 2. Did staff

More information

What Is Dementia? Type of Dementia

What Is Dementia? Type of Dementia What Is Dementia? Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer's is the most common type of dementia. About

More information

Montreal Cognitive Assessment (MoCA) Debbie Froese, B.M.R.-O.T., B.A. Christine Knight, Ph.D.,R.Psych.

Montreal Cognitive Assessment (MoCA) Debbie Froese, B.M.R.-O.T., B.A. Christine Knight, Ph.D.,R.Psych. Montreal Cognitive Assessment (MoCA) Debbie Froese, B.M.R.-O.T., B.A. Christine Knight, Ph.D.,R.Psych. Community Geriatric Mental Health Model of Continuum of Cognition with Aging Normal Mild cognitive

More information

Directing an Alzheimer s/dementia Care Unit

Directing an Alzheimer s/dementia Care Unit 9135 N. Meridian Street Suite B-4 Indianapolis, IN 46260 (317) 575-9620 (800) 272-3900 September, 2004 Funded by the Indiana State Department of Health Co-sponsored by: Indiana Association of Homes and

More information

Schizophrenia National Institute of Mental Health

Schizophrenia National Institute of Mental Health Schizophrenia National Institute of Mental Health U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Schizophrenia Do you know someone who seems like he or she has lost touch with

More information

DEMENTIA AND MILD COGNITIVE IMPAIRMENT John P. Moriarty, MD Week 7

DEMENTIA AND MILD COGNITIVE IMPAIRMENT John P. Moriarty, MD Week 7 DEMENTIA AND MILD COGNITIVE IMPAIRMENT John P. Moriarty, MD Week 7 Educational Objectives: 1. Define dementia and mild cognitive impairment 2. Understand the appropriate work-up for patients with complaints

More information

No Dementia Stage 2: Very Mild Cognitive Decline

No Dementia Stage 2: Very Mild Cognitive Decline Stages of Dementia Health professionals sometimes discuss dementia in "stages," which refers to how far a person's dementia has progressed. Defining a person's disease stage helps physicians determine

More information

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012 Chapter 26 Geriatrics Slide 1 Overview Trauma Common Medical Emergencies Special Considerations in the Elderly Medication Considerations Abuse and Neglect Expanding the Role of EMS Slide 2 Geriatric Overview

More information

Care Manager Resources: Common Questions & Answers about Treatments for Depression

Care Manager Resources: Common Questions & Answers about Treatments for Depression Care Manager Resources: Common Questions & Answers about Treatments for Depression Questions about Medications 1. How do antidepressants work? Antidepressants help restore the correct balance of certain

More information

PATIENT HISTORY FORM

PATIENT HISTORY FORM PATIENT HISTORY FORM If you are new to the office, have not been seen in over one (1) year, or are returning for a new problem, please complete this form in full. If there have been any changes since your

More information

COMPASS Therapeutic Notes on the Management of Dementia

COMPASS Therapeutic Notes on the Management of Dementia COMPASS Therapeutic Notes on the Management of Dementia In this issue Introduction: Background Symptoms & Diagnosis Page Prevention Strategies 6 Management of Cognitive Symptoms of Dementia Management

More information

Down Syndrome and Alzheimer s Disease. Overview. Alzheimer s Disease vs. Dementia 1/31/2012

Down Syndrome and Alzheimer s Disease. Overview. Alzheimer s Disease vs. Dementia 1/31/2012 Down Syndrome and Alzheimer s Disease Heather S. Anderson, M.D. Director, KU Down Syndrome Dementia Clinic Director, Education Core, KU Alzheimer s Disease Center Overview What is Alzheimer s disease?

More information

Dementia Revealed What Primary Care Needs to Know

Dementia Revealed What Primary Care Needs to Know Dementia Revealed What Primary Care Needs to Know A Primer for General Practice Prepared in partnership by NHS England and Hardwick CCG with the support of the Department of Health and the Royal College

More information

Depression Overview. Symptoms

Depression Overview. Symptoms 1 of 6 6/3/2014 10:15 AM Return to Web version Depression Overview What is depression? When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression

More information

Dallas Neurosurgical and Spine Associates, P.A Patient Health History

Dallas Neurosurgical and Spine Associates, P.A Patient Health History Dallas Neurosurgical and Spine Associates, P.A Patient Health History DOB: Date: Reason for your visit (Chief complaint): Past Medical History Please check corresponding box if you have ever had any of

More information

ASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA

ASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA ASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA Overview: Psychosis is a common clinical feature of dementia. Hallucinations and delusions are the two most common types of psychotic symptoms

More information

Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults

Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults Is This Information Right for Me? Yes, this information is right for you if: Your doctor* said you have alcohol use disorder

More information