Down Syndrome. Overview. Developmental Disabilities and Dementia. Down Syndrome and Dementia. History of Down Syndrome. James B. Leverenz, M.D.
|
|
- Randell Goodwin
- 7 years ago
- Views:
Transcription
1 Developmental Disabilities and Dementia James B. Leverenz, M.D. VA Northwest Network Parkinson Disease and Mental Illness Research Education and Clinical Centers Departments of Neurology and Psychiatry and Behavioral Sciences, University of Washington School of Medicine Pacific Northwest Udall Center UW Alzheimer s s Disease Research Center and Dementia James B. Leverenz, M.D. VA Northwest Network Parkinson Disease and Mental Illness Research Education and Clinical Centers Departments of Neurology and Psychiatry and Behavioral Sciences, University of Washington School of Medicine Pacific Northwest Udall Center UW Alzheimer s s Disease Research Center Overview Down syndrome overview» history and genetics Dementia» definitions, Alzheimer s s disease Dementia in Down syndrome» increased risk of Alzheimer s s disease and why» unique symptoms» medical management History of : John Langdon Down Physical characteristics Recognition as a distinct entity Reversion to primitive racial type: mongolian idiocy Proof that racial differences were not specific History of Fraser and Mitchell (1886)» 62 individuals with DS» Short life-span, similar appearance of individuals Wilmarth (1890)» Report on 100 brains Lejeune and colleagues (1959)» Persons with DS have extra chromosome 21
2 Genetics 101 Genetics Trisomy 21 Genetics 103 Chromosome 21 Cumulative rates of Down syndrome per 1000 live births for older mothers New York Sweden Massachusetts A ll A ll Dementia A ll A ll
3 Dementia A syndrome Progressive loss of intellectual abilities» interferes with social, occupational functioning Impairment of memory, abstract thinking, and judgment Prevalence of Alzheimer s s Disease Alzheimer s s Disease (%) Number (in millions) of DAT patients in the US Age (years) Adapted from Hebert LE, et al. JAMA. 1995;273:
4 History of Alzheimer s s Disease Auguste D. History - Alzheimer s Disease Auguste Autopsy: evenly affected atrophic brain Bielschowsky stain: very characteristic changes in the neurofibrils fibrils arranged parallel a tangled bundle of fibrils Dispersed over the entire cortex,miliary foci sites of deposition of a peculiar substance Alzheimer's Disease- Pathology Alzheimer's Disease- Pathology Silver Stain: Plaques & Tangles Normal AD Alzheimer's Disease- Pathology Alzheimer's Disease- Pathology Silver Stain: Neuritic Plaques Aβ Immunostain
5 Signs and Symptoms of Alzheimer s s Disease Early Stage Middle Stage Advanced Stage (years 0-4) (years 5-8) (years 8-12) memory loss* memory loss memory loss executive dysfunction* executive dysfunction executive dysfunction apathy apathy apathy depression (variable) depression (variable) poor insight poor insight poor insight aphasia* aphasia aphasia apraxia* apraxia apraxia disruptive agitation disruptive agitation psychosis psychosis Death rate of Down syndrome in California institutions to age 2.5 Dementia in cohort Death rate (cohort size cohort Death rate (cohort size Age in Years % (70) 1.1% (187) 1.7% (59) 2.2% (184) 1.8% (58) 0.6% (180) 1.8% (57) 0.0% (179) 5.5% (56) 0.0% (179) History of and Alzheimer s Disease Strowe (1929), plaques in 37 y.o. Bertrand and Koffas (1946), plaques in 34 y.o. Jervis (1948), 3 cases, first association DS/AD Melamud (1946), all 20 cases > 37 y.o. Whalley (1982) and Wisniewski et al. (1985), 91/93 over age 30 History of and Alzheimer s Disease Since mongoloid patients show a marked tendency to develop this type of reaction, it is suggested that the study of it offers some information which may contribute to a better understanding of the causes of senile dementia Jervis (1948)
6 Dementia in A connection is not evident, and it is a rather startling surprise to the initiate that a relationship has been reported to exist. Owens et al. (1971) Alzheimer s s Disease Pathology in Aβ deposition prior to NFT Early Aβ predominantly 1-42/431 Excess soluble AβA present at birth Paucity of patho-anatomic anatomic studies in under 30 years Leverenz and Raskind, Exp Neurol, 1998 Early AβA Deposition in Down Syndrome Early AβA Deposition in 42 cases DS under age 40 Hippocampus/parahippocampus Aβ immunohistochemistry and Bielschowsky silve strain Quantitative image analysis 12.5% 30% 75% 100% Leverenz and Raskind, Exp Neurol, 1998 Leverenz and Raskind, Exp Neurol, 1998 AGE Sex ITG/P CA-1 CA 2-4 DM HG 8 M F M F F F F M M M M M M * M M F * M * M Old DS (55.3) AD (76.1) Aβ Burden (% cortical area) in Hippocampal/ Parahippocampal Formation Early AβA Deposition in - 8 y.o. DS Silver stain Leverenz and Raskind, Exp Neurol, 1998 Aβ immunostain
7 Early AβA Deposition in Early AβA Deposition in PHG - diffuse plaques CA-1/Subiculum - neuritic plaques Leverenz and Raskind, Exp Neurol, 1998 Leverenz and Raskind, Exp Neurol, 1998 Early AβA Deposition in Down Syndrome Genetics Trisomy 21 Age dependent increase in AβA deposition Marked differences in AβA deposition within age groups Stereotypic deposition: PHG/ITG > CA-1/DM > CA 2-42 Earliest neuritic plaques in CA-1/Subiculum Gender independent Chromosome 21
8 Signs and Symptoms of Alzheimer s s Disease Early Stage Middle Stage Advanced Stage (years 0-4) (years 5-8) (years 8-12) memory loss* memory loss memory loss executive dysfunction* executive dysfunction executive dysfunction apathy apathy apathy depression (variable) depression (variable) poor insight poor insight poor insight aphasia* aphasia aphasia apraxia* apraxia apraxia disruptive agitation disruptive agitation psychosis psychosis Dementia in : Lai and Williams 89 84% of demented individuals with seizure disorder (10% in general AD population) 20% developed clinical Parkinsonism 14% with myoclonus 12 autopsied cases, all with AD changes, only one with Lewy bodies Dementia in : Lai and Williams 89 Stages of Dementia in DS: Memory loss, temporal disorientation, reduced verbal output, apathy reduced social interaction Loss ADL s, slowed gait, seizures Non-ambulatory, incontinent, frontal release signs Dementia in : Dalton et al available clinical/pathological studies: 58% - seizures 46% - personality change 36% - apathy/ inactivity 30% - impairment of ADL 21% - gait disturbance 18% - memory loss Behavioral Disturbances in? Frequency in non-demented DS Dementia» early personality change» apathy» agitation» psychosis Psychosis in 0.2 to 31.6% prevalence reported Little detail on characteristics Case reports» Depression» Basal ganglia calcifications
9 Psychosis in Psychosis in Case series from behavioral neurology clinic and Aging in Down Syndrome study Fifty cases All adults at time of assessment 24 males/26 females Twenty four with neuropsychiatric inventory (NPI) Six with autopsy Majority non-institutionalized Caucasian Twenty-two two with dementia (28 without) Twenty with psychosis (hallucinations and/or delusions) Psychosis in Psychosis in Psychotic Group» 67% female» Mean age 49.2 (vs years)» 60% with dementia (vs. 33%) Neuropsychiatric Inventory (NPI)» Twenty-four assessed» Psychotic Mean = 24.4 (vs. 9.8)» For all groups 71% agitation 46% depression or anxiety Psychosis in Neuropsychiatric Inventory» Psychotic Increased irritability and total scores Only mild increase in depression (1.8 vs. 0.8) A trend for higher psychosis scores for non- demented vs. demented (12.5 vs. 5.3) Psychosis in Treatment response» 85% of psychotics receiving psychotropics» Multiple agents associated with younger age» 40% positive response rate
10 Psychosis in : Conclusions Data on prevalence of psychosis in DS needs to be improved Psychosis in DS is observed in both non-demented and demented individuals Demented psychotics have less severe and more responsive disease Psychosis with early onset may have a different etiology with more severe disease Medical Mangement of Dementia Acetylcholine Rivastigmine H 3C Mechanism: AChE/BuChE-I O H 3CO C H 3 CO Donepezil Mechanism: AChE-I Cholinesterase Inhibitors H 3C + O CH N 3 H 3C CH O 3 N CH 3 CH 3 CH 3 O N CH 3 H 3C N H 2 N C H2 O O OCH 3 HO Galantamine Mechanism: AChE-I Behavior Cholinergic Drug Therapy in DS Activities of Daily Living Cognition Physicians Desk Reference 2003, 57th ed. Montvale, NJ: Medical Economics Company; November 2002 Managing Behavioral Disturbances: Depression Most common in PDD and DLB early in non-lewy body diseases true depression responds to antidepressants Behavioral management» activity (get out of the house!) Managing Behavioral Disturbances: Disruptive Agitation Complex problem that may involve more than one behavior» irritability» pacing» psychosis» aggression
11 Managing Behavioral Disturbances: Disruptive Agitation - irritability Reactive irritability» stimulus induced ( shower( shower )» antidepressants (sertraline my favorite)» caregiver education it s s the dementia (nothing personal) pick your fights distraction Managing Behavioral Disturbances: Psychosis Components» hallucinations» delusion (false beliefs) Antipsychotics» black box warning» quetiapine (low EPS, sedating) Don t t treat if not disturbing Managing Behavioral Disturbances: Disruptive Agitation - aggression Search for origin/source» irritability sertraline, distraction, etc.» psychosis antipsychotic» environmental move patient Other Disabilities & Dementia Very limited data» small numbers of cases» no clear relationships Aging disorders» Werner syndrome Werner Syndrome & Dementia Werner Syndrome & Dementia Mutation Chromome 8» DNA repair enzyme Aging disorder» short stature» premature graying» cataracts» diabetes» cancer»? dementia
12 Werner Syndrome & Dementia Werner Syndrome & Dementia 51 and 57 y.o. Werner syndrome sisters No clear dementia Brain pathology» amyloid deposition» limited neurofibrillary pathology Werner Syndrome & Dementia Questions? Amyloid Deposits Neurofibrillary tangles
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 informationCholinesterase 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 informationPrimary 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 information2012 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 informationObjectives. Aging and Forgetfulness Define Dementia Types of Dementia Treatment
Dementia David Lam, MD, FRCPC, Psychiatry Assistant Clinical Professor Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton, Ontario Objectives Aging and Forgetfulness Define
More informationMeeting 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 informationUpdate 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 informationMental 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 informationDementia & 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 informationDementa 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 informationRecognition and Treatment of Depression in Parkinson s Disease
Recognition and Treatment of Depression in Parkinson s Disease Web Ross VA Pacific Islands Health Care System What is depression? Depression is a serious medical condition that affects a person s feelings,
More informationIntellectual 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 informationMCDB 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 information9/20/2010. 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 informationStephen 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 informationAlzheimer 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 informationAlzheimer'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 informationCommon 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 informationClinical 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 informationJ/601/2874. This unit must be assessed in accordance with Skills for Care and Development s QCF Assessment Principles.
Unit 13: Dementia Awareness Unit code: DEM 201 Unit reference number: J/601/2874 QCF level: 2 Credit value: 2 Guided learning hours: 17 Unit summary The aim of the unit is to enable learners to gain knowledge
More informationMontreal 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 informationHow 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 informationDonepezil 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 information2016 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 informationDementia: Delivering the Diagnosis
Dementia: Delivering the Diagnosis Daniel D. Christensen, M.D. Clinical Professor of Psychiatry Clinical Professor of Neurology Adjunct Professor of Pharmacology University of Utah Diagnosing Dementia
More informationAn 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 informationAlzheimer 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 informationConjoint 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 informationASSESSMENT 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 informationDepression 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 informationRecognizing and Treating Depression in Children and Adolescents.
Recognizing and Treating Depression in Children and Adolescents. KAREN KANDO, MD Division of Child and Adolescent Psychiatry Center for Neuroscience and Behavioral Medicine Phoenix Children s Hospital
More information[KQ 804] FEBRUARY 2007 Sub. Code: 9105
[KQ 804] FEBRUARY 2007 Sub. Code: 9105 (Revised Regulations) Theory : Two hours and forty minutes Q.P. Code: 419105 Maximum : 100 marks Theory : 80 marks M.C.Q. : Twenty minutes M.C.Q. : 20 marks 1. A
More informationAntipsychotic drug prescription for patients with dementia in long-term care. A practice guideline for physicians and caregivers
SUPPLEMENT 1: (Supplementary Material for online publication) Antipsychotic drug prescription for patients with dementia in long-term care. A practice guideline for physicians and caregivers About this
More informationDementia 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 informationWhy study clinical neuropsychology?
University Leiden, The Netherlands Master (MSc) in Clinical Neuropsychology H.A.M.Middelkoop@lumc.nl www.neuropsychologie.leidenuniv.nl Why study clinical neuropsychology? You are interested in: brain/behavior
More informationLong 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 informationDepression and Anxiety in Parkinson s disease
Depression and Anxiety in Parkinson s disease Greg Pontone, MD Director, Movement Disorders Psychiatry Clinical Programs at Johns Hopkins Morris K. Udall Parkinson's Disease Research Center Johns Hopkins
More informationDrugs PSYCHOSIS. Depression. Stress Medical Illness. Mania. Schizophrenia
Drugs Stress Medical Illness PSYCHOSIS Depression Schizophrenia Mania Disorders In preschool children imaginary friends and belief in monsters under the bed is normal (it may be normal in older developmentally
More informationDepression 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 informationPatients 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 informationPrescribing 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 informationDepression 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 informationDown 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 informationHow To Treat An Elderly Patient
1. Introduction/ Getting to know our Seniors a. Identify common concepts and key terms used when discussing geriatrics b. Distinguish between different venues of senior residence c. Advocate the necessity
More informationThe Physician s Perspective:
The Physician s Perspective: A Health Policy Brief from the Institute for Patient Access Medication for Long-Term Care Residents: Reducing Overuse Without Compromising Access and Care By David Charles,
More informationSteps 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 informationhepatolenticular degeneration (E83.0) human immunodeficiency virus [HIV] disease (B20) hypercalcemia (E83.52) hypothyroidism, acquired (E00-E03.
ICD-10-CM Codes for Mental, Behavioral and Neurodevelopmental Disorders Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Includes: disorders of psychological development Excludes2:
More informationOverview of Mental Health Medication Trends
America s State of Mind Report is a Medco Health Solutions, Inc. analysis examining trends in the utilization of mental health related medications among the insured population. The research reviewed prescription
More informationTHEORIES OF NEUROLOGICAL AGING AND DEMENTIA
THEORIES OF NEUROLOGICAL AGING AND DEMENTIA Aging Overview The primary care physician must advise middle-age and older patients about ways to age successfully. Dementia is a common disabling illness that
More informationLewy 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 informationHow To Write Long Term Care Insurance
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 informationAlcohol and Brain Damage
Alcohol and Brain Damage By: James L. Holly, MD O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves
More informationSocial 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 informationUPDATES TO NEUROCOGNITIVE DISORDERS IN DSM-5 and DSM-5 DESK REFERENCE UPDATED 10-18-13
UPDATES TO NEUROCOGNITIVE DISORDERS IN DSM-5 and DSM-5 DESK REFERENCE UPDATED 10-18-13 SUMMARY: These coding changes ensure that insurance reimbursement can be obtained when the specifier With behavioral
More informationCRITERIA FOR AD DEMENTIA June 11, 2010
CRITERIA F AD DEMENTIA June 11, 2010 Alzheimer s Disease Dementia Workgroup Guy McKhann, Johns Hopkins University (Chair) Bradley Hyman, Massachusetts General Hospital Clifford Jack, Mayo Clinic Rochester
More informationSee also www.thiswayup.org.au/clinic for an online treatment course.
Depression What is depression? Depression is one of the common human emotional states. It is common to experience feelings of sadness and tiredness in response to life events, such as losses or disappointments.
More informationLecture Objectives/ Goals
Lewy Body Dementia: Challenges and Treatment Karen Mullins, D.O. Knoxville Neurology Clinic Lecture Objectives/ Goals Be familiar with signs and symptoms of the pt with LBD Review pathophysiology of LBD
More informationDefinition of Terms. nn Mental Illness Facts and Statistics
nn Mental Illness Facts and Statistics This section contains a brief overview of facts and statistics about mental illness in Australia as well as information that may be useful in countering common myths.
More informationEveryone 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 informationAUTISM SPECTRUM DISORDERS
AUTISM SPECTRUM DISORDERS JAGWINDER SANDHU, MD CHILD, ADOLESCENT AND ADULT PSYCHIATRIST 194 N HARRISON STREET PRINCETON, NJ 08540 PH: 609 751 6607 Staff Psychiatrist Carrier clinic Belle Mead NJ What is
More informationAbnormal Psychology PSY-350-TE
Abnormal Psychology PSY-350-TE This TECEP tests the material usually taught in a one-semester course in abnormal psychology. It focuses on the causes of abnormality, the different forms of abnormal behavior,
More informationBiomarkers for Alzheimer's Disease in Down Syndrome
Biomarkers for Alzheimer's Disease in Down Syndrome Brad Christian, Ph.D. Waisman Laboratory for Brain Imaging Outline Rationale for Studying AD in Down Syndrome Background of Alzheimer s Disease Biomarkers
More informationMixed Dementia 9/21/2015. No financial relationships. Case History 76yo M semi-retired CPA c/o forgetfulness
Mixed Dementia Leslie W. Norris, DNP, FNP-C, CNE No financial relationships Case History 76yo M semi-retired CPA c/o forgetfulness Pt/spouse note ability to remember names and misplacing items over past
More informationDepression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City
Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,
More informationDementia Causes and Neuropsychological Evaluation of the Older Adult
Dementia Causes and Neuropsychological Evaluation of the Older Adult Laurie N. Culp, Ph.D. Pate and Culp Psychological Assoc. 2440 Lawrenceville Highway Suite 200 Decatur, GA 30033 678-595-0062 lculp@emory.edu
More informationTraumatic brain injury (TBI), caused either by blunt force or acceleration/
Traumatic Brain Injury (TBI) Carol A. Waldmann, MD Traumatic brain injury (TBI), caused either by blunt force or acceleration/ deceleration forces, is common in the general population. Homeless persons
More informationMAJOR DEPRESSION DURING CONCEPTION AND PREGNANCY: A Guide for Patients and Families
MAJOR DEPRESSION DURING CONCEPTION AND PREGNANCY: A Guide for Patients and Families David A. Kahn, MD, Margaret L. Moline, PhD, Ruth W. Ross, MA, Lee S. Cohen, MD, and Lori L. Altshuler, MD www.womensmentalhealth.org
More informationbasics 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 informationGuidelines 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 informationDEMENTIA 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 informationAttention, memory and learning and acquired brain injury. Vicki Anderson. Jamie M. Attention & learning: an information processing model
Attention, memory and learning and acquired brain injury Vicki Anderson Jamie M. Childhood acquired amnesia Attention & learning: an information processing model MANAGEMENT Organising, problem solving
More informationSummary 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 informationDisorders Considered. A Brief Synopsis of Select Neurological Disorders. Neurological and Psychiatric Symptoms. Neurological Basis
Disorders Considered A Brief Synopsis of Select Neurological Disorders Four neurological disorders are examined to illustrate pathological conditions that can develop related to course material Myasthenia
More informationAlcohol: The good, the bad and
Alcohol: The good, the bad and the Clare Wilhelm, Ph.D. Portland VA Medical Center Oregon Health & Science University Supported by VA Career Development Grant (BX001294) Overview Alcohol statistics the
More informationStaging 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 informationPsychology and Aging. Psychologists Make a Significant Contribution. Contents. Addressing Mental Health Needs of Older Adults... What Is Psychology?
AMERICAN PSYCHOLOGICAL ASSOCIATION Psychologists Make a Significant Contribution Psychology and Aging Addressing Mental Health Needs of Older Adults... People 65 years of age and older are the fastest
More informationCOMPREHENSIVE MANAGEMENT OF THE ELDERLY PATIENT WITH MANIA
COMPREHENSIVE MANAGEMENT OF THE ELDERLY PATIENT WITH MANIA Manic depressive illness is a biological brain disorder that produces significant alterations of mood and psychosis. Mania in the elderly occurs
More informationCollaborative Care for Alzheimer s Disease
The Health Care Workforce for Older Americans: Promoting Team Care Institute of Medicine Symposium October 2008 Collaborative Care for Alzheimer s Disease Christopher M. Callahan, MD Cornelius and Yvonne
More informationDelusions are false beliefs that are not part of their real-life. The person keeps on believing his delusions even when other people prove that the be
Schizophrenia Schizophrenia is a chronic, severe, and disabling brain disorder which affects the whole person s day-to-day actions, for example, thinking, feeling and behavior. It usually starts between
More informationDepression 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 informationDr Steve Moss BSc MSc Phd, Consultant Research Psychologist attached to the Estia Centre, Guys Hospital, London.
INFORMATION SHEET Mental health problems in people with learning disabilities Dr Steve Moss BSc MSc Phd, Consultant Research Psychologist attached to the Estia Centre, Guys Hospital, London. In the whole
More informationWhat Is Genetic Counseling? Helping individuals and families understand how genetics affects their health and lives
What Is Genetic Counseling? Helping individuals and families understand how genetics affects their health and lives What does the career involve? Explore family histories to identify risks Reducing risks
More informationPrimary Endpoints in Alzheimer s Dementia
Primary Endpoints in Alzheimer s Dementia Dr. Karl Broich Federal Institute for Drugs and Medical Devices (BfArM) Kurt-Georg-Kiesinger-Allee 38, D-53175 Bonn Germany Critique on Regulatory Decisions in
More informationadaptations whenever possible, to prevent or reduce the occurrence of challenging behaviours.
POSITION STATEMENT on Management of Challenging Behaviours in People with Dementia 1. AIM OF THE POSITION STATEMENT This position statement applies to people living in supported accommodation and those
More informationTraumatic 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 information2014 Alzheimer s Disease Facts and Figures
2014 Alzheimer s Disease Facts and Figures Includes a Special Report on Women and Alzheimer s Disease Almost two-thirds of Americans with Alzheimer s disease are women. Alzheimer s Disease is the six eading
More information309.28 F43.22 Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with disturbance of conduct
Description ICD-9-CM Code ICD-10-CM Code Adjustment reaction with adjustment disorder with depressed mood 309.0 F43.21 Adjustment disorder with depressed mood Adjustment disorder with anxiety 309.24 F43.22
More informationNEUROPSYCHOLOGY 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 informationDEPRESSION 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 informationDown syndrome and Alzheimer s disease
Down syndrome and Alzheimer s disease Research What is Alzheimer s disease? Dementia is a syndrome consisting of a number of symptoms that include a reduced ability to perform familiar tasks, impairment
More informationPSYC PSYCHOLOGY. 2011-2012 Calendar Proof
PSYC PSYCHOLOGY PSYC1003 is a prerequisite for PSYC1004 and PSYC1004 is a prerequisite for all remaining Psychology courses. Note: See beginning of Section F for abbreviations, course numbers and coding.
More informationThese 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 informationWhat is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician
What is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician Overview of presentation Case history Video example pre and post treatment Historical review PD in the UK Epidemiology and aetiology Making
More informationAge Associated Cognitive Decline and Mild Cognitive Impairment (MCI)
Age Associated Cognitive Decline and Mild Cognitive Impairment (MCI) Mike R. Schoenberg, PhD, ABPP-CN Diplomate, American Board of Clinical Neuropsychology Licensed Psychologist Departments of Psychiatry
More informationCosts of Medical Care for Dementia Patients in Taiwan: A Population-Based Study
Costs of Medical Care for Dementia Patients in Taiwan: A Population-Based Study L.-J. E. Ku 1, T.-H. Lu 1, S.-L. Wu 1, M.-C. Pai 2* 古 鯉 榕, 呂 宗 學, 吳 士 良, 白 明 奇 April 19, 2013 1 Institute of Public Health,
More informationNeuropsychiatry Disorders
Neuropsychiatry Disorders Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems (Copyright UHS 2009; All rights reserved) For more information: Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems 12710
More informationEarly detection of dementia and the Initial-phase intensive support team for preventing BPSD.
Early detection of dementia and the Initial-phase intensive support team for preventing BPSD. Haruyasu Yamaguchi, MD Gunma University Graduate School of Health Sciences Japanese cat is now doing weight
More informationChronic mental illness in LTCF. Chronic mental illness. Other psychiatric disorders.
Chronic mental illness in LTCF Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence Chronic mental illness 1. Schizophrenia and Schizoaffective disorder. 2. Bipolar disorder (Type 1 and
More informationDelivering Integrated Dementia Care: The 8 Pillars Model of Community Support
Delivering Integrated Dementia Care: The 8 Pillars Model of Community Support This report was researched and written by Lindsay Kinnaird, Alzheimer Scotland. With grateful acknowledgements to: Barbara
More informationCopywrite - 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