QUESTIONS AND ANSWERS
When should a person with cognitive decline be advised to do neuro imaging (ct/mri)?
✅✅ANSW-Only if pt shows a neurologic abnormalities on exam.
Falls or trauma
Anticoagulants
and a pt who is less than 65 years old or has rapidly progressive disease
Which type of imaging would a pt with cognitive decline, be less likely to tolerate? ✅✅ANSW-
MRI
Non-pharmacologic therapy therapy for AD? ✅✅ANSW-Physical activity, Mediterranean diet,
memory aids, routines, assistance surroundings, memory stimulant puzzles or word games, cognitive
behavioral therapy, music, dance, animal therapy
All screening tools used for AD? ✅✅ANSW-MMSE, moca, SLUMS, AD 8, mini-cog
Alzheimer's disease (AD) pharmacological therapy? ✅✅ANSW-Cholinesterase inhibitors and
NMDA receptor inhibitors
Cholinesterase inhibitors? ✅✅ANSW-Donepezil
Rivastigmine
Galantamine
NMDA receptor inhibitors? ✅✅ANSW-memantine
S/E of cholinesterase inhibitors? ✅✅ANSW-GI distress, wt loss, bradycardia, syncope, and sleep
disturbances
Cholinesterase inhibitors are contraindicated in who? ✅✅ANSW-Pts w/baseline bradycardia, or
cardiac conduction disorders ( av node)
,Cholinesterase inhibitors do not have an effect on what? ✅✅ANSW-No effect on behavioral
dementia symptoms
NMDA receptor inhibitors s/e? ✅✅ANSW-Less side effect than cholinesterase inhibitors
Dizziness, hallucinations, increased agitation
NMDA receptor inhibitors are contraindicated in who? ✅✅ANSW-Pts w/ severe hepatic
impairment (child Pugh score > 10)
Dose reeducation is recommended in patients with. Child Pugh score of 5-9
NMDA receptor inhibitors are shown to have what effect ? ✅✅ANSW-Some effect on behavioral
symptoms in moderate stage dementia.
NMDA Receptor Inhibitors should not be used for who? ✅✅ANSW-Patients with frontal lobe
dementia bc they may worsen symptoms.
NMDA Receptor Inhibitors should be avoided in who? ✅✅ANSW-Patients with urge
incontinence, chronic diarrhea, or when risks of side effects outweighs the benefits.
What therapy is used for depression and dementia? ✅✅ANSW-First line therapy is SSRIs
Depression can mimic? ✅✅ANSW-dementia
Patients who are undergoing cognitive evaluation should be concurrently screened for?
✅✅ANSW-Mood disorders
OSA can cause what symptoms that can mimic dementia? ✅✅ANSW-Daytime somnolence and
deficits in short term memory.
What medications can be involved in causing symptoms that can mimic dementia? ✅✅ANSW-
Anticholinergic agents found in OTC cold and sleep meds. Also benzos, psychotropic and opioids.
, Cholinesterase inhibitors cannot do what? ✅✅ANSW-In patients With MCI, it is NOT effective in
treating Symptoms or preventing progression to dementia
What is the MediCog? ✅✅ANSW-An assessment instrument that can help providers assess if a pt
with dementia has the capacity to self-manage a pill box.
What is a strong influential factor to frailty? ✅✅ANSW-Sarcopenia
What is sarcopenia? How does it develop? ✅✅ANSW-Abnormally low lean muscle mass with low
strength and function. Develops from low protein intake, chronic inflammation, disuse atrophy, and
endocrine dysregulation.
With sarcopenia, what are the two failures that are occurring? ✅✅ANSW-Reduced intake (
anorexia) and reduced muscle mass
Who is at risk for frailty? ✅✅ANSW-Those w/ lower education, lower income, and poorer health
What factor over a lifetime can influence the development of frailty? ✅✅ANSW-Socioeconomic
status. If this improves, it can be mitigated.
What are the S characteristics of physical frailty? ✅✅ANSW-Unintentional weight loss,
exhaustion/ fatigue, low energy, decreased grip strength, slow-walking steam
Comorbidities of frailty? ✅✅ANSW-AML, myeloma, lymphoma, myelodyspasia, CKD, COPD, lung
transplant, ILD, CAD, CHF, rhythm disorders. Thyroid, obesity, growth hormone, testosterone,
cortisol, Ui, prostate disease
What does cognitive Status have to do w/ frailty? ✅✅ANSW-Cognitive frailty has 13x the rate of
functional disability.
Frailty has been associated w? ✅✅ANSW-A formal dementia diagnosis, and it has been to bea
significant predictor of AD.
Frailty increases the risk of? ✅✅ANSW-Dementia.