Module 2: Direct Comprehensive Primary Care in the LTC Setting

46 2.5.4 Dementia

Alzheimer’s Disease Vascular Dementia Frontotemporal Dementia Lewy Body Dementia Other Dementias
Prevalence 60-70% 10-20% 10% 5% 5%
Characterized by Amyloid plaques and beta tangles Stroke or white matter disease Atrophy of the frontal and temporal lobes Lewy body protein deposits
•Parkinson’s Disease
•Huntington’s disease
•HIV
•Creutzfeldt- Jakob disease
•Korsakoff syndrome
Symptoms Memory, language and visuospatial impairments Impaired motor skills and judgement Personality changes and language impairments Hallucinations, REM sleep disorder, impaired thinking and motor skills

[1][2][3]

Global Deterioration Scale:

  • Stage 1: No cognitive impairment
  • Stage 2: Subjective memory complaints
  • Stage 3: Mild cognitive impairment
  • Stage 4: Moderate Cognitive impairment
  • Stage 5: Moderately severe cognitive impairment
  • Stage 6: Severe cognitive impairment
  • Stage 7: Very severe cognitive impairment[4]
  • Diagnostic Pathways for Dementia:
  • Complete medical history
  • Cognitive Assessment
  • Physical Examination
  • Lab investigations
  • Imaging
  • Other Considerations
  • Rule out other medical conditions[5][6]

Management of Dementia:

  • Multimodal:
    • Non-pharmacological management
    • Pharmacological options: Cholinesterase inhibitors, Glutamate antagonists
    • Social prescribing
    • Education of patient and caregivers
  • Collaborative interprofessional team approach
  • Responsive behaviours / non-cognitive symptoms
  • Capacity assessment
  • Driving
  • Power of Attorney for Care

  1. Summerfield of Redlands, 2022
  2. Statistics Canada, 2016
  3. Government of Canada, 2022
  4. Hermann & Gauthier, 2008
  5. National Institute of Aging, 2022a
  6. Woodford, 2007

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Nurse Practitioners Delivering Primary Care in the Long Term Care Setting Copyright © 2024 by Erin Ziegler, Carrie Heer and Adhiba Nilormi is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.

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