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 |
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]
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