Mrs. Taylor Outcome is a 73-year-old female currently living at her own residence; however, her daughter is worried that Mrs. Outcome may be “losing it” after she left a burner on and caused a small fire in her house. After this event, Mrs. Outcome’s daughter, Teresa, stayed with her mother to make sure she was “all right”. Teresa noted that during the night her mother once yelled out “help me, help me.” Teresa also noted some confusion between day and night evidenced by her mother sleeping in the day and staying up at night.
Mrs. Outcome and her daughter arrive at your practice. As is standard, you have the nurse perform some standardized tests.
The scores on her tests are listed below:
- FAQ = 13/30
- GAD-7 = 7/21
- PHQ-9 = 8/27
- MMSE = 20/30
- Clock drawing test = 2/5
Please answer the following questions about Mrs. Outcome.
- Based on the test scores above, do you believe that Mrs. Outcome does have dementia?
- What are the differences between delirium and dementia?
- What two categories of medications are often used to treat dementia and how do these medications work?
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Your initial response is due by Wednesday at 11:59 pm CT.
Estimated time to complete: 2 hours
Peer Response
Instructions:
Please read and respond to at least two of your peers’ initial postings. You may want to consider the following questions in your responses to your peers:
- Compare and contrast your initial posting with those of your peers.
- How are they similar or how are they different?
- What information can you add that would help support the responses of your peers?
- Ask your peers a question for clarification about their post.
- What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
All peer responses are due by Sunday at 11:59 pm CT.
Estimated time to complete: 1 hour
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Unit 10: Discussion Medications for Dementia
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Based on the test scores provided, it is likely that Mrs. Outcome is experiencing cognitive impairment, but it is not possible to definitively conclude that she has dementia based solely on this information. The scores on the Mini-Mental State Examination (MMSE) and Clock Drawing Test suggest cognitive impairment, but further assessment and diagnostic criteria, such as a clinical evaluation by a specialist and neuroimaging, would be needed to confirm a dementia diagnosis.
- Differences between Delirium and Dementia: Delirium and dementia are distinct conditions with some key differences:
- Onset and Course: Delirium typically has an acute onset, with symptoms developing rapidly, often over hours or days. In contrast, dementia is characterized by a gradual and chronic decline in cognitive function over an extended period.
- Attention and Consciousness: Delirium is marked by disturbances in attention and consciousness, while dementia primarily affects memory, thinking, and reasoning.
- Reversibility: Delirium is often reversible when the underlying cause, such as an infection or medication side effect, is identified and treated. Dementia, on the other hand, is typically irreversible.
- Fluctuation: Delirium symptoms can fluctuate throughout the day, while dementia symptoms tend to be relatively stable over time.
Given that Mrs. Outcome’s daughter reported confusion between day and night and an incident where she yelled for help, it may indicate the possibility of delirium, which can be triggered by various medical conditions, including infections or medication interactions. Further clinical evaluation is necessary to determine the exact cause.
- Medications for Dementia: Two categories of medications commonly used to treat dementia are cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists. These drugs do not cure dementia but can help manage symptoms and improve cognitive function to some extent.
- Cholinesterase Inhibitors: These drugs, including donepezil, rivastigmine, and galantamine, work by increasing the levels of acetylcholine, a neurotransmitter, in the brain. Acetylcholine is involved in memory and learning. By inhibiting the breakdown of acetylcholine, these medications can temporarily improve cognitive function, particularly in the early stages of Alzheimer’s disease.
- NMDA Receptor Antagonists: Memantine is the primary drug in this category. It works by regulating glutamate, a neurotransmitter involved in information processing and memory. Memantine helps to modulate glutamate activity and can be used in moderate to severe Alzheimer’s disease to reduce symptoms like confusion and agitation.
It is important to note that medication for dementia should be prescribed by a qualified healthcare professional after a thorough evaluation and diagnosis. Additionally, the efficacy of these medications can vary from person to person.
References:
- Alzheimer’s Association. (2021). Medications for Memory. https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).