Paper II — Dementia and caregiving

CONSOLIDATED NIGHT-BEFORE MASTER SHEET

Questions 21–28 on One Page

The single fact most likely to earn # Topic Marks the mark 21 BPSD — types, aetiology, 15 + 7 90–98% develop at least one investigation, management, NPS; DICE; brexpiprazole drugs 2023 and dextromethorphan– bupropion 2026 now licensed for agitation 22 Non-pharmacological 7 Caregiver-directed interventions:

management of behavioural 23 trials, ~3300 dyads, effect disturbance size 0.34 — greater than antipsychotics 23 Addressing caregiver stress 7 Zarit Burden Interview; caregiver counselling prevents caregiver depression; treat the dyad 24 Innovations to ease caregiver 7 ICT delivery of proven burden interventions; telemedicine prevents psychiatric admissions from LTC homes 25 Reversible dementias 7 <4% truly reversible; treatment does not guarantee reversal; PENS 2025 — gait improves, cognition does not 26 Mild cognitive impairment 7 >20% of those 71+ have CIND; 15–20% convert per year; anti-amyloid antibodies now licensed at MCI stage 27 Vascular dementia 7 VCI is the umbrella term; ChEIs not recommended for pure VaD, use in mixed; SPRINT MIND for prevention 28 Delirium vs depression vs 7 Judge by onset, attention and dementia level of consciousness; you cannot diagnose dementia during delirium The Twelve Numbers to Carry Into the Hall Fact Number Dementia patients developing at least one NPS 90–98% Caregiver intervention effect size on behavioural symptoms 0.34 Brexpiprazole CMAI effect size ~0.35 AXS-05 relapse rate versus placebo (ACCORD-2) 8.4% vs 28.6% Truly reversible dementias <4% Depression coexisting with dementia in outpatients >1/3 Cognitive impairment without dementia, age 71+ >20% MCI annual conversion to dementia 15–20% VCI prevalence over age 65 ~5% White matter lesion threshold, NINDS-AIREN >25% of white matter Delirium prevalence on admission / incidence in hospital ~15% / up to one-third PENS trial gait velocity gain (iNPH shunting) 0.21 m/s; 80% vs 24% improved Indian Policy Sentences to Drop Into Any of These Answers LASI-DAD: dementia prevalence 7.4% in adults 60+, about 8.8 million cases, projected 16.9 million by 2036; caregiving data from 4196 informants (2025) confirm measurable caregiver stress and mental-health impact Over 90% of dementia care in India is family-provided, with scarce respite and long-term care infrastructure — the case for digital and community-based caregiver support NPHCE — Regional Geriatric Centres, district geriatric units and CHC/PHC geriatric clinics: the platform for cognitive and caregiver screening National and District Mental Health Programme — the practical route for BPSD management and caregiver depression AB-PMJAY and the Ayushman Vay Vandana Card — cover for all citizens aged 70 and above regardless of income Maintenance and Welfare of Parents and Senior Citizens Act, 2007 — legal remedy where caregiving breaks down Rights of Persons with Disabilities Act, 2016 — disability certification including chronic neurological conditions and mental illness Rashtriya Vayoshri Yojana / AVYAY — assistive devices and senior citizen welfare Elder Line 14567 — national toll-free helpline ARDSI — caregiver training, day care, support groups, Dementia India reports WHO ICOPE (2nd edition) — cognitive decline as one of the six domains of intrinsic capacity screened in primary care End of compilation — Questions 21 to 28.