Exam 38 · 第38回 · 認知症の理解 (Understanding Dementia)
Question 85 問85
次のうち，レビー小体型認知症（dementia with Lewy bodies）の症状として，最も適切なものを1つ選びなさい。
- ノンレム睡眠行動障害による大声
- 自律神経症状による起立性低血圧（orthostatic hypotension）
- 聴覚認知機能の障害による幻聴
- 側頭葉の萎縮による意味性失語
- 嚥下機能の促進による食欲増加
Translation
Which of the following is a symptom of dementia with Lewy bodies (レビー小体型認知症)? Choose the most appropriate one.
- Shouting caused by non-REM sleep behavior disorder (ノンレム睡眠行動障害)
- Orthostatic hypotension (起立性低血圧) caused by autonomic nerve (自律神経) symptoms
- Auditory hallucination (幻聴) caused by a disorder of hearing-related cognitive function
- Semantic aphasia caused by shrinking of the temporal lobe
- Increased appetite caused by improved swallowing function (嚥下機能)
Show answer and explanation
Answer: 2
Why 2 is correct
In dementia with Lewy bodies, the autonomic nerves (自律神経) do not work well, so orthostatic hypotension — a drop in blood pressure when standing up — happens easily. So answer 2 is correct.
Why 1 is wrong
What is seen in dementia with Lewy bodies is REM sleep behavior disorder (レム睡眠行動障害), not non-REM sleep behavior disorder. While asleep, the person shouts or moves their body to match their dreams.
Why 3 is wrong
The key feature of dementia with Lewy bodies is visual hallucination (幻視), not auditory hallucination (幻聴). The person clearly sees people or insects that are not really there.
Why 4 is wrong
Semantic aphasia caused by shrinking of the temporal lobe is a symptom seen in semantic dementia, which is one type of frontotemporal lobar degeneration.
Why 5 is wrong
In dementia with Lewy bodies, parkinsonism (パーキンソン症状) makes swallowing function (嚥下機能) likely to get worse, not better. Care is needed to prevent choking or aspiration.
Key point
Dementia with Lewy bodies easily causes orthostatic hypotension (起立性低血圧), a drop in blood pressure on standing.
Key terms
- 起立性低血圧
- A state where blood pressure drops suddenly on standing up, causing dizziness or falling.
- 自律神経症状
- Symptoms caused by poor function of the nerves that control blood pressure, body temperature, bowel movements, and more.
- 幻聴
- Hearing voices or sounds that are not really there.
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Exams 36–38, all 13 subjects, with furigana and an English explanation of every choice. The subject 「認知症の理解」 is free.