Praxis 5331 Dementia Questions

Dementia is progressive, so ETS never rewards restorative answers. The scored reasoning is compensatory and environmental: support spared abilities, reduce demands on impaired ones, and train partners and staff. Correct answers tend to involve external memory aids, simplified routines, errorless learning, spaced retrieval, visual supports, and caregiver education. Answer choices that propose drilling memory tasks to rebuild capacity are distractors in nearly every stem.

Spared abilities matter because they define what treatment can lean on. Procedural memory, overlearned routines, reading aloud, and recognition are typically preserved much longer than free recall and episodic memory. A memory book works because it converts a free-recall demand into a recognition and reading task.

Alzheimer's disease presents with early episodic memory loss, anomia, and empty speech, with syntax and articulation relatively preserved until late. Vascular dementia shows stepwise decline tied to infarcts, with more variable and patchy deficits plus frequent dysarthria and dysphagia. Frontotemporal dementia, behavioral variant, presents with disinhibition, apathy, and poor social judgment while memory is comparatively spared early.

Primary progressive aphasia is the variant most often tested by description. The semantic variant shows anomia and impaired word comprehension with fluent speech. The nonfluent/agrammatic variant shows effortful, halting speech with agrammatism and often apraxia of speech. The logopenic variant shows word-finding pauses and impaired sentence repetition with intact grammar and articulation. Repetition performance is the fastest discriminator among the three.

Delirium has acute onset, fluctuating course, and impaired attention, and it is medically reversible — a scenario describing a hospitalized patient with sudden confusion after surgery calls for medical referral, not language treatment. Depression, sometimes called pseudodementia, produces effortful 'I don't know' responses and inconsistent performance that improves with encouragement. Mild cognitive impairment involves measurable decline without loss of functional independence and is the ideal window for teaching compensatory strategies while learning capacity is high.

Practically, when a stem gives a rapid change in mental status, the expected first action is to rule out a medical cause. When it gives a gradual multi-year decline with functional loss, dementia management is on the table.