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\author{Michellephillips02}
\pdfinfo{
  /Title (dementia-and-parkinsons.pdf)
  /Creator (Cheatography)
  /Author (Michellephillips02)
  /Subject (Dementia \& Parkinsons Cheat Sheet)
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\noindent
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Dementia \& Parkinsons Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Michellephillips02} via \textcolor{DarkBackground}{\uline{cheatography.com/214485/cs/46740/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Michellephillips02 \\
  \uline{cheatography.com/michellephillips02} \\
  \end{tabulary}
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 11th July, 2025.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Guidelines \& References}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{2015 ESPEN guidelines on nutrition in dementia: provides possible support based on stage of disease} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Best practice guidelines for aged care} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{NICE Parkinson's Disease in Adults Guidelines} \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{What is it?}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Dementia}} & {\bf{Parkinsons}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\emph{It's a cognitive impairment with a decline in memory AND at least one other cognitive domain such as language, object recognition, motor skills, abstract thought, visuospatial or executive function. There are two major changes believed to interrupt normal processes of the brain: formation of amyloid plaques and formation of neurofibrillary tangles.}} & {\emph{Neurological condition where the brain cells in the brain stem are destroyed. These cells usually produce the neurotransmitter, dopamine, which is needed for control of movement and coordination. This results in a range of S/S that predominantly affects movement.}} \tn 
% Row Count 19 (+ 18)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Cause}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{unclear - Likely genetic \& environmental factors} \tn 
% Row Count 1 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.14471 cm} x{3.83229 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Risk factors}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Dementia}} & {\bf{Parkinsons}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Age & Age \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
CVD & Sex (males more common) \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
Genetics & Ethnicity (less common in Asian/African Americans) \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Dementia \& malnutrition}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Affects food purchasing, preparation \& intake – smell and taste changes, loss of eating skills, loose the ability to recognise foods, disturbed eating patterns, refusal to eat, forgetting how to chew or swallow} \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Dry mouth: mouth rinses \& gels. Adding gravies or sauce to meals.} \tn 
% Row Count 7 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Update preferences regularly} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4577 cm} x{2.05965 cm} x{2.05965 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{5.377cm}}{\bf\textcolor{white}{Stages \& NIS}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Stage}} &  & {\bf{NIS}} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
Early & memory loss \& disorientation & Difficulty shopping, preparing and storing food. Forgetting to eat. Food preferences change or unusual choice. \tn 
% Row Count 10 (+ 7)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Mild-mod} & loss of function in ADLs & Food not chewed or swallowed properly.  Poor concentration.  Impaired reasoning and judgement – ability to recognised \seqsplit{hunger/thirst/satiety}. Agnosisa – cannot recognise objects or food  Malnutrition and dehydration risk. \tn 
% Row Count 23 (+ 13)
% Row 3
\SetRowColor{white}
\seqsplit{Severe} & communication difficulties and reliance on others for ADLs. May be bed-bound at this advanced stage and lack ability to communicate & Food refusal. Aphasia – inability to understand or produce speech. Dysphasia \tn 
% Row Count 31 (+ 8)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Parkinsons S/S}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Non-motor:}} depression/anxiety, memory problems, anosmia (loss of smell), Hypersalivation (drooling), dysphagia, slowed gastric motility (gastroparesis), Sleep disturbances, pain} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Motor:}} Bradykinesia (slowness of movement), Akinesia (loss or impairment of the power of voluntary movement), Resting tremor, shuffling gait, mucle rigidity, postural instability} \tn 
% Row Count 8 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Assessment}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Nut concerns: Vit D, B12, Iron} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Chewing \& swallowing: dentures, dry mouth, dysphagia} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Dehydration: urine colour, thirst sensation} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Constipation: linked w/ inadequate fluid/food. Physical activity?} \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Altered taste \& ↓ smell (hyposmia)} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Appetite: when is it strongest?} \tn 
% Row Count 8 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Favourite flavours – changes likely} \tn 
% Row Count 9 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Parkinsons Medication}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Levodopa}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{S/E {[}short term{]}: nausea, vomiting, loss of appetite, fatigue – usually subsides after continued use} \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{S/E {[}long term{]}: delayed/absent response resulting in motor and non-motor fluctuations ('off periods') and Dyskinesia (involuntary movements)} \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Take 30-45min gap between dosage and consumption of meal – since meals can slow down absorption due to {\bf{slowed gastric motility}}} \tn 
% Row Count 10 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Parkinsons Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{IF pt taking levodopa AND experiencing motor fluctuations – redistribute protein to end of the day – majority in the evening - to maximise effectiveness of medication during the day} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Avoid a reduction in total daily protein consumption} \tn 
% Row Count 6 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Vitamin D supplement – medical team} \tn 
% Row Count 7 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Do not offer creatine supplements} \tn 
% Row Count 8 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Don't take over-the-counter dietary supplements without consulting pharmacist or other HCP} \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Nut Reqs}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Increase EER:}} restlessness, constant pacing up and down, tremors} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Decrease EER:}} immobility, apathy (emotional indifference or lack of motivation), somnolence (drowsiness)} \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{ESPEN: {\emph{no indications that nut reqs are generally different in persons with dementia}} (*very low evidence)} \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Acute elderly: 100-125kg/day, 1-1.5g P/day (NEMO)} \tn 
% Row Count 9 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Repletion: 125-145kJ/day, 1.2-1.5g P/day (NEMO)} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} x{4.4793 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Strategies}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Difficulty with ADLs}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
 & Easy, basic recipes \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
 & Frozen meals/snacks \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
 & Having someone with them at meal times \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
 & Adaptive utensils \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
 & Mealtime socialisation \tn 
% Row Count 7 (+ 1)
% Row 6
\SetRowColor{LightBackground}
 & Flavour enhancers – herbs, spices, citrus, soy sauce, garlic/onion, oils \tn 
% Row Count 10 (+ 3)
% Row 7
\SetRowColor{white}
 & Pleasant eating environment \tn 
% Row Count 11 (+ 1)
% Row 8
\SetRowColor{LightBackground}
 & Help with grocery shopping – support worker – home care package \tn 
% Row Count 13 (+ 2)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Forgetting to eat/drink - Reduced oral intake Fatigue}}} \tn 
% Row Count 15 (+ 2)
% Row 10
\SetRowColor{LightBackground}
 & {\emph{*Malnut screen}} \tn 
% Row Count 16 (+ 1)
% Row 11
\SetRowColor{white}
 & Supervision during meals \tn 
% Row Count 17 (+ 1)
% Row 12
\SetRowColor{LightBackground}
 & Verbal prompting \tn 
% Row Count 18 (+ 1)
% Row 13
\SetRowColor{white}
 & Pouring fluids in front of them - acts as a prompt \tn 
% Row Count 20 (+ 2)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Recognizing food and ability to eat independently}}} \tn 
% Row Count 22 (+ 2)
% Row 15
\SetRowColor{white}
 & Feeding assistance \tn 
% Row Count 23 (+ 1)
% Row 16
\SetRowColor{LightBackground}
 & ↑ time with nurses spent feeding \tn 
% Row Count 24 (+ 1)
% Row 17
\SetRowColor{white}
 & Identify flavour preferences \tn 
% Row Count 25 (+ 1)
% Row 18
\SetRowColor{LightBackground}
 & Offer one meal at a time or food – avoid having condiments out to choose from \tn 
% Row Count 28 (+ 3)
% Row 19
\SetRowColor{white}
 & ONS \tn 
% Row Count 29 (+ 1)
% Row 20
\SetRowColor{LightBackground}
 & Educating – eating even when you don't want to \tn 
% Row Count 31 (+ 2)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{p{0.4977 cm} x{4.4793 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Strategies (cont)}}  \tn
% Row 21
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Swallowing issues}}} \tn 
% Row Count 1 (+ 1)
% Row 22
\SetRowColor{white}
 & {\bf{Malnut screen}} \tn 
% Row Count 2 (+ 1)
% Row 23
\SetRowColor{LightBackground}
 & Texture-modification \& swallowing assessment – speechies \tn 
% Row Count 4 (+ 2)
% Row 24
\SetRowColor{white}
 & Oral care \tn 
% Row Count 5 (+ 1)
% Row 25
\SetRowColor{LightBackground}
 & Dental treatment \tn 
% Row Count 6 (+ 1)
% Row 26
\SetRowColor{white}
 & Soft, moist food. Avoid: tough, crunchy, sticky, dry foods \tn 
% Row Count 8 (+ 2)
% Row 27
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Xerostomia (Dry mouth)}}} \tn 
% Row Count 9 (+ 1)
% Row 28
\SetRowColor{white}
 & Check medication \tn 
% Row Count 10 (+ 1)
% Row 29
\SetRowColor{LightBackground}
 & Adequate fluid intake \tn 
% Row Count 11 (+ 1)
% Row 30
\SetRowColor{white}
 & Mouth rinse and gel \tn 
% Row Count 12 (+ 1)
% Row 31
\SetRowColor{LightBackground}
 & Offering drinks \tn 
% Row Count 13 (+ 1)
% Row 32
\SetRowColor{white}
 & Moist foods – gravies, dressings, mayonnaise, sauce, custard, butters \tn 
% Row Count 15 (+ 2)
% Row 33
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Inadequate fluid intake}}} \tn 
% Row Count 16 (+ 1)
% Row 34
\SetRowColor{white}
 & Assess med S/E that could interfere with adequate fluid intake \tn 
% Row Count 18 (+ 2)
% Row 35
\SetRowColor{LightBackground}
 & Edu: what fluid is \tn 
% Row Count 19 (+ 1)
% Row 36
\SetRowColor{white}
 & Schedule small frequent amounts of fluids (esp. surrounding meals) \tn 
% Row Count 21 (+ 2)
% Row 37
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Nausea}}} \tn 
% Row Count 22 (+ 1)
% Row 38
\SetRowColor{white}
 & Small frequent meals \tn 
% Row Count 23 (+ 1)
% Row 39
\SetRowColor{LightBackground}
 & Cold foods \tn 
% Row Count 24 (+ 1)
% Row 40
\SetRowColor{white}
 & Sipping ONS/HPHE through straw \tn 
% Row Count 25 (+ 1)
% Row 41
\SetRowColor{LightBackground}
 & Limit fatty and fried foods \tn 
% Row Count 26 (+ 1)
% Row 42
\SetRowColor{white}
 & Ginger products \tn 
% Row Count 27 (+ 1)
% Row 43
\SetRowColor{LightBackground}
 & Levodopa may need to be taken with food if 'on/off' periods are stable \tn 
% Row Count 30 (+ 3)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{p{0.4977 cm} x{4.4793 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Strategies (cont)}}  \tn
% Row 44
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Loss of smell and taste}}} \tn 
% Row Count 1 (+ 1)
% Row 45
\SetRowColor{white}
 & Flavour enhancers – herbs, spices, citrus, chilli, garlic, onion \tn 
% Row Count 3 (+ 2)
% Row 46
\SetRowColor{LightBackground}
 & Enhance food is presented nicely – variety/colour \tn 
% Row Count 5 (+ 2)
% Row 47
\SetRowColor{white}
 & Identify specific issue – bitter? Metallic? \tn 
% Row Count 7 (+ 2)
% Row 48
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Constipation}} (and overflow diarrrhea, urinary incontinence, abdo pain)} \tn 
% Row Count 9 (+ 2)
% Row 49
\SetRowColor{white}
 & ↑ fluid, adequate fluid \tn 
% Row Count 10 (+ 1)
% Row 50
\SetRowColor{LightBackground}
 & Physical exercise \tn 
% Row Count 11 (+ 1)
% Row 51
\SetRowColor{white}
 & Fibre supps – Metamucil \tn 
% Row Count 12 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Example PESS}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Inadequate oral intake} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Inadequate protein-energy intake} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\emph{Self-feeding difficulty, related to diagnosis of Parkinson's Diseases with increasing tremor and fatigue, as evidenced by observation at mealtime, calorie count and recent 5\% weight loss.}}} \tn 
% Row Count 6 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}