DEMENTIA

by : group
D

dementia

Dementia - is a permanent decline in cognitive

function and memory from a previous level of function.
Dementia is far more common in the geriatric
population, it can occur before the age of 65, in which
case it is termed "early onset dementia".
Dementia is not a single disease, but rather a nonspecific illness syndrome. (i.e., set of signs and
symptomes) in which affected areas of cognition may
be memory, attention, language , and problem solving.
Cognitive dysfunction that has been seen only over
shorter times.

Causes of the dementia syndrome

There are many potential dementia

causes. The most common cause is
Alzheimer's disease, which is
responsible for more than half of all
dementia cases. Other common causes
of the condition include a brain tumor,
brain cancer, hypothyroidism, and
vitamin B12 deficiency. Some of the
less-common causes include
Huntington's disease, Creutzfeldt-Jakob
disease, and neurosyphilis.

Many different disease states can produce

the clinical syndrome of dementia. These
can be divided into two groups:

Dementias can be reversible or

irreversible, depending upon the cause.
They can be fixed and static, as in from
trauma, or progressive, as in the case of a
disease caused dementia. In any case, all
dementias are potentially treatable. There
may not be an actual cure or a means to
reduce the symptoms, but professionals
are able to provide such patients and their
families with some kind of useful
assistance. Dementia can be caused by
more than fifty illnesses (Cummings &
Benson,).

Reversible dementia syndrome

The term reversible or potentially/ partially reversible

is used to define a cognitive disorder in which normal
or nearly normal function may be restored.
The potential to reverse or delay deterioration
emphasizes the importance of an early diagnosis of a
reversible dementia.
The most common causes of reversible dementia are
depression, delirium, and drug toxicity.
Other causes include normal pressure hydrocephalus,
neoplasm's, metabolic disorders, trauma, medications
and infections.
Less than 10% of cases of dementia are due to
causes that may presently be reversed with
treatment.

Irreversible dementia syndrome

The most common causes of irreversible

dementia include:
* Alzheimers disease
* Vascular dementia
These account for at least 7080% of all cases.
Less common, and more difficult to recognize
clinically, are:
* Dementia of Lewy body type
* Picks disease (dementia of the frontal lobetype [DFT])

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Symptoms of Dementia Hallucinations

People with dementia often have
hallucinations. It's not clear if this is an
indication that the dementia is getting
worse. But most dementia does worsen
over time. Hallucinations can also be a
symptom of specific types of dementia,
such as lewy body disease.

Stages of Dementia

Early Symptoms of Dementia

Early indications that someone may be
suffering
from the onset of dementia
include:

Difficulty with regular tasks

Forgetfulness at work, having negative
consequences, such as frequently forgetting
appointments, or deadlines
Becoming apathetic, losing the ability, or
desire, to take initiative on tasks, or take
part in hobbies and activities.

Problems remembering familiar

locations, such as where the patient
lives, or what year it is.
Problems with abstract thinking, which
is the ability to make and understand
generalizations. Could lead to difficulty
handling money.
Trouble remembering simple words;
often dementia sufferers will substitute
inappropriate words without realizing,
making them difficult to understand.

Sudden mood swings with no obvious

causes. Changes in personality and
increased irritability are also possible.
Dementia sufferers will experience
diminished judgment, often doing or
saying completely inappropriate things.
Losing things and blaming others for
"stealing" from them

Moderate Dementia
During this phase, the dementia symptoms
will
likely become more obvious. They may include:

Forgetting recent events, becoming confused

about times and places, remembering events
from the past as though they are the present.
Forgetting names and faces, confusing family
members with each other.
Becoming lost, wandering outdoors, often at
inappropriate times or in inappropriate
clothing.

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Forgetting to eat, or maintain proper

hygiene
Auditory and visual hallucinations
Getting frustrated and becoming upset
or angry.

Severe Dementia
This is the final stage of dementia,
patients will likely be unable to care for
themselves and need round the clock care.
Symptoms may include:

Uncontrollable movements
Incontinence
Failure to recognize even objects that we
use every day
Restlessness, inability to sleep
Symptoms worsen at night

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No longer recognize family or friends;

may search for long-dead relatives
Need help using the toilet, washing or
getting dressed.
Difficulty walking and getting around
Become aggressive and easily
threatened

A Classification System for the Types of

Dementia
Examples of dementia types include:
Cortical dementia
Subcortical dementia
Progressive dementia
Primary dementia
Secondary dementia.

Cortical dementia

Cortical dementia refers to dementia in

which brain damage primarily affects the
brain's cortex, or outer layer. Cortical
dementias tend to cause problems with
memory, language, thinking, and social
behavior.

Subcortical Dementia

Subcortical dementia is dementia that

affects parts of the brain below the
cortex. This dementia type tends to
cause changes in emotions and
movement in addition to problems with
memory. One example of this dementia
type is Binswanger's disease.

Progressive Dementia

Progressive dementia is dementia that

gets worse over time, gradually
interfering with more and more cognitive
abilities. Lewy body dementia is an
example of a progressive dementia.

Primary Dementia

Primary dementia is dementia (such as

Alzheimer's disease) that does not result
from any other disease.

Secondary Dementia

Secondary dementia is dementia that

occurs as a result of a physical disease
or injury.

Etiology :
Brain Neuronal loss - that may be
due to neuronal degeneration or to cell
death secondary to trauma, infarction,
hypoxia, infection, or hydrocephalus.
In addition, there are a large number
of general medical, substance-related,
and multifactorial causes of dementia.

Manifestations :
Neuropsychiatric symptoms are a
common
feature of all
neurodegenerative dementias.
They are often more disturbing to
the
caregivers than cognitive
decline.
Leading cause for hospitalization,
residential
placement or
psychopharmacologic therapy.
Major contributors to the emotional,
social and
economic burden
dementia.
Very distressing to patients and
should be
promptly recognized and
treated.

Ten Warning Symptoms of Alzheimer's

disease or dementia.
1. Memory Loss That Affects Job Skills
2. Difficulty Performing Familiar Tasks
3. Problems with Language
4. Disorientation of Time and Place
5. Poor or Impaired Judgment
6. Problems with Abstract Thinking
7. Misplacing Things
8. Changes in Mood or Behavior
9. Changes in Personality
10. Loss of Initiative

Home management
staying active in a variety of activities could help
to keep the mind sharp and memory loss at bay.
Leisure activities such as playing a musical
instrument, dancing, knitting, reading or playing
board games are all thought to help ward off
dementia.
Eating a balanced, healthy diet full of fresh
fruits, vegetables and whole grains to ensure
that the body gets all of the nutrients it needs on
a daily basis is also thought to be helpful in the
battle against memory loss.
Taking Sage oil and vitamin E might also be
helpful, but be sure to discuss any natural
remedies with your doctor before you start using
them.

Treatments

The key to dealing with dementia is highquality, comprehensive care that will help
the patient feel more comfortable and safe.
Helping dementia sufferers maintain their
sense of individuality can also be beneficial.
Regular routines can help
Sensory therapies
Proper diet

Another classification system that is used for

dementia separates the causes of dementia into
Treatable Dementia
treatable or untreatable.
About 10 percent of conditions that cause
dementia are treatable. With treatment, the
dementia can either be reversed or at least halted.
Examples of conditions that cause treatable cases
of dementia include:
o Normal pressure hydrocephalus
o A brain tumor or brain cancer
o Hypothyroidism - deficiency of thyroid hormone
o Vitamin B
12 deficiency
o Neurosyphilis, which is a syphilis infection in the
brain
o Reactions to medications
o poisoning

Non-Treatable Dementia
Although a number of diseases can cause dementia,
Alzheimer's disease is by far the most common. More than
one-half of all dementia cases are caused by Alzheimer's
disease. The second most common cause of dementia is
multi-infarct dementia, which is a type of vascular
dementia.

Lewy body dementia Binswanger's disease

Frontotemporal dementia
Corticobasal degeneration
Certain conditions that can cause childhood dementia
HIV-associated dementia
Other infections within the brain, such as Creutzfeldt-Jakob
disease
Huntington's disease and other rare hereditary dementias
Head trauma, such as dementia pugilistica (also known as
boxer's syndrome).

Role as a caregiver

learn to recognize the warnings signs of

frustration;
intervene to calm yourself down
physically;
modify your thoughts in a way that
reduces your stress;
learn to communicate assertively;
learn to ask for help.

Differential Diagnosis

Normal process of aging

Delirium
Schizophrenia
Major Depressive Episode
Factitious Disorder with Psychological
Symptoms.

Definition of terms:
Aberrant Motor Behavior - excessive motor
activity such as
pacing , wandering,
fidgeting, hand- wringing, inability to sit still,
etc.
Agitation excessive motor activity associated
with feeling of inner tension.
Anxiety - excessive and unjustified
apprehension, feeling of foreboding and
thoughts of impending doom.
Apathy lack of motivation and diminished
goal- directed behavior , reduced goaldirected cognition and
decreased emotional
engagement.
Delusions false beliefs based on incorrect
references about
external reality that are

Hallucinations sensory perceptions with

compelling sense of reality but without
concomitant stimulation of the relevant sensory
organ.
illusions misinterpretation of visual stimuli from
distorted perception.
Irritability susceptibility to easily provoked anger
or annoyance.
Obsessive compulsive behavior recurrent
thoughts repetitive acts, or compulsive
purposeless behavior.
Lewy bodies - Lewy bodies are abnormal
microscopic protein deposits in the brain that
disrupt the brain's normal functioning causing it
to slowly deteriorate

KEY POINTS

1. Dementia is a disorder of memory

impairment coupled with other cognitive
defects.
2. It has a gradual onset and progressive
course.
3. It may be caused by a variety of illnesses.
4. Dementia predisposes to delirium.

Dementia is a group of symptoms caused by disorders

Facts
andthe
Tips
about
that affected
brain and
loss of Dementia
mental abilities and

most commonly occurs late in life

Dementia is characterized the progressive decline in
cognitive function due to damage or disease in the body
beyond what might be expected from normal aging.
People have dementia may not be able to think well
adequate to do normal activities, for example getting
dressed or eating.
Memory loss is a common symptom of dementia.
Though, memory loss by itself does not mean you have
dementia.
Risk factor of dementia is genetics/family history,
smoking and alcohol use, atherosclerosis, cholesterol,
plasma homocysteine, diabetes, mild cognitive
impairment.
Generally seen in the older people whos age after 60
and person loss your intellectual and social abilities,
healthy brain tissue degenerates, causing a steady
decline in memory and mental abilities.
No one treatment for stop this disease.Though some
drugs would be helpful keep symptoms from control for

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