DEMENTIA(continued)

Commonly called “childishness.” It is a condition of mental declination that occurs in certain older persons. The basic change is a progressive deterioration of the nerve cells within the brain in which the person affected was progressively having difficulties in intellectual activities; defective memory, reduced ability to understand what is taking place, and disorientation for time and place.

290.4xVASCULAR DEMENTIA

(formerly MULTI INFARCT DEMENTIA)

• A permanent cognitive impairment caused by an interruption of the blood supply to the brain.

• Stroke may increase the risk of dementia but not all who had strokes will proceed to have vascular dementia.

• Onset is earlier than Dementia of the Alzheimer’s

• More common in males

RISK FACTORS FOR VASCULAR DEMENTIA

DIABETES OBESITY

HEART DISEASE LACK OF EXERCISE

UNHEALTHY DIET WITH HIGH AMOUNTS OF SATURATED FATS SMOKING

LONG TERM ALCOHOL ABUSE INCREASING AGE

ATHEROSCLEROSIS HIGH CHOLESTEROL

ATRIAL FIBRILLATION HISTORY OF HEART ATTACK, STROKES, OR MINI STROKES

DEFINITE RISKS

AGE APOE - E4 (whites)

ATRIAL FIBRILLATION DEPRESSION

DOWN SYNDROME FAMILY HISTORY

POSSIBLE RISKS

DELIRIUM HEAD TRAUMA

HEAVY SMOKING HYPERCHOLESTEROLEMIA

HYPERTENSION LOWER EDUCATIONAL LEVEL

OTHER GENES POSTMENOPAUSAL HORMONE THERAPY

NEUROPSYCHAIATRIC SYMPTOMS

PSYCHOTIC SYMPTOMS (HALLUCINATION, DELIRIUM) DEPRESSIVE SYMPTOMS

APATHY AGITATION AND AGGRESSION

DIAGNOSTIC CRITERIA

A. The development of multiple cognitive deficits manifested by both1. Memory impairment2. One or more of the following cognitive disturbances

a. Aphasiab. Apraxiac. Agnosiad. Disturbance in executive functioning

SUBTYPES• With Delirium (290.41) – if delirium is

superimposed on the dementia• With Delusions (290.42) – delusions are the

predominant feature• With Depressed Mood (290.43) – if depressive

mood (including presentation of symptoms of Major Depressive Episode) is predominant

• Uncomplicated (290.40) – if none of the other subtypes predominates

Dementia Associated with Other Medical Conditions

(294.1)Head TRAUMA

Traumatic Brain Injury

• Common in both young and old but for the dementia, the old aged are more at risk.

• 2 most common causes of TBI: driving and falls• May also be caused by penetrating head

injuries• Dementia pugilistica – a sports related type of

dementia due to repetitive head injuries– Characterized by cognitive symptoms of dementia,

various personality changes, extrapyramidal symptoms (e. i, Parkinson’s disease).

Traumatic Brain Injury

Pick’s Disease(290.10)

• Similar to Alzheimer’s except that the first symptom of this disease is personality change followed by memory loss.

• People with this disease have Pick cells inside nerve cells in the damaged area of the brain.

• Protein tau is normally found in nerve cells but people with this disease have an abnormal amount of this protein.

• May also be hereditary.• It can occur in people as young as 20, but usually begins

between ages 40 and 60. The average age at which it begins is 54.

• This disease gets worse slowly for the tissues in the frontal and temporal lobes start to shrink over time

• People with Pick's disease tend to behave the wrong way in different social settings. The changes in behavior continue to get worse and are often one of the most disturbing symptoms of the disease. Some patients will have more prominent difficulty with decision making, complex tasks, or language (trouble finding or understanding words or writing).

Creutzfeldt-Jakob Disease(290.10)

• A form of brain damage that leads to rapid decrease of mental function and movement

• May be associated with mad-cow disease (cattle), chronic wasting disease (deer), Kuru (in New Guinea women who ate the brains of dead relatives as part of a ritual), scrapie (sheep), and fatal familial insomnia (humans)

• Caused by prions – proteins that can produce on their own and can be infectious. The diseases caused by this proteins are called spongiform diseases for the deterioration of the brain of an infected individual is in the form of holes giving it a sponge-like appearance

• Occurs spontaneously in 1 out of a million people• Strikes people at the age of 50-75• Can be caused by exposure to contaminated

products. Other cases have occurred when people were given corneal transplants, other tissues, or blood transfusions from infected donors. It may also have been caused by contaminated electrodes used in brain surgery (before instruments started to be properly disinfected).

• Symptoms are dementia, muscle twitching, and vision problems

PARKINSON’S DISEASE

(294.1)

• It is a chronic progressive disorder that usually occurs in middle-aged or elderly persons, characterized by slow movement, muscle rigidity, tremor, and progressive weakness.

• Early Parkinsonism may be a sequel of encephalitis (serious inflammation of brain tissue) or when the cells of the brain were deprived of their supply of oxygen for at

least five to ten minutes resulting to a permanent damage to the brain.

• This mainly results from the death of the cells in the brain that produce the neurotransmitter dopamine.

• There may be tremors, but the most common tremor to the Parkinson’s patients is the repetitive movement by which the tips of the fingers brush past the ball of the thumb – “pill-rolling movement”

• Tremors are worse when the patient is tired or excited

HIV

Human Immunodeficiency Virus(294.9)

• Also known as the Acquired Immunodeficiency Syndrome

• HIV dementia complex is caused by the HIV itself• HIV may affect the brain through several mechanisms.

Viral proteins may damage nerve cells directly or by infecting inflammatory cells in the brain and spinal cord. HIV may then induce these cells to damage and disable nerve cells. HIV appears to cause generalized inflammation, which causes chronic disease, memory issues, accelerated aging processes, heart disease, and other diseases.

• Common symptoms include decline in thinking, or "cognitive," functions such as memory, reasoning, judgment, concentration, and problem solving.

• Other common symptoms are changes in personality and behavior, speech problems, and motor (movement) problems such as clumsiness and poor balance.

Huntington’s Disease(294.1)

• Huntington’s disease is a hereditary disease characterized by disorders of movement, progressive dementia, and psychiatric/ behavioural disturbance.– Chorea – purposeless jerking, involuntary

movements, and progressive mental deterioration

Sub-cortical regions – thalamus, hypothalamus, cerebellum, brain stem

• Patients with HD find challenges in accomplishing cognitive tasks that require retrieval and synthesis of known facts, such as forming abstractions. They can accomplish tasks that require semantic memory under the right conditions, though, they have difficulties in retrieving facts/ information and remembering new information.

TREATMENTS FOR DEMENTIA

TREATMENTS WHEN DEMENTIA CAN BE REVERSEDTAKE VITAMINS OF A DEFICIENCY OF B12

TAKE TYROID HORMONES FOR HYPOTHYROIDISMHAVE SURGERY TO REMOVE BRAIN TUMOR OR TO REDUCE

PRESSURESTOP OR CHANGE MEDICINES THAT CAN CAUSE MEMORY LOSS

OR CONFUSIONTAKE MEDICINES TO TREAT INFECTIONS SUCH AS ENCEPHALITIS

TAKE MEDICINE TO TREAT DEPRESSIONGET TREATMENT FOR REVERSIBLE CONDITIONS CAUSED BY AIDS

TREATMENTS FOR DEMENTIA

TREATMENTS WHEN DEMENTIA CANNOT BE REVERSEDTIPS TO HELP THE PERSON BE INDEPENDENT AND MANAGE

DAILY LIVINGMEDICINES CANNOT CURE DEMENTIA BUT IT CAN HELP THE

PERSON IMPROVE MENTAL FUNCTION, MOOD, AND BEHAVIORA DIAGNOSIS OF DEMENTIA CAN CREATE FEELINGS OF ANGER,

FEAR, AND ANXIETY. A PERSON IN THE EARLY STAGE OF THE ILLNESS SHOULD SEEK EMOTIONAL SUPPORT FROM FAMILY,

FRIENDS, AND PERHAPS A COUNSELOR EXPERIENCED IN WORKING WITH PEOPLE WHO HAVE DEMENTIA.

ENDElyza Mae D.

Buenavista