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S. eriksson dementia disorders overview

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  • 1. Dementia Care overviewSture ErikssonVsterbotten Lns Landsting aa 29 maj 2012

2. Cognitive disordersGroup of symptomsI Cognitive symptomsI Functionell decline (ADL)I BPSD (Behavoiural and Psychic Symptoms in Dementia) 3. Cognitive disordersClassicationI Mild cognitiv impairment (MCI)I Dementia disordersI Confusional syndromeI Mnestiska syndrome 4. Mild cognitiv impairmentDenition 1. Subjectiv memory decline 2. Pathology in delay recall (16 word test)80% develops manifest dementia disorder within 5 yearNo established pharmacological treatment. 5. Dementia disordersClassicationI Alzheimers diseaseI Dementia of Lewy body typI Vaskular dementiaI Dementia in Parkinsons diseaseI Other forms of dementia disorders 6. What is dementia?Denition 1. Development of memory decline 2. Afasi, agnosi, apraxi or exekutiva disturbances 3. Severe enough to interfere with occupational and/orsocial abilities 4. Not only confusional state 7. Alzheimers diseaseDenition1. Dementia syndrome2. Incidious onset and progressive course3. Other disorders excludedPatogenes: Pathological metabolism av -amyloid giving forexample disturbances of signal substancesLow levels of acetylcholine, serotonin, dopamin and otherIncrease of glutamat. 8. Diagnostic methods in cognitive declineI Auto- and heteroanamnesisI Clincal assessementI Testing including neuropsylogical assessmentI Laboratory investigmentI Occupational and social assessmentsI Imageing such asI CT-scan, MRI, SPECT, PET-scan 9. Treatment in decits of acetylcholineCholinergic decients in for exampleI Alzheimers diseaseI Dementia av Lewy body typeI Dementia vid Parkinsons disease 10. Cholinerga drugsAcetylkolinesteras inhibitorsI donezepil 5-10 mg/dygnI rivastigmin 3 - 12 mg/dygnI galantamin 8 - 16 mg/dygn 11. Eect of cholinergic drugsSymptomatic eectI AttentionI StabilityI Cognitiv improvementEects during long term treatment! 12. Eects of cholinergic drugs NivTid

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