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S. eriksson dementia disorders overview

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Dementia Care overview Sture Eriksson asterbotten L¨ ans Landsting 29 maj 2012
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Page 1: S. eriksson dementia disorders overview

Dementia Care overview

Sture Eriksson

V

¨

asterbotten L

¨

ans Landsting

29 maj 2012

Page 2: S. eriksson dementia disorders overview

Cognitive disorders

Group of symptoms

I Cognitive symptoms

I Functionell decline (ADL)

I BPSD (Behavoiural and Psychic Symptoms in Dementia)

Page 3: S. eriksson dementia disorders overview

Cognitive disorders

Classification

I Mild cognitiv impairment (MCI)

I Dementia disorders

I Confusional syndrome

I Mnestiska syndrome

Page 4: S. eriksson dementia disorders overview

Mild cognitiv impairment

Definition

1. Subjectiv memory decline

2. Pathology in delay recall (16 word test)

80% develops manifest dementia disorder within 5 yearNo established pharmacological treatment.

Page 5: S. eriksson dementia disorders overview

Dementia disorders

Classification

I Alzheimer’s disease

I Dementia of Lewy body typ

I Vaskular dementia

I Dementia in Parkinson’s disease

I Other forms of dementia disorders

Page 6: S. eriksson dementia disorders overview

What is dementia?

Definition

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

Page 7: S. eriksson dementia disorders overview

Alzheimer’s disease

Definition

1. Dementia syndrome

2. Incidious onset and progressive course

3. Other disorders excluded

Patogenes: Pathological metabolism av �-amyloid giving forexample disturbances of signal substancesLow levels of acetylcholine, serotonin, dopamin and otherIncrease of glutamat.

Page 8: S. eriksson dementia disorders overview
Page 9: S. eriksson dementia disorders overview

Diagnostic methods in cognitive decline

I Auto- and heteroanamnesis

I Clincal assessement

I Testing including neuropsylogical assessment

I Laboratory investigment

I Occupational and social assessments

I Imageing such asI CT-scan, MRI, SPECT, PET-scan

Page 10: S. eriksson dementia disorders overview

Treatment in deficits of acetylcholine

Cholinergic deficients in for example

I Alzheimer’s disease

I Dementia av Lewy body type

I Dementia vid Parkinsons disease

Page 11: S. eriksson dementia disorders overview

Cholinerga drugs

Acetylkolinesteras inhibitors

I donezepil 5-10 mg/dygn

I rivastigmin 3 - 12 mg/dygn

I galantamin 8 - 16 mg/dygn

Page 12: S. eriksson dementia disorders overview

E↵ect of cholinergic drugs

Symptomatic e↵ect

I Attention

I Stability

I Cognitiv improvement

E↵ects during long term treatment!

Page 13: S. eriksson dementia disorders overview

E↵ects of cholinergic drugs

Nivå

Tid


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