+ All Categories

Download - Dementia

Transcript
Page 1: Dementia

SENILE DEMENTIA

PREPARED BY: RESURRECCION, Carls Burg A.

Page 2: Dementia
Page 3: Dementia

DEFINITIONS/DISTINCTIONS Dementia is a clinical

syndrome of cognitive deficits that involves both memory impairments and a disturbance in at least one other area of cognition (e.g., aphasia, apraxia, agnosia) and disturbance in executive functioning.

Page 4: Dementia

In addition to disruptions in cognition, dementias are commonly associated with changes in function and behavior.

The most common forms of progressive dementia are Alzheimer's disease, vascular dementia, and dementia with Lewy bodies; the pathophysiology for each is poorly understood.

Page 5: Dementia

Differential diagnosis of dementing conditions is complicated by the fact that concurrent disease states (i.e., co-morbidities) often coexist.

Page 6: Dementia

PREVALENCE Dementia affects about 5% of

individuals 65 and older. Four to five million Americans

have Alzheimer's disease (AD) 13.2 million are projected to

have AD by 2050. Global prevalence of dementia

is about 24.3 million, with 6 million new cases every year.

Page 7: Dementia

RISK FACTORS Advanced age Mild cognitive impairment Cardiovascular disease Genetics: family history of

dementia, Parkinson's disease, cardiovascular disease, stroke, presence of ApoE4 allele on chromosome 19

Environment: head injury, alcohol abuse

Page 8: Dementia

TYPES OF

DEMENTIA

Page 10: Dementia

1.Alzheimer’s disease Alzheimer’s

disease is the most common type of dementia. In patients aged 65 years or older, who have some kind of cognitive decline, it accounts for over 50% of cases. Progression to full dementia may take several years following the signs of mild cognitive impairment (MCI) at the early stage of AD.

 

Page 11: Dementia

Characteristics: Aphasia – loss or impairment of

language caused by brain dysfunction Apraxia – inability to execute learned

movements on command Agnosia – inability to recognize or

associate meaning to a sensory perception

Acalculia – inability to perform arithmetical calculations

Agraphia – inability to write Alexia – inability to read

Page 12: Dementia
Page 13: Dementia

2.Vascular dementia Vascular dementia is the second most common cause of dementia. It results from vascular or circulatory lesions or from diseases of the cerebral vasculature leading to ischaemia or infarction.

Page 14: Dementia
Page 15: Dementia

Characteristics:

Presence of clinical dementia

Evidence of cerebrovascular disease

Exclusion of other conditions capable of producing dementia

Page 16: Dementia

3.Dementia with Lewy bodies Dementia with Lewy bodies

(DLB) is an increasingly recognized cause of dementia in elderly patients. The typical presenting features of DLB include fluctuating dementia with prominent deficits in attention, frontal executive tasks and visuospatial abilities. The cognitive profile of DLB contains both cortical and subcortical features.

Page 17: Dementia
Page 18: Dementia

Clinical features: Periods of confusion Fluctuations in cognition

(especially attention and alertness)

Visual hallucinations Spontaneous extrapyramidal

signs such as rigidity or slowing (mild

parkinsonism) Bradykinesia (paucity of

movement)

Page 19: Dementia

4.Fronto-temporal dementia Fronto-temporal dementia

(FTD) – sometimes called Pick’s complex – is characterized by focal frontal atrophy with personality and behavioural disturbances, or temporal atrophy with either progressive aphasia or semantic dementia [Hodges, 1992; Neary, 1998]. Onset of FTD is observed in a younger age group than other dementias and diagnosis may be difficult in the early stages of disease.

Page 20: Dementia

Routine neuropsychological assessment procedures such as the Mini-Mental State Examination (MMSE) are usually insensitive at detecting frontal abnormalities, therefore more extensive neuropsychological testing is required to establish frontal deficit in patients suspected with FTD. The clock drawing test may be helpful.

 

Page 21: Dementia

Presenting features of FTD include:

Insidious onset and slow progression

Preservation of memory to late-stage disease making diagnosis difficult

Early and prominent personality changes (eg, apathy, irritability, jocularity, euphoria,

loss of personal and social awareness)

Page 22: Dementia

Loss of tact and concern Impaired judgement and insight Mental rigidity and inflexibility Hypochondriasis Unrestrained exploration of objects and the

environment (hypermetamorphosis) Distractability and impulsivity, depression

and anxiety Language difficulties (eg, problems with

word recall, circumlocution, word repetition – also known as gramophone syndrome)

Inertia

Page 23: Dementia
Page 24: Dementia
Page 25: Dementia
Page 27: Dementia

ANATOMY

Page 28: Dementia
Page 29: Dementia

CLINICAL MANIFESTATION

Page 30: Dementia

Memory loss

Page 31: Dementia

Symptoms at the early stage include the following:

Forget recent events and distant memory also fades as the disease progresses

Experience difficulty in reasoning, calculation, and accepting new things

Become confused over time, place and direction

Page 32: Dementia

Affect the activity of daily living

Judgment will be reduced Personality will be changed

Become passive and lose initiative.

Page 33: Dementia

Symptoms at the middle stage include the following: Lose cognitive ability, such as the

ability to learn, judge, and reason Become emotionally unstable, and

easily lose temper or become agitated

Need help from his or her family with activities of daily living

Confuse night and day, and disturb the family's normal sleeping time.

Page 34: Dementia

Symptoms at the later stage include the following: Lose all cognitive ability

Become entirely incapable of self-care, including eating, bathing, and so on

Neglect personal hygiene, and will become incontinent

Lose weight gradually, walk unsteadily and become confined to bed.

Page 35: Dementia

DIAGNOSIS

Page 36: Dementia

If you think you may be developing dementia, visit your GP. It's very important to seek help early so you can get the support you need.

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may do blood and urine tests to rule out the possibility of other conditions that could cause symptoms similar to dementia.

Page 37: Dementia

You may also have a memory test - one that is often used to help find out if you have dementia is the 'mini mental state examination (MMSE)'. In this test, your GP will ask you some questions and test your attention and ability to remember words. How you score in this test indicates how serious your condition is, for example:

-an MMSE score of 20 to 24 indicates mild dementia -a score of 10 to 20 suggests moderate

dementia -a score below 10 implies severe

dementia

Page 38: Dementia

TREATMENT

Page 39: Dementia

Medicines

donepezil galantamine rivastigmine

Page 40: Dementia
Page 41: Dementia

Talking therapiesYou may find other therapies helpful,

such as: group activities and discussions -

these aim to stimulate your mind (this is sometimes referred to as cognitive stimulation therapy)

reminiscence therapy - discussing past events in groups, usually using photos or familiar objects to jog your memory, although there are conflicting opinions on whether this is effective

Page 42: Dementia

Complementary therapies

It's possible that aromatherapy will help you to feel less agitated. However, there is only a small amount of evidence to support this.

Page 43: Dementia

Top Related