Dementia 6

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DEMENTIASherwin T. Villegas RN.

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Definition

• Taken from the latin word originally meansMADNESS

• And “DE” meaning nothing

• “MENS” meaning mind• Its is a serious loss of cognitive ability in a

previous unimpaired person

• And is usually common in and aging person• This could be static or a result of brain

damage or due to a disease of the body.

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Definition

• Dementia is not a specific disease. It is a descriptiveterm for a collection of symptoms that can becaused by a number of disorders that affect thebrain.

• People with dementia have significantly impairedintellectual functioning that interferes with normalactivities and relationships.

• They also lose their ability to solve problems andmaintain emotional control, and they mayexperience personality changes and behavioralproblems such as agitation

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Definition

• While memory loss is a common symptom ofdementia, memory loss by itself does notmean that a person has dementia.

• Doctors diagnose dementia only if two ormore brain functions - such as memory,language skills, perception, or cognitive

skills including reasoning and judgment - aresignificantly impaired without loss ofconsciousness.

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Senile Dementia

• dementia of the elderly was called seniledementia or senility and viewed as a normalaspect of growing old rather than as being

caused by any specific diseases• Dementia is a non-specific illness syndrome (set

of signs and symptoms) in which affected areasof cognition may be memory, attention,

languag e, and problem solving . It is normallyrequired to be present for at least 6 months to bediagnosed

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Signs and symptom

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Signs and symptoms

• Its not merely the problem of memory

• It reduces the ability to learn

• Reduces ability to reason

• Reduces ability to retain and recall pastexperiences

• Loss pattern of thoughts, feelings and activities

• May influence quality of life

• May neglect themselves, incontinence progressas their condition worsens.

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Signs and symptoms

• Disorientation

• Inability to solve problems

• Inability to maintain emotional control

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Types of Dementia

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Cortical Dementia

• CORTICAL DEMENTIADementia where thebrain damage primarilyaffects brain cortex orouter layer. Corticaldementia tend to causeproblems with memory,language and thinking

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Subcortical Dementia

• Affects parts ofbrain which is belowthe cortex that cause

changes in emotionsand motions inaddition toproblems withmemory

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Progressive Dementia

• Dementia getsworse over time ,gradually

interfering withmore and morecognitive abilities

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Lewy body dementia

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Lewy body dementia• Most common type of progressive dementia, it

usually occurs sporadically in people with noknown family history

• Cells die in the brain cortex outer layer and in

part of the mid brain called substantia nigra thatcontain abnormal cell structure that is calledLewy Bodies that are hallmark of the disease

• Includes symptoms like parkinsons,

hallucinations, memory impairment and poor judgment

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Primary Dementia

• Dementia such asalzheimer’s diseasedoes not result from

any other disease

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Secondary Dementia

• Dementia thatoccurs as a result ofa physical disease or

injury

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Vascular Dementia

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Multi infarct dementia

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Vascular Dementia

• here are several types of vascular dementia,which vary slightly in their causes andsymptoms.

• One type, called multi-infarct dementia(MID), is caused by numerous small strokesin the brain.

• Multi-infarct dementia typically includesmultiple damaged areas, called infarcts,along with extensive lesions in the white

matter, or nerve fibers, of the brain.

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Vascular Dementia

• Although not all strokes cause dementia, insome cases a single stroke can damage thebrain enough to cause dementia.

• This condition is called single-infarctdementia. Dementia is more commonwhen the stroke takes place on the left side

(hemisphere) of the brain and/or when itinvolves the hippocampus, a brainstructure important for memory.

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Frontotemporal Dementia

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• there is an abnormal form of protein inthe brain, which accumulates into

neurofibrillary tangles. This disruptsnormal cell activities and may cause thecells to die.

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• Frontotemporal dementia, sometimescalled frontal lobe dementia, describes agroup of diseases characterized by

degeneration of nerve cells - especiallythose in the frontal and temporal lobes ofthe brain.

• Unlike Alzheimer's disease, frontotemporaldementia usually does not includeformation of amyloid plaques

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Abnormal proteins in the brain

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Risk Factors

• Age• Genetics

• Smoking alcohol use

• Atherosclerosis

• Cholesterol

• Plasma homocysteine – very strongamino acid

• Down syndrome

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How dementia is Diagnosed?

• It is important that they rule out anytreatable conditions, such as depression,normal pressure hydrocephalus, or vitamin

B12 deficiency, which can cause similarsymptoms.

• early diagnosis may allow them to plan for

the future while they can still help to makedecisions. These people also may benefitfrom drug treatment.

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How dementia is Diagnosed?

• patient's history, physical examination,neurological evaluations (balance, sensoryfunction, reflexes, etc.)

• cognitive and neuropsychological tests (memory,language skills, math skills, problems solving,etc.)

• brain scans (computed tomographic (CT) scans

and magnetic resonance imaging (MRI), etc.),laboratory tests (blood tests, urinalysis, toxicologyscreen, thyroid tests, etc.), psychiatric evaluation,and presymptomatic testing

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Treatment

• people can sometimes be taught to usememory aids, such as mnemonics,computerized recall devices, or note taking.

• Behavior modification - rewardingappropriate or positive behavior and ignoringinappropriate behavior - also may help

control unacceptable or dangerous behaviors.

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Treatment

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Treatment

• donepezil (Aricept),

• rivastigmine (Exelon),

• and galantamine (Razadyne – previously called Reminyl)

• This are all cholinesterase inhibitor

these result to behavioral symptoms

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Prevention

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Prevention

• studies have shown that people who

maintain tight control over their glucoselevels tend to score better on tests ofcognitive function than those with poorly

controlled diabetes• Several studies also have suggested thatpeople who engage in intellectuallystimulating activities, such as social

interactions, chess, crossword puzzles, andplaying a musical instrument, significantlylower their risk of developing Alzheimer's

disease and other forms of dementia

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Prevention• Other preventive actions include lowering

homocysteine (amino acids), loweringcholesterol levels

• lowering blood pressure, exercise,

education, controlling inflammation,• and long-term use of nonsteroidal anti-

inflammatory drugs (NSAIDs) such as

ibuprofen, naproxen, and similar drugs.

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Nursing care

• People with moderate and advanceddementia typically need round-the-clockcare and supervision to prevent them fromharming themselves or others.

• They also may need assistance with dailyactivities such as eating, bathing, anddressing.

• Meeting these needs takes patience,understanding, and careful thought by theperson's caregivers.

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Nursing Care• A typical home environment can present many

dangers and obstacles to a person with dementiasuch as sharp knives, dangerous chemicals, tools,and other hazards which should be removed orlocked away.

• Safety measures include installing bed andbathroom safety rails

• removing locks from bedroom and bathroom doors,

• and lowering the hot water temperature to 120° F(48. 9° C) or less to reduce the risk of accidentalscalding.

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Nursing care

• People with dementia often developbehavior problems because of frustrationwith specific situations.

• Understanding and modifying or preventingthe situations that trigger these behaviorsmay help to make life more pleasant for the

person with dementia as well as his or hercaregivers

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Documents

Dementia 6