Rabu, 04 Februari 2015

Dementia: The decline in mental ability

Dementia is a decline in mental ability that usually progresses slowly , where there is a disturbance of memory , thought, judgment and ability to focus , and personality deterioration can occur .

At a young age , dementia may occur suddenly if severe injury , disease or toxic substances ( eg carbon monoxide ) causing the destruction of brain cells .
But dementia usually occurs slowly and attack aged over 60 years .
But dementia is not part of the normal aging process . Along with age , the changes in the brain can cause a loss of some memory ( especially short-term memory ) and a decrease in some learning abilities . These changes do not affect the normal function .

Forgotten in the elderly is not a sign of dementia or early-stage Alzheimer's disease .
Dementia is a decline in mental abilities are more serious , the more and more severe .
In normal aging , a person may forget the things that detail ; but a person with dementia may forget the whole event has just occurred .

CAUSE

The most frequent cause of dementia is Alzheimer's disease .
The cause of Alzheimer's disease is unknown , but is thought to involve genetic factors , because the disease seems to be found in some families and are caused or influenced by some specific gene abnormality .

In Alzheimer's disease , some parts of the brain decline , resulting in cell damage and reduced response to a chemical signal channel in the brain .
Found in the brain of abnormal tissue ( called senile plaques and tangled nerve fibers ) and abnormal proteins , which can be seen at autopsy .

Dementia Lewy figure closely resembles Alzheimer's disease , but have differences in the microscopic changes that occur in the brain .

2nd most common cause of dementia is a stroke that row.
Single stroke is small and causes mild weakness or weaknesses that arise slowly . This small strokes gradually cause damage to brain tissue , brain regions that were damaged due to blockage of blood flow is called infarction .
Dementia is derived from several small strokes called multi - infarct dementia . The majority of sufferers have high blood pressure or diabetes , both of which cause damage to blood vessels in the brain .

Dementia can also occur after a person experienced a brain injury or cardiac arrest .

Other causes of dementia are :
- Pick disease
- Parkinson's disease
- AIDS
- Creutzfeldt- Jakob Disease

Normal pressure hydrocephalus occurs when the fluid that normally surrounds the brain and protect it from injury , failed to properly absorbed .
Hydrocephalus is an unusual cause of dementia , which not only leads to loss of mental function but also occurred urine incontinence and walking abnormalities .

People who suffer repeated head injuries ( eg boxers ) pugilistika often experience dementia ( progressive chronic traumatic encephalopathy ) ; some of them also suffer from hydrocephalus .

Elderly people who suffer from depression also experience pseudodemensia .
They rarely eat and sleep and often complain about reduced memory ; whereas the true dementia , memory loss sufferers often disown them .

SYMPTOMS

Dementia usually begins slowly and progressively become more severe , so that the state did not at first realize .
There was a decline in memory , the ability to remember the time and ability to recognize people , places and objects .

Patients have difficulty in finding and using the right words and the abstract thinking ( eg in the use of numbers ) .

Often a change in personality .

Dementia due to Alzheimer's disease usually begins subtly .
The initial symptoms are usually oblivious to the events that had just occurred ; but could also started as depression , fear , anxiety , decreased emotional or other personality changes .
There is a change in the pattern of speaking lightly ; people use words more simply, using words that are not appropriate or not able to find the right words .
Inability to interpret the signs could lead to difficulties in driving.
In the end people can not run a social function .

Dementia due to minor stroke have a disease with such a pattern down the stairs .
Symptoms worsen suddenly , then somewhat improved and will further deteriorate again when the next stroke occurs .
Controlling high blood pressure and diabetes can sometimes prevent subsequent stroke and occasionally happen healing light .
Some people can hide their flaws well .
They avoid complex activity ( such as reading or working ) .
Patients who do not succeed in changing their lives can experience frustration because of his inability to perform daily tasks .
Patients forget to perform the essential duties or wrong in doing its job .

Distinguishing Delirium With Dementia
Delirium
Demensia
Occurs suddenly
Occurs slowly
Lasted for several weeks
can be settled
Associated with the use of drugs or drug withdrawal symptoms, severe disease, metabolic disorders
Can without disease
Almost always worse at night
Often worse at night
Not being able to focus
Attention 'wandering'
Fluctuating alertness of lethargy into agitation
Preparedness is often reduced
Orientation to the environment varies
Orientation to the environment disturbed
Its language is slow, often not understood and not appropriate
Sometimes having trouble finding the right words that
Mixed memory, confusion
Lost his memory, especially for recent events occurring

Diagnosis

The diagnosis of dementia is made based on a thorough assessment , taking into account patient age , family history , the beginning and the development of symptoms and the presence of other diseases ( eg, high blood pressure or diabetes ) .

Standard blood chemistry examination .
CT scan and MRI examination is intended to determine the presence of a tumor , hydrocephalus or stroke .

If on an older memories setbacks occur gradually , it is thought to cause Alzheimer's disease .
Diagnosis of Alzheimer's disease proved only if performed an autopsy on the brain , which indicates the number of nerve cells are lost . The remaining cells appear chaotic and scattered throughout the brain tissue plaques composed of amyloid (a type of abnormal proteins ) .
Diagnostic methods used to diagnose this disease is the examination of the lumbar puncture and PET ( positron emission tomography ) , which is a specific brain skening pemerisaan .

TREATMENT

Most cases of dementia can not be cured .
Takrin drugs help people with Alzheimer's disease , but cause serious side effects .

Takrin has been replaced by donepezil , which cause fewer side effects and slow the progression of Alzheimer's disease for 1 year or more .
Ibuprofen can also slow the course of the disease .
These drugs are best if given at an early stage .

Dementia due to stroke in a row can not be cured , but its development can be slowed or even halted by treating high blood pressure or diabetes -related stroke .

If memory loss are due to depression , given anti -depressants .

If diagnosed early , the normal -pressure hydrocephalus dementia because it can sometimes be overcome by removing excess fluid in the brain through the drainage hose ( shunting ) .

To control the agitation and explosive behavior , which can accompany advanced stages of dementia , often digunakanobat anti -psychosis ( eg tioridazin and haloperidol ) . But these drugs are less effective and cause serious side effects .
Effective anti - psychotic drugs given to patients who experience hallucinations or paranoia .

Helping people with dementia and their families :

1 . Maintaining a familiar environment will help patients have a fixed orientation . Calendar huge , bright light , wall clock with large numbers or radio can also help people stay oriented .
2 . Hiding car keys and installing detectors on doors can help prevent the occurrence of an accident in people who love to walk around .
3 . Undergoing bathing , eating , sleeping and other routine activities , can provide a sense of order to the patient .
4 . Scold or punish people will not help , it will even make things worse .
5 . Enlist the help of organizations that provide social services and care , would be very helpful

Prognosis

Development of dementia in each person is different .
AIDS dementia usually begins as a vague but growing steadily for several months or years .
While dementia because Ceutzfeldt - Jakob disease typically causes severe dementia and death often occurs within 1 year .

In the most advanced stages of dementia , a decline in brain function almost complete .
Patients become more attractive and not able to control her behavior. Moods change often and happy walk around ( wandering ) .
In the end the patient is unable to follow a conversation and can lose the ability to speak .

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