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a 65 years old man talking to himself Helvi Ramadhani 1908260083 -…
a 65 years old man talking to himself
Helvi Ramadhani 1908260083
Definition of dementia
Dementia is a syndrome of chronic progressive cognitive decline resulting in functional impairment
Dementia education and prevention
Counseling must be given about regular clinic visits about medication compliance, a healthy diet, exercise, and sleep hygiene
Support groups can help with the reduction of issues like anxiety, frustration, anger, loneliness, and depression.
The patient should be counseled about the diagnosis and the prognosis. Creating an individualized care plan can empower the patient.
Complications of dementia
Inability to perform self-care tasks
Personal safety challenges
Fractures due to falls
Apathy
Agitation
Dysphagia
Death
Dementia diagnostic criteria
In the Diagnostic Manual of Mental Disorders, Fifth Edition (DSM-V), cognitive decline is quantified as deficits in one or more domains (e.g., memory, executive function, visuospatial, language, attention)
criteria for dementia diagnosis based on PPDGJ III
Gradual onset
Absence of clinical evidence, or findings from special examinations, that the mental condition may be caused by a brain or other systemic disease that can lead to dementia
Presence of symptoms of dementia
Absence of sudden apoplectic attacks, or neurologic symptoms of focal brain damage
classification of dementia
Lewy body dementia (LBD)
accounts for 5% to 10% of cases of dementia.
Frontotemporal dementia (FTD)
is the second most common cause of dementia in patients less than 65 years of age
Vascular dementia (VD)
accounts for 5% to 10 % of all dementia cases
Creutzfeldt-Jakob disease (CJD)
is very rare and occurs in about 1 in a million.
Alzheimer disease (AD)
is the most common cause of dementia
Mixed dementia
is a condition in which patients have more than 1 type of dementia. In this condition, AD with LBD or vascular dementia are the most common coexistent dementias.
Psychiatric examination in dementia
prognosis of dementia
The prognosis with dementia is poor. Dementia is often a progressive condition with no cure or treatment. The 1-year mortality rate was 30 to 40% while the 5-year mortality rate was 60-65%.
Mortality rates among admitted patients with dementia were higher than those with cardiovascular diseases
treatment for dementia
Donepezil, rivastigmine, galantamine, and tacrine are cholinesterase inhibitors used to treat mild to moderate cognitive impairment
Cholinesterase inhibitors prevent the breakdown of acetylcholine and can slow or delay the worsening of symptoms.
Dementia risk factors
Men had a higher risk than women.
Age, ±2% at 65 – 70 years
• >30% at 85 years
family history of dementia
Pathogenesis of dementia
Vascular dementia occurs as a result of cerebral tissue ischemia causing gliosis and demyelination. Ischemia may occur as a result of atherosclerosis, thrombosis, or vasculopathy.
The pathophysiology of dementia is not understood completely. Most types of dementia, except vascular dementia, are caused by the accumulation of native proteins in the brain.
Signs and symptoms of dementia
difficulty maintaining mental performance, fatigue, and a tendency to fail when it is a new or complex task
The inability to carry out tasks becomes increasingly difficult and spreads to daily tasks such as shopping
Symptoms and disability have been present for at least 6 months
require constant supervision and assistance to perform the most basic tasks of daily life
a decrease in memory and thinking abilities, which interferes with a person's daily activities such as: bathing, dressing, eating, personal hygiene, defecation and urination.
The major defects in dementia involve orientation, memory, perception, intellectual function, thinking
No disturbance of consciousness was found
Differential diagnosis speaks for itself
Delirium
Depression
Drug use
skizofrenia
Mild cognitive impairment
Stress
etiology dementia
Some researchers reveal that 50% of the prevalence of Alzheimer's cases is inherited through an autosomal dominant gene.
Abnormalities of the neurotransmitter acetylcholine are more common than other types of neurotransmitters in Alzheimer's disease.
