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♂ 65 Tahun Bicara Sendiri, M. FARHAN HABIBIE - 1908260041 - Coggle Diagram
♂ 65 Tahun Bicara Sendiri
Gejala
Aktivitas kegiatan dasar harian perlu dibantu
Kendali emosi buruk
Apatis, acuh tak acuh
Ada kesulitan dalam menentukan kata-kata
Sering lupa kejadian baru
Disorientasi waktu, tempat, dan orang
Keliru membuat keputusan/penilaian
APA ITU?
merupakan sindrom berupa gangguan kognitif biasanya disebabkan oleh perubahan anatomi di otak, memiliki onset yang lebih lambat, dan umumnya ireversibel. Demensia terutama mempengaruhi memori.
TATALAKSANA
Non-Farmako
Encourage patients to maintain social, physical and recreational activities
Brain stimulation and engagement therapy
Education for families and carers
Farmako
Cholinesterase inhibitors – for Alzheimer’s disease only
Loss of cholinergic neurones = ↓ acetylcholine levels
Cholinesterase inhibitors act to prolong effects of acetylcholine
Antiglutaminergic treatment
NMDA antagonist = ↓ glutamate-induced neuronal degradation
Antidepressant with minimal anticholinergic side effects
MAJOR DEMENTIA SYNDROME
Lewy-Body Dementia (10%)
Frontaltemporal Lobe Dementia
Vascular Disease (10-20%)
Alzheimer’s Disease (50-70%)
DIAGNOSIS BANDING
Delirium
Decline (normal age related)
Depression
CMD
Pemfis
Penurunan daya ingat yang bersifat kronik dan progresif.
Pemeriksaan untuk menyingkirkan adanya gangguan neurologic (neurologic signs e.g.: gangguan kognitif, focal sign, parkinsonism, dll.) atau penyakit sistemik (e.g.:for vascural and metabolic diseases)
Kesadaran sensorium baik
Penunjang
Pemeriksaan Kognitif
MMSE
Abbreviated Mental Test (AMT)
Pemeriksaan Mini Cog dan Clock Drawing Test
CT/MRI Brain
Electroencephalogram (EEG)
CXR
Lumbar puncture
CSF analysis
Anamnesis
Riwayat medis umum
Riwayat neurologis
Riwayat gangguan kognitif
Riwayat gangguan perilaku dan kepribadian
Riwayat keracunan, nutrisi dan obat-obatan
ETIOLOGI
Reversible Causes
Vitamin B12 deficiency
Normal pressure hydrocephalus
Depression
Neurosyphilis
Hypothyroidism
Chronic Alcohol use
Irreversible Causes
Pick’s disease
Cerebral infarct
Huntington’s disease
Creutzfeldt-Jakob disease
Lewy body dementia
Chronic substance abuse
Alzheimer’s disease
FAKTOR RESIKO
Head trauma
Alcohol
Cardiometabolic factors
Homocysteine
Old Age
Medications
PATOFISIOLOGI
Vascular Disease (10-20%)
Focal or diffuse infarcts or haemorrhage
Small vessel disease; white matter ischaemia
Lewy-Body Dementia (10%)
Accumulation or protein aggregates in neurons
Lewy bodies in cerebral cortex – cytoplasmic inclusion bodies composed of ubiquitin and alpha-synuclein
Alzheimer’s Disease (50-70%)
Senile plaques and neurofibrillary tangles
Cortical atrophy
Accumulation of beta amyloid precursor proteins → progressive neurological damage
Frontaltemporal Lobe Dementia
Atrophy of frontal/temporal lobes
Agyrophilic cytoplasmic inclusion bodies of tau
KOMPLIKASI
Wandering
Aggression
Falls risk
Medication administration
Driving problems
M. FARHAN HABIBIE - 1908260041