S. eriksson dementia disorders overview

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S. eriksson dementia disorders overview

  1. 1. Dementia Care overview Sture Eriksson V¨sterbotten L¨ns Landsting a a 29 maj 2012
  2. 2. Cognitive disorders Group of symptoms I Cognitive symptoms I Functionell decline (ADL) I BPSD (Behavoiural and Psychic Symptoms in Dementia)
  3. 3. Cognitive disorders Classification I Mild cognitiv impairment (MCI) I Dementia disorders I Confusional syndrome I Mnestiska syndrome
  4. 4. Mild cognitiv impairment Definition 1. Subjectiv memory decline 2. Pathology in delay recall (16 word test) 80% develops manifest dementia disorder within 5 year No established pharmacological treatment.
  5. 5. Dementia disorders Classification I Alzheimer’s disease I Dementia of Lewy body typ I Vaskular dementia I Dementia in Parkinson’s disease I Other forms of dementia disorders
  6. 6. What is dementia? Definition 1. Development of memory decline 2. Afasi, agnosi, apraxi or exekutiva disturbances 3. Severe enough to interfere with occupational and/or social abilities 4. Not only confusional state
  7. 7. Alzheimer’s disease Definition 1. Dementia syndrome 2. Incidious onset and progressive course 3. Other disorders excluded Patogenes: Pathological metabolism av -amyloid giving for example disturbances of signal substances Low levels of acetylcholine, serotonin, dopamin and other Increase of glutamat.
  8. 8. Diagnostic methods in cognitive decline I Auto- and heteroanamnesis I Clincal assessement I Testing including neuropsylogical assessment I Laboratory investigment I Occupational and social assessments I Imageing such as I CT-scan, MRI, SPECT, PET-scan
  9. 9. Treatment in deficits of acetylcholine Cholinergic deficients in for example I Alzheimer’s disease I Dementia av Lewy body type I Dementia vid Parkinsons disease
  10. 10. Cholinerga drugs Acetylkolinesteras inhibitors I donezepil 5-10 mg/dygn I rivastigmin 3 - 12 mg/dygn I galantamin 8 - 16 mg/dygn
  11. 11. E↵ect of cholinergic drugs Symptomatic e↵ect I Attention I Stability I Cognitiv improvement E↵ects during long term treatment!
  12. 12. E↵ects of cholinergic drugs Nivå Tid

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