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DEMENTIA
   75 year old Retd school teacher.
   Memory loss- lost purse, searches for
    objects - 2 months.
   Mental stressor – quarrel with son - 2
    months.
AMNESIA
   Amnesia is a deficit of memory, i.e., the
    storage or retrieval of consciously
    processed information.

   Focal lesions in limbic structures.

   Anterograde n retrograde amnesia
WHAT IS DEMENTIA?
   Global impairment of cognitive function,
    memory affected in the early stages;
    visuospatial function, language ability,
    concentration and attention gets affected
    gradually.

   Acquired and persistent impairment in
    multiple areas of intellectual function not
    due to delirium.
   Loss of mental functions.

   Usually above 65 yrs

   Most common cause- ALZHIEMER`S
    DISEASE and CEREBRAL VASCULAR
    DIEASE.
DSM 1V DEFINITION
Multiple cognitive deficits

memory impairment
Aphasia,
Apraxia,
Agnosia,
Disturbance in executive functioning.
CAUSES OF DEMENTIA
   Vascular            -diffuse small
                      vessel disease
   Deg/inherited      - Alzheimer`s
                          disease
   Neoplastic        - secondary
                          deposits
   Inflammatory    -multiple sclerosis
   Infective
   Traumatic         -c/c subdural
                      haematoma,
                      post head injury
   Toxic/nutritional-alcoholism

   Hydrocephalus

   Prion`s disease
REVERSIBLE VS
IRREVERSIBLE
   Reversible – can be corrected
                   infection,SDH,B12 def
                   hypothyroidism,neoplasm
                   hydrocephalus

   Irreversible –Alzhiemer`s disease
                     Prion`s disease
                     SSPE
CORTICAL VS SUBCORTICAL

     CORTICAL (AD)                 SUBCORTICAL (PD)
Normal cognitive processing,    Slowing, but correct
wrong answers
Severe amnesia, recall n        Better recognition, improved by
recognition affected            clues

Executive abilities preserved   Disproportionately affected

Aphasia prominent               Normal with dysarthria n less
                                word output
Personality intact until late   Apathetic n inert

Mood normal, sometimes elated Depression
DELIRIUM
   Disturbance in the level of consciousness.
   Acute disorder of cognition characterized
    by fluctuating disturbance in attention.
   Often reversible
   Develops over a short period of time and
    tends to fluctuate during the course of
    the day.
DELIRIUM
DEMENTIA
   Onset -       Acute/subacute insidious

   Course-   Fluctuating        stable

   Duration - Hrs to days      Months to
                                    yrs
   Consciousness -Clouded      Clear

   Attention -     Impaired     normal
Thank you

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Dementia

  • 2. 75 year old Retd school teacher.  Memory loss- lost purse, searches for objects - 2 months.  Mental stressor – quarrel with son - 2 months.
  • 3. AMNESIA  Amnesia is a deficit of memory, i.e., the storage or retrieval of consciously processed information.  Focal lesions in limbic structures.  Anterograde n retrograde amnesia
  • 4. WHAT IS DEMENTIA?  Global impairment of cognitive function, memory affected in the early stages; visuospatial function, language ability, concentration and attention gets affected gradually.  Acquired and persistent impairment in multiple areas of intellectual function not due to delirium.
  • 5. Loss of mental functions.  Usually above 65 yrs  Most common cause- ALZHIEMER`S DISEASE and CEREBRAL VASCULAR DIEASE.
  • 6. DSM 1V DEFINITION Multiple cognitive deficits memory impairment Aphasia, Apraxia, Agnosia, Disturbance in executive functioning.
  • 7. CAUSES OF DEMENTIA  Vascular -diffuse small vessel disease  Deg/inherited - Alzheimer`s disease  Neoplastic - secondary deposits  Inflammatory -multiple sclerosis  Infective
  • 8. Traumatic -c/c subdural haematoma, post head injury  Toxic/nutritional-alcoholism  Hydrocephalus  Prion`s disease
  • 9. REVERSIBLE VS IRREVERSIBLE  Reversible – can be corrected infection,SDH,B12 def hypothyroidism,neoplasm hydrocephalus  Irreversible –Alzhiemer`s disease Prion`s disease SSPE
  • 10. CORTICAL VS SUBCORTICAL CORTICAL (AD) SUBCORTICAL (PD) Normal cognitive processing, Slowing, but correct wrong answers Severe amnesia, recall n Better recognition, improved by recognition affected clues Executive abilities preserved Disproportionately affected Aphasia prominent Normal with dysarthria n less word output Personality intact until late Apathetic n inert Mood normal, sometimes elated Depression
  • 11. DELIRIUM  Disturbance in the level of consciousness.  Acute disorder of cognition characterized by fluctuating disturbance in attention.  Often reversible  Develops over a short period of time and tends to fluctuate during the course of the day.
  • 12. DELIRIUM DEMENTIA  Onset - Acute/subacute insidious  Course- Fluctuating stable  Duration - Hrs to days Months to yrs  Consciousness -Clouded Clear  Attention - Impaired normal