2. DEMENTIA (MEMORY LOSS)
A syndrome characterized by multiple cognitive defect
including disturbance of memory without disturbance of
consciousness.
3. CLASSIFICATION OF ORGANIC BRAIN DISORDER
(F00-f09) organic,including symptomatic,mental disorders
(FO0) Dementia in Alzheimer’s disease
(F01)Vascular dementia
(F02) Dementia in other diseases classified elsewhere
(F03) unspecified dementia
(F04) organic amnestic syndrome,not induced by alcohol and psychoactive substance
(F05) delirium not induced by alcohol and other psychoactive substances
(F06) Other mental disorders due to brain damage and dysfunction and to physical
disease
(F07) personality and behavioural disorders due to brain disease,damage and dysfunction
(F09) unspecified organic or symptomatic mental disorder.
5. ETIOLOGY
1. Significant loss of neuronsand volume in brain regions devoted to memory and higher
mental functioning.
2. Environmentalfactors:- infection,metal and toxins.
3. Excessive amount of metal ions, such as zinc and copper in brain.
4. Deficiency of vitamin b⁶, b12 and foliate possible risk factors due to increasedlevel of
hemocysteine (amino acid) that may interfere with nerve cell repair.
5. Early Depression:- common genetic factors seen in those with early depression and
Alzheimer’s disease.
6. TYPES
Stage 1 = No Apparent symptoms
There is no apparent decline in memory.
Stage 2 = Forgetfulness
Inthis Individual begins to lose things or forget names of people.
Stage 3 = mild cognitive decline
In this there is interference with work performance, which become noticeable to co workers such as his or her own child
birthday.
Experience decline ability to perform take, such as shoping and managing personal finance.
Stage 5 = moderate cognitive decline, early Dementia ( the individual lose the ability to perform some activities of daily
living, indepently such as hygiene, Dressing and grooming and requiredsome assistance to manage these on an going
basics.
stage 6 = moderate to serve cognitive decline ( At this stage Individual Maybe unable to recall the Recent major life Or
even name of person.
stage 7 = severe cognitive decline, late Dementia ( in this individual Is unable to recognise the name of their family
7.
8. CLINICAL FEATURES OF ALZHEIMER’S DISEASE
1. Personality changes:- lack of interest in day-to-day activities, easy
mental fatigability, self-centred, withdrawn, decreased self-care.
2. Memory impairment: recent memory is prominently affected.
3. Cognitive impairment: disorientation poor judgement, difficulty in
abstraction, decreased attention span.
4. affective impairment: labile mood, irritableness, depression.
5. Behavioural impairment: stereotyped behaviour, alteration in sexual
drives and activities, psychotic behaviour.
6. Neurological impairment: stereotyped behaviour, alteration in sexual
drives and activities.
9. DIAGNOSTIC EVALUATION
Cognitive assessment evaluation- mini mental status examination (MMSE) – shows
cognitive impairment.
Functional dementia scale (to indicate the degree of dementia).
Magnetic resonance imaging (MRI): of the brain shows structural and neurologic
changes.
Spinal fluid analysis shows increased beta amyloid deposits.
11. ANTIDEPRESSANT AGENTS AND MOOD
STABILIZERS •
Low doses of the selective serotonin reuptake inhibitors and other
newer antidepressive agents should be considered.
13. Data to be included for nursing assessment
• Disorientation
• Mood changes
• Fear Suspiciousness
• Self-care deficit
• Social behaviour
• Level of mobility, wandering behaviour
• Judgement ability
• Sleep disturbances
• Speech or language impairment
• Hallucinations, illusions or delusions
14. NURSING INTERVENTIONS
• Daily routine
• Nutrition & body weight
• Personal hygiene
• Toilet habits and incontinence
• Accidents • Fluid management
• Moods and emotions
• Wandering Disturbed sleep
• Interpersonal relationship
