Health and medicine

1. DEMENTIA

2. DEMENTIA
INTRODUCTION :DEMENTIA IS NOT A SINGLE
ILLNESS BUT A CAUSED BY DAMAGE TO THE BREAIN.
THE SYMPTOMS CAUSED GROUP OF SYMPTOMS BY
DAMAGE TO THE BREAIN. THE SYMPTOMS INCLUDE
LOSS OF MEMORY. • MOOD CHANGES AND
CONFUSION. DEMENTIA IS CAUSED BY A NUMBER OF
DISEASES OF THE BRAIN.

3. DEFINITION
Dementia is a Characterized by progresive
neurodegenerative disorder impairment of
cognitive functioning without loss of
consciousness.

4. ICD 10 CLASSIFICATION
• FOO – FO9: Organic, including symptomatic, mental disorders
• .FOO: Dementia in Alzheimer's disease.
• FO1: Vascular dementia.
• F04. Organic amnestic syndrome.
• FO5: Delirium
• F06: Other mental disorderus due to brain damage and
dysfunction and physical disease.
• FO7: Personality and behavioral disorders due to brain disease,
damage and dysfunction.

5. ETIOLOGY
1. · Significant loss of neurons and volume in brain regious devoted to
memory wightre mental functioning.
2. •Neurofibrillary tangles (twisted nerve cell fibers that are the damaged
remains of fiberus microtubules - support structures that permit nutrients
to flow though. neurons)
3. • Build up of amyloid +· Accumulation of beta amyloid. an insoluble
protein, which forem sticky patches (neurities plaques) surrounded by
debris of dying neverions.
4. . Environmental factores: -Infection, metals and toxins.
5. • Excessive amounts of mentalions, such as zine and copper, in brain
6. Other possible factors. being are:
7. - researched -Deficiencies of vitamimus B6, B12. andfolate: Possible risk
factore due to increased levels of homocysteine (amino and that may

6. 1. •Personality changes 1:- Lack of interest in day-to
day activities, easy mental fatigability, self
centerced, with dreawn, decreased self-care
2. •Memory impairment:- Recent memory is
prominently affected.
3. • Cognitive impairement :-disorientation, poor
judgement, difficulty in abstraction, decreased
attention span.“
4. •Affective impairement: Labile mood, inritableness,
depression.
Clinical feature:

7. CLINICAL FEATURE:
• Neurological impairment.. Aphasia, apraxia, agnosia, seizures,
headache.
• •Catastrophic reaction:- Agitation attempt to compensate fore
defectsby using strategies to avoid demonstreating failures in
intellectual performance. such as changing the subject.cracking
jokes or otherwise diverting the interviewer.
• Sundowner Syndrome: -It is characterized m by drowsiness,
confusion ataxia, accidental falls may occure at night when
external stimuli; such as light and interpersonal orienting cues
are diminished

8. DIAGNOSTIC STUDY
1. History taking:
•Identification data
• Presenting complaints•
• Personal HistoryMarital
History •
• Family History
• Social History
• Any positive family
history.alcohol hi history.
·Phychological factor.
2) Mental Status Examination:
•General appearence and behaviour.
• Motore activity
• Talk and speech.
• Thought, content, mood,perception.
• Orientation, memory,
intelligency,judgement, insight.
• Attention, concentration.
• functional dementia scale (to indicate
degree of dementia).•
• Magnetic resonance image (MRI) of the
breain shows structural and neurologie
changes.
• Spinal fluid analysig shows increased
beta amyloid deposits.•
• MRI

9. DIAGNOSTIC STUDY
1. Serious head injury:
2. fossible link between injury in early adulthood and later development of Alzheimer’s disease.
3. Education level: Increased risk in those with less education than in those who reemain mentally
active (possibly because leavening may stimulate increased neuron growth, resulting ingreater
brain reserve).
4. Small focal deficits-typically caused by a series of small strokes.
5. Contributing factores
6. •Advanced age. – cercebal emboli ore thrcombosis
7. Diabetes
8. Heart disease.
9. High blood cholesterol level.
10.Hy purclension (leading to stroke)
11. Transient ischemic attacks.

10. •MANAGEMENT:
1. PHARMACOLOGICAL THERAPY
1. Tacrim hydro choloride (cognex).
2. Antipsychotic medications such as risperidone (risperidal) and. haloperidol (
Haldol) may be used to alleviate hallucination and dellusions.
3. Resent Bonzodiazepines for insomnia and anxiety.
4. Anti depressants fore depression.
5. Anticonvulsants to control seizurus.

11. NONPHARMACOLOGICAL THERAPY.
1. •Cognitive behavioural therapy: may be useful to assist with
adjustment to the initial diagnosis, forward planning and in
treeating depression in early stage dementia.
2. Psychotherapy: may assist carceros to assisting the соре with -
person assisting with the person with dementia and to main tain
their own health and well being•
3. Behavioural Management therapy: may be useful in targeting
challenging behaviourcal patterns in dementia. pereson with•
4. Memory training and using memory external aids can assist a
person in the early. stages of dementia tomaximise their cognitive
functioning and independence
5. Alternative therapies:light massage and aromatherapy music and

12. DIAGNOSIS
• A)Self cared defict related to impairment of memory.
• B) Distrurbed thought process related to deficits .
• C)Impaired sleeping pattern relaqted to prolonged
hospitalization.
• D) Imbalalance nutration less than body requirement
related to unable to take food.

13. A) Assess needs of the
patient and intervence
accordingly.-B)Give
portient enough time
fore completion of tout.-
.C)Maintain adequate
nutrition. of the patient
to promot health and
strength-
D)Assist the patient in
daily. activities of living
PLANNING PLANNING
A) Patient is dioriented
and his memory is
decreased thereforce.
freequenty and needed
orienta utation to time,
plate and person ntis
mandatory.
B) Give instruction in
asimple easy to
understand ragional
language.
C) Talk slowly’
D) Wait fore poctient to
respond.

14. •A) Assess the sleeping
pattern of the patient.
B) Give a comfortable
environment.
C) Give a psychological
suppert to the patient.
D) Advice the patient
empty the bladdere
before sleep.
PLANNING PLANNING
A) Assess the nestration
level of the patient.
B) Provide little amount of
food frequently.
C) Advice the patient to
take a heavy meal.
D) Check weight
frequently.

15. REHABILITATION:
• Mental rehabilitation → at is important because after the patient improved and
reco nnected to them normal mood state, mental rehabilitation that with
cognitive changes is also important preocess.
• Through rehabilitation the dementia start the convey cognitive distortion to
• Improve the patient's quantity of life.Repeatedly educate the patient so that the
patient to take medicine actincey. to prevent the racervance of the disease, there
is no problem in social. Occupational familial and school life.
• Though rehabilitation the patient manage come one's own disease indepedently
and release self confidence in social adjustment .
• Appropriate leizeure time activities.
• • Money management.
• • Transportation.
• Teaching basic home keeping course.
• Group therapy, hospital rehabilitation, cognitive behavioural therapy.
• Psychotherapy.

16. PROGNOSIS
•Insidious on set but slow progressive
deorientation occurus in Demeti Dementia. The
cause of demetia in 15% of the case is
reversible and in those cases prognosis of
dementia is good. The causes which are not
reversible rather prognosis of dementia
patients.