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Dementia Slides


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Dementia description

  • Dementia Cause and Care
    Dementia may be a general term accustomed outline decline in memory of an individual and will be troublesome to address even daily routine task.
    Memory loss
    Inability in communication
    Inability to concentrate
    Visual issues
    Reasoning and Judgement
    Regular excersise could cut back some variety of insanity
    Balance diet is important for reducing some variety of insanity
    Donot smoke please keep your pressure ,cholesterol balanced
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Dementia Slides

  1. 1. Dementia Randi Jones, Ph.D. 4/11/2008 Positive Impact
  2. 2. Delirium v. Dementia  Delirium- transient global cognitive impairment. Consciousness fluctuates. Reversible. Acute onset  Dementia- global impairment of cognitive function, usually progressive, interferes with normal social and occupation function  -Ayd, Frank. Lexicon of Psychiatry, Neurology and the Neurosciences, 2000. Randi Jones, Ph.D. copyright 4/11/2008
  3. 3. Mild Cognitive Impairment  Age related  May go on to become dementia  Amnestic or nonamnestic  No FDA approved tx, but Aricept is often prescribed Randi Jones, Ph.D. copyright 4/11/2008
  4. 4. Broad Classification by Brain Area Affected  Cortical  Subcortical  A way to categorize and understand.Could be viewed as continuum.  Some disorders affect a variety of areas in the brain, so don’t categorize neatly Randi Jones, Ph.D. copyright 4/11/2008
  5. 5. Cortical Characteristics  Short-term memory problems. Encoding and storage  Information is lost  Verbal ability declines-anomia  Aphasia, apraxia, agnosia Randi Jones, Ph.D. copyright 4/11/2008
  6. 6. Subcortical Characteristics  Verbal comprehension is retained  Memory problems due to retrieval  Slowed mentation, but much remains intact, including general IQ  Typically frontal sx: attention, organization, judgment, disinhibited behavior, apathy  Depression is very common Randi Jones, Ph.D. copyright 4/11/2008
  7. 7. Classification by Possibility of Recovery  “Pseudodementia”-cognitive impairment caused by a psychiatric disorder. Most often depression, but also NPH, meningiomas, etc.  Toxic conditions  Alcohol or drug induced Randi Jones, Ph.D. copyright 4/11/2008
  8. 8. Alzheimer’s spectrum  Early v. late onset. Early has greater possibility of genetic etiology.  Hippocampus, amygdala  Treatments: Aricept,Reminyl, Exelon [Cognex rarely used now]. acetylcholinesterase inhibition. NMDA action: Namenda  Environmental stimulation and enrichment  Education of family caregivers Randi Jones, Ph.D. copyright 4/11/2008
  9. 9. HIV (Aids Related Dementia Complex)  Subcortical, frontal areas affected.  Motor sx possible.  Depression is common. Watch for suicidal behavior.  Rate initially declined as result of antiretroviral tx, but is on the rise again.  ADC increases chances for more rapid progression, early death  May distinguish “haves” from “have nots.”  HIV Dementia Scale (4 subtests) and Memorial Sloan Kettering Rating Scale (research)  HAART can improve dementia sx. Randi Jones, Ph.D. copyright 4/11/2008
  10. 10. Vascular  2nd most common cause of dementia  Mostly subcortical, but varies with brain area affected.  Treatment designed to minimize causes such as hypertension or treat depression  Possibility of physical limitations as well such as hemiparesis and neglect. Randi Jones, Ph.D. copyright 4/11/2008
  11. 11. Alcohol or other Substance Induced  Korsakoff’s syndrome. Hippocampus. Thiamine deficiency.  Alcohol dementia. Separate disorder? Frontal, cerebellum  Some recovery is possible with abstinence. Randi Jones, Ph.D. copyright 4/11/2008
  12. 12. Parkinson’s & other typically subcortical dementias  Parkinson’s disease: some genetic component for specific phenotypes, but largely causes remain idiopathic. Includes parkinson pugilistica.  Huntington’s disease: genetic. Midlife onset. Fully penetrant, autosomal dominant. Course 15-20 years. No treatment.  Spinal cerebellar ataxias: many are genetic, some are dominant, some recessive.  Multiple sclerosis. Dementia more common in primary progressive, but cognitive impairment is expected in ~50% of patients. Randi Jones, Ph.D. copyright 4/11/2008
  13. 13. Nonmedical Treatment Issues  Optimizing function  Assessing disability, if still employed  Driving  Competency  End of life decisions  Location of care  Family dysfunction/reorganization  Family education and caregiving Randi Jones, Ph.D. copyright 4/11/2008