Dementia is a type of Organic brain disorder . Mainly Alzheimer's type is described in the given ppt . Warning signs and nursing management and also treatment modalities have discussed in the ppt .

2. PRESENTATIONON DEMENTIA :
Presented by –
Soumita Maiti
3 rd Yr B.Sc Nursing
Student
W.B.G.C.O.N , SSKM
Campus

3. Introduction:
Cognition is that operation of the mind
process by which we become aware of
objects of thought and perception,
including all aspects of perceiving, thinking
& remembering. Organic brain syndrome
is general term referring to many physical
disorders that cause impaired mental
function.
.J
...
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4. Classification of organic Mental Disorders
(F00-f09} organic, including symptomatic,
mental disorders
• (F00) 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 other psychoactive substances
.
,

5. CONT.......
• (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.

6. Definition :
Dementia is an acquired
global impairment of
intellect , memory and
personality but without
impairment of
consciousness .
or

7. Dementia is a progressive
brain dysfunction , which
results in a restriction of
daily activities .
Or
Dementia is the loss of mental
abilities and most commonly
occurs late in life .

8. Incidence:
• Dementia occurs more
commonly in the elderly than
in the middle-aged.
• It increases with age from 0.1
% in those below 60 years of
age to 15% to 20 % in those
who are 80 years of age .
• Dementia affects more than
three million Indians .
,

9. Etiology:
• Significant loss of neurons
and volume in brain regions
devoted to memory and
higher mental functioning
• Neurofibrillary tangles
(twisted nerve cell fibers
that are the damaged
remains of microtubules ) ,

10. ,
• Environmental factors: infection, metals and
toxins.
• Excessive amount of metal ions, such as zinc
and copper, in brain
• Deficiencies of vitamin B6, B12 And Folate
• Early depression: common genetic factors
seen in those with early depression and
Alzheimer's disease
• Education level

11. Untreatable and irreversible cause of
dementia :
• Degenerating disorders of CNS
• Alzheimer's disease (this is the most common
of all dementing illnesses)
• Pick's disease
• Huntington's chorea
• Parkinson's disease
,

12. Treatable and reversible causes of
dementia
• Vascular-multi-infarct dementia
• lntracranial space occupying lesions
• Metabolic disorders-hepatic failure, renal
failure
• Endocrine disorders- myxedema, Addison's
disease
• Infections- AIDS, meningitis, encephalitis
,

13. Cont....
• Intoxication- Alcohol,
heavy metals (lead,
arsenic)
• Anoxia- Anemia, post-
anesthesia, chronic
respiratory failure
•Vitamin deficiency,
especially deficiency of
thiamine and nicotine

14. • Physiologic:
Normal pressure hydrocephalus
• Metabolic:
Endocrinopathies (e.g. hypothyroidism)
• Tumor:
Primary or metastatic (e.g. meningioma or
metastatic breast or lung cancer)
• Traumatic:
Subdural hematoma
....
.
,

15. ,
TYPES OF DEMENTIA:
the classifications include.
Cortical dementia: dementia
where the brain damage primarily
affects the brain's cortex, or outer
layer. Cortical dementias tend to
cause problems with memory,
language, thinking, and social
behaviour.

16.  Subcortical dementia : dementia that
affects parts of the brain below the cortex.
Sub cortical dementia tends to cause
changes in emotions and movement in
addition to problems with memory.
 Progressive dementia: dementia that gets
worse over time, gradually interfering with
more and more cognitive abilities.

17. Primary dementia: dementia such as Alzheimer's
disease that does not result from any other disease.
Secondary dementia: dementia that occurs as a
result of a physical disease or injury.

18. • Stage I: Early stage (2 to 4 years):
 Forgetfulness
 Declining interest in environment
 Hesitancy in initiating actions
 Poor performance at work

19. • Stage II: Middle stage (2 to 12 years):
 Progressive memory loss
 Hesitates in response to questions
 Has difficulty in following simple instructions
 Irritable, anxious
 Wandering
 Neglects personal hygiene
 Social isolation

20. • Stage Ill: Final stage (up to a year):
Marked loss of weight because of inadequate
intake of food
Unable to communicate
Does not recognize family
Incontinence of urine and feces
Loses the ability to stand and walk
Death is caused by aspiration pneumonia

21. WARNING SIGNS OF DEMENTIA
 Recent memory loss :
Recent memory is prominently affected .

22.  Difficulty performing familiar
tasks :
They may forget how to
perform the familiar jobs .

23.  Problems with language :
They may forget simple words or
use the wrong words . This
makes it hard to understand
what they want .

24.  Loss of initiative :
They may become
passive . They might
not want to go places
or see other people .
 Poor Judgement :
They forget simple
things , like forgetting
to put on a coat before
going out in rain .

25.  Problems with abstract
thinking :
They might have trouble
balancing a cheque book ,
as they may forget what
the numbers are and what
has to be done with them .
 Misplacing things :
They might put things in the
wrong places .Like they may
keep an iron in the freezer or
a wristwatch in the sugar jar .

26.  Changes in mood :
They experience fast mood
swings ,going from calm
to tears to anger in a few
minutes .
 Disorientation to time
and places :
They cannot tell the dates
and the times .

27.  Personality changes :
People who have dementia may have drastic changes in
personality . They might become irritable ,suspicious
or fearful .

28. Diagnosis:
Following test are used for diagnosis:
• 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

29. Treatment Modalities :
• Tacrine hydrochloride (cognex)
Dose : 40 mg /day for 4 weeks
• Donepezil hydrochloride
(Aricept)
Dose :

30. •Antipsychotic medications (Haldol and risperdal )
• Benzodiazepum
• Antidepressants
• Anticonvulsants
...
.

31. Nursing Management:

32. • Disorientation
• Mood changes
• Fear
• Suspiciousness
• Self-care deficit
• Social behaviour
• Level of mobility, wandering behaviour
• Judgement ability

33. • Sleep disturbances
• Speech or language impairment
,•Hallucinations, illusions or delusions
• Bowel and bladder incontinence
• Apathy
• Any decline in nutritional status
• Recognition of family members
• Identify primary care giver, support system and
the knowledge base of the family
members.

34. Nursing intervention:

35. • Daily routine :

36. Nutrition & body weight :

37. Personal hygiene :

38. Toilet habits and incontinence :

39. Accidents :

40. Fluid management :

41. Moods and emotions :

42. Wandering :

43. Disturbed sleep :

44. Interpersonal relationship :

45. Dementia and the loved ones :
Dementia requires a great deal
of patience from the family
members who should give
sufficient love and care to the
person suffering .

46. Role of care giver :
• As a care giver ,you need to
take proper of yourself so
that you can take proper care
of your loved ones .
• Take breaks from care giving
• Get help at home
• Eat , sleep and exercise
regularly

47. Summary:
• Introduction
• Classification
• Definition
• Etiology
• Types
• Stages
• Warning signs
• Clinical features
• Diagnosis
• Treatment modalities
• Nursing management
• Role of a care giver

48. Conclusion:
• Dementia is a serious cognitive
disorder all together dementia is
a far common in the geriatric
population, it may be occur in any
stage of childhood
• So as a nurse we need to get aware
about the preventive measures of
dementia and educative the
individuals about its signs and
symptoms with its treatment