Dementia is a syndrome involving the deterioration of memory, thinking, behavior, and the ability to perform everyday tasks. It has various etiologies including hypoglycemia, arteriosclerosis, hydrocephalus, hypoxic or anoxic states, toxins, brain tumors, trauma, infections, genetic causes, and vitamin deficiencies. Diagnostic investigations include clinical history, neuroimaging, blood and CSF tests, and neurophysiology studies. Treatment involves managing symptoms, ensuring safety, providing structure, and addressing needs like nutrition, hygiene, toileting, and preventing accidents and wandering. Nursing care focuses on maintaining routines, orientation, proper nutrition, personal hygiene, toileting, fluid intake, and preventing injuries.

1. Dementia
memory, thinking, behaviour & ( ADL )

2. By:
(Nursing
Tutor-AmitDas)
[RN|MSN-Psy]
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3. About Dementia Definition :
Dementia is a syndrome in which there
is deterioration in memory, thinking,
behaviour and the ability to perform
everyday activities – (W.H.O)

4. ETIOLOGY
 Hypoglycemia glucose level
 Arteriosclerosis (thickening and hardening of the
walls of the arteries)
 hydrocephalus
 Hypoxic and anoxic states O2
• Toxins and drugs
• Brain tumours
• trauma
• Infections(meningitis, encephalitis
• [AIDS|Hiv]
• Genetic Causes
• Deficiencies of vitamins B1 and
B12, vitamin B6 and folic acid
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5. Pathological pathways
Etiology , Risk factors, Common forms
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Dementia syndromes result from the disruption of
specific large-scale neuronal networks
Behavior and mood are modulated by noradrenergic,
serotonergic, and dopaminergic pathways
cholinergic signaling is critical for attention and memory
functions.
The dementias differ in the relative neurotransmitter
deficit profiles

6. Dementia Stages |Types
Early stage: Common symptoms include:
A. forgetfulness
B. losing track of the time
C. becoming lost in familiar places.
Middle stage: middle stage, the signs and
symptoms include:
A. becoming forgetful of recent events and people's
names
B. becoming lost at home
C. having increasing difficulty with communication
D. needing help with personal care
E. experiencing behaviour changes, including
wandering and repeated questioning.
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7. Dementia Stages
Late stage: Memory disturbances are serious and the
physical signs and symptoms become more obvious.
Symptoms include:
A. becoming unaware of the time and place
B. having difficulty recognizing relatives and friends
C. having an increasing need for assisted self-care
D. having difficulty walking
E. experiencing behaviour changes that may escalate and
include aggression.

8. Diagnostic Investigations
• Clinical history
• Behavioral features and psychiatric history
• Degree of functional impairment
• Onset and progression of symptoms
• Past medical history
• Social history including educational and occupational attainment, and
family history of neuropsychiatric illness
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9. 1. Neuroimaging(preferably MRI)
2. Blood tests: (toxic/metabolic encephalopathies, infectious
etiologies such as HIV or syphilis, and autoimmune illnesses)
3. CSF analysis
4. Neurophysiology studies :electroencephalography (EEG),
electromyography (EMG), and nerve conduction studies (NCS)
5.Genetic testing
6.Cerebral biopsy
LAB INVESTIGATIONS
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10. Vitamin therapy for thiamine or B12 deficiency.
Antimicrobials for opportunistic infections
Antiretrovirals for HIV
benzodiazepines
second-generation antipsychotics such as quetiapine (starting dose,
12.5–25 mg daily) can be used for patients with agitation, aggression,
and psychosis
Depression; treatment can begin with a low dose of an SSRI (e.g.,
escitalopram 5–10 mg daily)
MANAGEMENT
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11. • safety: as patients often lack insight and demonstrate impaired judgment
Environmental modification, including distraction with exercise or activities
and restricting access to food and harmful instruments, plays an important
role.
Patients who wish to drive should be evaluated by an occupational therapist.
Occupational and speech therapists may assist with other daily activities and
alternative modes of communication.
Support groups may help patients and caregivers share stories with others in
similar situations.
Non-Pharmacological Treatment
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12.  Legal counsel may be helpful; it is advisable for patients to create living
wills and select a power of attorney early in the course.
Home nursing or residential nursing care are often important resources for
patients and families in later stages.
Non-Pharmacological Treatment
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13. Daily routine: maintaining a daily routine includes drawing up a fixed
time table
Orient to reality in order to avoid confusion
Use clock with large faces, calender with large writing
Nursing care:
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14. 1. Nutrition: Well balanced diet with plenty of time to eat
Semi solid foods can be given as liquids may be aspirated
3. Personal hygiene
4. Toilet habits and incontinence
5. Prevention of accident
6. Fluid management
7. Wandering
Nursing care:
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15. 1. Nutrition:
Well balanced diet with plenty of time to eat
Semi solid foods can be given as liquids may be aspirated
3. Personal hygiene
4. Toilet habits and incontinence
5. Prevention of accident
6. Fluid management
7. Wandering
Nursing care:
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16. Thankyou