Dementia ppt. DR HUDA BUKHARI
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topic on dementia covering all aspects regarding classification,pathophysiology and treatment .Difference between MCI and DEMENTIA .best for post graduates ,house officers and medical students
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Approach to dementia
The document provides an overview of the approach to dementia. It discusses the diagnostic criteria for dementia, epidemiology, etiology including neurodegenerative, vascular, neurological and other causes. It describes cortical vs subcortical dementia and reversible vs irreversible dementias. The document also provides details on how to diagnose a case of dementia including history, examination, investigations and differential diagnosis. Specific subtypes like Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementia, Parkinson's disease, normal pressure hydrocephalus and CJD are also discussed.
Dementia
The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
Dementia
This document provides information about dementia, including:
1. Dementia is characterized by progressive deterioration of intellect, behavior, and personality due to diffuse brain disease, especially affecting the cortex and hippocampus. Memory impairment is required for diagnosis.
2. Symptoms include memory loss, abnormal behavior, intellectual decline, mood changes, and difficulty with daily tasks. Insight is initially retained but lost over time.
3. Causes of dementia include Alzheimer's disease (60% of cases), cerebrovascular disease, neurodegenerative diseases, infections, head injuries, and tumors. Dementia must be distinguished from delirium and depression.
Dementia
Dementia is a syndrome involving the deterioration of memory, thinking, behavior and the ability to perform everyday activities. It is caused by damage to brain cells that interferes with communication between cells. Alzheimer's disease is the most common form of dementia, potentially contributing to 60-70% of cases. Dementia is diagnosed based on medical history, exams, tests and characteristic changes in thinking and functioning. While there is no cure, medications and therapies can help reduce symptoms or slow progression for some time.
Approach to Dementia
1. Dementia is a growing problem worldwide, affecting over 47 million people in 2015 and projected to increase significantly by 2050 as populations age.
2. Dementia involves the deterioration of cognitive abilities such as memory, judgment, and problem solving that impair daily living. It can be caused by neurodegenerative, vascular, or other medical conditions.
3. Assessing dementia involves evaluating memory impairment, ruling out other causes like depression, and using screening tools such as the MMSE alongside medical exams and tests to determine severity and guide further evaluation.
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This document provides an overview of dementia, including its definition, diagnosis, causes, and approach to evaluation and management. It defines dementia as acquired cognitive impairment that interferes with daily life. The diagnostic criteria from the DSM-V are outlined. Common causes of dementia like Alzheimer's disease, vascular dementia, and Lewy body dementia are reviewed. The document discusses taking a history, performing a physical and neurological exam, cognitive testing, and medical investigations to diagnose the underlying cause of dementia.
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The document provides an overview of the approach to dementia. It discusses the diagnostic criteria for dementia, epidemiology, etiology including neurodegenerative, vascular, neurological and other causes. It describes cortical vs subcortical dementia and reversible vs irreversible dementias. The document also provides details on how to diagnose a case of dementia including history, examination, investigations and differential diagnosis. Specific subtypes like Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementia, Parkinson's disease, normal pressure hydrocephalus and CJD are also discussed.
Dementia
The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
Dementia
This document provides information about dementia, including:
1. Dementia is characterized by progressive deterioration of intellect, behavior, and personality due to diffuse brain disease, especially affecting the cortex and hippocampus. Memory impairment is required for diagnosis.
2. Symptoms include memory loss, abnormal behavior, intellectual decline, mood changes, and difficulty with daily tasks. Insight is initially retained but lost over time.
3. Causes of dementia include Alzheimer's disease (60% of cases), cerebrovascular disease, neurodegenerative diseases, infections, head injuries, and tumors. Dementia must be distinguished from delirium and depression.
Dementia
Dementia is a syndrome involving the deterioration of memory, thinking, behavior and the ability to perform everyday activities. It is caused by damage to brain cells that interferes with communication between cells. Alzheimer's disease is the most common form of dementia, potentially contributing to 60-70% of cases. Dementia is diagnosed based on medical history, exams, tests and characteristic changes in thinking and functioning. While there is no cure, medications and therapies can help reduce symptoms or slow progression for some time.
Approach to Dementia
1. Dementia is a growing problem worldwide, affecting over 47 million people in 2015 and projected to increase significantly by 2050 as populations age.
2. Dementia involves the deterioration of cognitive abilities such as memory, judgment, and problem solving that impair daily living. It can be caused by neurodegenerative, vascular, or other medical conditions.
3. Assessing dementia involves evaluating memory impairment, ruling out other causes like depression, and using screening tools such as the MMSE alongside medical exams and tests to determine severity and guide further evaluation.
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This document discusses frontotemporal dementia (FTD), including its subtypes, genetics, neuropathology, and clinical presentation. FTD is characterized by degeneration of the frontal and temporal lobes. The main subtypes are behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Genetic factors like mutations in the MAPT and PGRN genes contribute to FTD. Neuropathologically, FTD involves tauopathies or TDP-43 proteinopathies. Imaging shows atrophy typically in the frontal and temporal regions depending on the subtype.
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Dementia is characterized by progressive deterioration of intellect, behavior, and personality due to diffuse brain disease, especially affecting the cerebral cortex and hippocampus. Memory impairment is required for diagnosis. Common causes include Alzheimer's disease, cerebrovascular disease, Lewy body disease, and frontotemporal dementia. Evaluation involves assessing cognitive function, neurological exam, imaging, and lab tests to identify underlying causes and rule out other conditions. There is no cure for dementia, but some types can be temporarily slowed with medications or treated if potentially reversible causes are identified.
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Dementia is a progressive deterioration of intellect, behavior and personality caused by diseases of the brain. The most common causes are Alzheimer's disease (~60% of cases) and cerebrovascular disease (~20% of cases). Dementia is not a single disease but an overall term for loss of brain function. Treatment depends on the underlying cause but currently available medications can only temporarily improve symptoms and do not cure or slow progression. Lifestyle factors may help reduce risk of conditions that can lead to dementia like stroke.
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2) Five clinical cases are presented and summaries are provided to illustrate the diagnosis and features of different types of dementia.
3) The document is a comprehensive reference for diagnosing various forms of dementia based on clinical history, examination findings, investigations, and imaging characteristics.
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1. Structural imaging such as CT and MRI are useful in evaluating dementia by identifying structural abnormalities and patterns of atrophy that help differentiate between neurodegenerative and vascular causes.
2. Specific scales have been developed to assess atrophy on MRI in regions implicated in different dementias, such as the medial temporal lobe atrophy scale for Alzheimer's disease.
3. Functional imaging with PET, SPECT and fMRI can provide additional metabolic and neural activity information, especially in distinguishing Alzheimer's from other dementias, but are not widely used due to limited availability.
Neurocognitive seminar
This document provides an overview of neurocognitive disorders including delirium and dementia. It begins with an introduction noting the aging population and prevalence of these conditions. It then discusses delirium as an acute decline in consciousness and cognition often caused by medical conditions or substances. Dementia is defined as progressive cognitive decline without altered consciousness. Common causes of dementia like Alzheimer's and vascular dementia are explained. The document provides details on assessing, diagnosing, treating and managing delirium and dementia. It concludes with take home messages about the importance of recognizing these conditions in elderly patients.
Dementia And Memory Disturbances
Dementia is characterized by progressive loss of intellectual function, especially memory loss. Cortical dementia affects areas like the temporal cortex and causes major changes in memory and language, while subcortical dementia affects areas like the thalamus and causes behavioral changes and motor slowing. Common causes of dementia include Alzheimer's disease, Lewy body disease, vascular dementia, and frontotemporal dementias. Tests can help determine if dementia has an underlying neurodegenerative, structural, infectious, or metabolic cause. Treatment depends on the specific cause but may include cholinesterase inhibitors or management of behavioral symptoms.
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Dementia ppt. DR HUDA BUKHARI
- 1. DEMENTIA
- 2. LEARNING OBJECTIVES INTRODUCTION RISK FACTORS TYPES CLASSIFICATION INVESTIGATIONS MANAGEMENT
- 3. DEMENTIA • Progressive deterioration of cognitive function(language, visuospatial ability, calculation, judgment, and problem solving) due to diffuse disease of cerebral hemisphere,maximally affecting CEREBRAL CORTEX AND HIPPOCAMPUS • More common in elderly age (above 65 years) • If occurs before age of 60,then it is called pre-senile dementia.
- 4. PSEUDODEMENTIA Pseudodementia is a type of cognitive impairment that mimics dementia but actually occurs due to DEPRESSION This condition is typically seen in older individuals
- 5. RISK FACTORS
- 6. TYPES Alzheimer's Disease Dementia with Lewy Bodies. ... Vascular Dementia. ... Frontotemporal Dementia. ... Mixed Dementia.
- 7. CLASSIFICATION -BASED ON CAUSE 1-ALZHEIMER’S DISEASE (60% of all cases) 2-CEREBRO VASCULAR DISEASES (20% of all cases) - multi infarct (atherosclerotic) dementia - subcortical vascular disease 3-NEURO DEGENERATIVE - pick’s disease ; huntington’s chorea ; parkinson disease
- 8. CONT. 4-INFECTIONS HIV(aids dementia comlex), viral encephalitis,progressive multifocal leucoencephalopathy 5-NORMAL PRESSURE HYDROCEPHALUS 6-NUTRITIONAL -wernicke korsakoff (thiamine deficiency); b12 deficiency; folate deficiency
- 9. CONT. 7-METABOLIC - hepatic disease; thyroid disease, parathyroid disease; cushing’s syndrome 8-CHRONIC INFLAMMATORY - - collagen vascular disease & vasculitis, multiple sclerosis
- 10. CONT. 9-TRAUMA - head injury, punch-drunk syndrome 10-TUMOR - subfrontal meningoma
- 13. HOW TO APPROACH DEMENTIA HISTORY EXAMINATION DIAGNOSTIC STUDIES
- 14. HISTORY FROM PATIENT OR RELATIVE RATE OF INTELLECTUAL DECLINE IMPAIRED SOCIAL FUNCTION GENERAL HEALTH AND RELEVANT DISORDERS NUTRITIONAL STATUS DRUG HISTORY FAMILY HISTORY
- 15. PHYSICAL EXAMINATION LOOK FOR FOCAL SIGNS INVOLUNTARY MOVEMENTS PSUDOBULBAR SIGNS PRIMITIVE REFLEXES
- 17. ALZHEIMER’S DISEASE Most common type of dementia Disorientation, poor judgment, poor concentration, aphasia, and apraxia are increasingly evident as the disease progresses In end-stage AD, pts become rigid, mute, incontinent, and bedridden Death results from malnutrition, secondary infections, pulmonary emboli, heart disease, or, most commonly, aspiration
- 18. PATHOPHISIOLOGY: Deposits of the protein fragment beta-amyloid (plaques) and twisted strands of the protein tau (tangles) as well as nerve cell damage and death in the brain.
- 19. EARLY SYMPTOMS DIFFICULTY REMEMBERING NAMES AND RECENT EVENTS APATHY DEPRESSION
- 20. LATE SYMPTOMS Impaired judgment Disorientation Confusion Behaviour changes Difficulty speaking,swallowing and walking
- 21. DIAGNOSTIC APPROACH MMSE LAB STUDIES CBC,ESR,TFTs, Vit-B12 LFTs,HIV TEST,ANA IMAGING CT,MRI,PET SCAN,SPECT CONFIRMATION AUTOPSY,BIOPSY
- 22. CT FINDINGS TEMPORAL LOBE ATROPHY TEMPOROPARIETAL ATROPHY
- 25. GENERAL MANAGEMENT TREAT THE CAUSE - Thyroid replacement - Vit-B12 replacement - Antibiotics PREVENT FURTHER STROKES - In vascular dementia Manage depression, insomnia, hallucinations, and agitation
- 26. CONT. VITAMIN D Good glycemic control Control HTN Exercise Maintain diet Reduce carbs Take enough protein,vitamins- C,D,E,B12,omega 3s fatty acid, zinc
- 27. SPECIFIC MANAGEMENT CHOLINESTRASE INHIBITORS DONEPEZIL GALANTAMINE RIVASTIGMINE MEMANTINE
- 28. CONT. MOOD STABILIZERS .RISPERIDONE .OLANZEPINE ANTI-DEPRESSANTS .SSRI
- 29. VASCULAR DEMENTIA CAUSE- STROKE CT-MICROSCOPIC BLEED ND VESSEL BLOCKAGE TREAT UNDERLYING CAUSE OF ATHEROSCLEROSIS MEMANTINE (NMDA RECEPTOR ANTAGONIST)
- 30. DEMENTIA WITH LEWY BODIES INTRANEURONAL CYTOPLASMIC INCLUSION LIKE PROTIEN SYNUCLEIN AGGREGATION TREATED BY ANTICHOLINESTRASE INHIBITORS,ANTI DEPRESSANTS ND ANTI PSYCHOTICS
- 31. FRONTOTEMPORAL DEMENTIA BEHAVIORAL SYMPTOMS PREDOMINATE CT FINDINGS-FRONTAL AND TEMPORAL DEGENRATION SYMPTOMATIC TREATMENT ND SSRI
- 32. THANK YOU