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OVERVIEW OF DEMENTIA

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View recording of webinar at http://www.alzpossible.org/wordpress-3.1.4/wordpress/nonaddementias-the-basics/

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OVERVIEW OF DEMENTIA

  1. 1. Recommended pre-requisite presentation for “The Other Dementias: Virtual Training and Active Learning on Non-Alzheimer’s Dementias” three-part series, which is made possible through a grant funded from
  2. 2. TYPICAL CHANGES • Making a bad decision once in a while • Missing an occasional monthly payment • Forgetting which day it is and remembering later • Sometimes forgetting which word to use • Losing things from time to time A-TYPICAL CHANGES • Consistent poor judgment and decision making • Loss of an ability to manage money • Inability to keep track of the date or the season • Difficulty having a conversation • Misplacing things and loss of the ability to retrace steps to find them
  3. 3. There are many causes of dementia symptoms. Is NOT a specific disease. Alzheimer's disease is the most common cause of a progressive dementia. Is a GROUP OF SYMPTOMS affecting intellectual and social abilities severely enough to interfere with daily functioning. Memory loss generally occurs in dementia, but memory loss alone does not imply you have dementia.
  4. 4. memory language Dementia causes changes in: thought navigation behavior personality/ mood
  5. 5. • Depression/delirium • Medication sideeffects • Excess alcohol use • Thyroid problems • Poor diet • Vitamin deficiencies • Certain infections Reversible DEMENTIAS • • • • Alzheimer’s disease Parkinson’s Lewy-body dementia Etc. Irreversible
  6. 6. 2013 Alzheimer’s Disease Facts and Figures, Alzheimer’s Association
  7. 7. Alzheimer’s disease is more prevalent among African-Americans than among whites Estimates range from 14% to almost 100% higher; There is a greater familial risk of Alzheimer’s in African-Americans The cumulative risk of dementia among firstdegree relatives of AfricanAmericans who have Alzheimer’s disease is 43.7% Genetic and environmental factors may work differently to cause Alzheimer’s disease in African-Americans Data from a large-scale longitudinal study indicate that persons with a history of either high blood pressure or high cholesterol levels are twice as likely to get Alzheimer’s disease. Those with both risk factors are four times as likely to become demented. 65% of African-American Medicare beneficiaries have hypertension, compared to 51% of white beneficiaries. They are also at higher risk of stroke. (Data from the Current Medicare Beneficiary Survey) African-Americans have a 60% higher risk of type 2 diabetes — a condition that contributes directly to vascular disease. African-Americans have a higher rate of vascular dementia than white Americans. http://www.alz.org/national/documents/report_africanamericanssilentepidem
  8. 8. Brain disorder, most common form of dementia Affects 5% of people at age 65 Affects 50% of people age 85+ ASSOCIATED RISK FACTORS: • • • • • • • • • • TREATMENT: • • Late-onset (65+) is most common, s lowestprogressin g Average course of DAT: 6-20 years Age Family history Down syndrome Incidence higher in women Alcohol use Atherosclerosis Blood pressure Cholesterol Depression Diabetes (type 2) • • No treatment available to slow or stop the deterioration of brain cells in Alzheimer's disease. US FDA has approved five drugs that temporarily slow worsening of symptoms for about 6 - 12 months. Effective for only about ½ of the individuals who take them. Inconclusive research: Vitamin E Anti-inflammatory drugs Estrogen Vaccine Diet INCIDENCE: AD more prevalent among African-Americans and Hispanics
  9. 9. Plaques Acethylcholine Deficiency Tangles
  10. 10. Memory loss that disrupts daily functioning Challenges in planning or solving problems Changes in mood and personality Withdrawal from work or social activities Difficulty completing familiar tasks at home, at work or at leisure Decreased or poor judgment Confusion with time or place Trouble understanding visual images and spatial relationships Misplacing things and losing the ability to retrace steps New problems with words in speaking or writing
  11. 11. VaD can be cortical and subcortical 2nd most common dementia after Alzheimer's disease Result of a damage to the brain caused by problems with the arteries serving the brain or heart. Approx. 2530% of all dementias are VaD Prevalence of VaD ranges from 1 to 4 percent in people over the age of 65. CAUSES: • Untreated high blood pressure • Diabetes • High cholesterol • Heart disease ASSOCIATED SYMPTOMS: • Confusion and agitation; depression • Unsteady gait • Problems with memory • Urinary frequency, urgency, incontinence • Night wandering • Decline in ability to organize thoughts/actions, difficulty planning • Poor attention/concentration TREATMENT: Damage caused by infarcts cannot be reversed. Future cerebrovascular incidents can be controlled (control of cardiovascular risk factors)
  12. 12. Pick's disease affects parts of the brain that contain fibrous tangles made up of an abnormal protein called tau protein Group of diseases characterized by the degeneration of nerve cells in the F-T areas of the brain Begins earlier and progresses faster than AD Occurs at ages younger than AD, i.e., 40-70. One form of this condition is Pick's disease. (Fronto-temporal areas of the brain are generally associated with personality, behavior and language). In these dementias, portions of these lobes atrophy. CAUSES: • Unknown • Possible genetic mutations. ASSOCIATED SYMPTOMS: • socially inappropriate behaviors • loss of mental flexibility • decline in personal hygiene • language problems, and • movement disorders • difficulty with concentration and thinking.
  13. 13. CJD is a degenerative brain disorder that leads to dementia and, ultimately, death. (rapid progression) Variant CJD is linked primarily to eating beef infected with bovine spongiform encephalopathy (mad cow disease. The "classic" CreutzfeldtJakob disease has not been linked to contaminated beef. 1 in 1 million people are diagnosed with CJD per year (usually older adults). CAUSES: abnormal versions of a protein called a prion. TRANSMISSION Risk of CJD is low. Cannot be transmitted through coughing, sneezing, touching or sexual contact. CJD DEVELOPS: • Spontaneously (majority of cases) • Genetic mutation (family history) • Contamination. (very low number of exposures to infected human tissue during a medical procedure) ASSOCIATED SYMPTOMS: personality changes, anxiety, depression, memory loss, impaired thinking, blurred vision, insomnia difficulty swallowing, motor issues.
  14. 14. Dementia Multifactorial AD and another type of dementia can exist at the same time MD: nearly half of the cases where AD is present
  15. 15. Deposition of Lewy bodies in both, cortical and subcortical Has features of both PD and AD Affects 1% of those age 65, 5% over age 85 Usually progresses more rapidly than DAT (average = 6 years)
  16. 16. PD is a progressi ve disorder of the CNS Results from a deficiency in the neurotran smitter DOPAMIN E Affects more than 1.5 million people in the US 20-40% have more severe symptom s/ dementia 50%+ of people with PD have MCI.
  17. 17. Sometimes referred to as WernickeKorsakoff’s syndrome A dementia syndrome caused by many years of heavy drinking Usually the result of a combo: malnutrition + brain damage directly caused by alcohol Accounts for < 5% of all dementias
  18. 18. Dementia of the Alzheimer’s type Mixed Dementias Vascular Dementia Huntington’s Disease Dementia Frontotemporal Dementia Normal Pressure Hydrocephalus Lewy Body Dementia Parkinson’s Disease Dementia Alcoholinduced Dementia CJD
  19. 19. Educational programs for families and professionals 1-800 272-3900 The Alzheimer's Association is the leading voluntary health organization in Alzheimer’s, care, support and research. Its mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. • • • • • • 24-hour Helpline Information and referrals Care consultation Support groups Online community Safety services www.alz.org
  20. 20. www.vda.virginia.gov
  21. 21. Virginia Easy Access is a FREE resource providing a simple method to search for specific services anywhere in Virginia. Virginia Easy Access is a gateway to VirginiaNavigator (which lists over 21,000 programs and services throughout the Commonwealth) and to the 2-1-1 Virginia Call Center. easyaccess.virginia.gov
  22. 22. seniornavigator.org
  23. 23. www.sahp.vcu.edu/gerontology/

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