Dementia(literal translation from Latin: dementia- "madness") - acquired dementia, a condition in which there are violations in cognitive(cognitive) sphere: forgetfulness, loss of knowledge and skills that a person possessed before, difficulties in acquiring new ones.
Dementia is an umbrella term. There is no such diagnosis. It is a disorder that can occur with a variety of medical conditions.
Dementia in numbers and facts:
- According to 2015 statistics, there are 47.5 million dementia patients in the world. Experts believe that by 2050 this figure will increase to 135.5 million, that is, approximately 3 times.
- Doctors diagnose 7.7 million new cases of dementia each year.
- Many patients are unaware of their diagnosis.
- Alzheimer's disease is the most common form of dementia. It occurs in 80% of patients.
- Dementia (acquired dementia) and mental retardation (mental retardation in children) are two different conditions. Oligophrenia is an initial underdevelopment of mental functions. In dementia, they were previously normal, but over time they began to disintegrate.
- People call dementia senile insanity.
- Dementia is a pathology, not a symptom of the normal aging process.
- At the age of 65, the risk of developing dementia is 10%, it rises strongly after the age of 85.
- Senile dementia refers to senile dementia.
What are the causes of dementia? How do brain disorders develop?
After 20 years, the human brain begins to lose nerve cells. Therefore, small problems with short-term memory are quite normal for older people. A person can forget where he put the keys to the car, what is the name of the person with whom he was introduced at a visit a month ago.Such age-related changes happen to everyone. They usually do not lead to problems in everyday life. In dementia, the disorders are much more pronounced. Because of them, problems arise both for the patient himself and for the people who are with him.
The development of dementia is based on the death of brain cells. Its reasons can be different.
What diseases are associated with dementia?
| Name | The mechanism of brain damage, description | Diagnostic methods |
| Neurodegenerative and other chronic diseases |
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| Alzheimer's disease | The most common form of dementia. According to various sources, it occurs in 60-80% of patients. During Alzheimer's disease, abnormal proteins build up in the brain cells:
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| Lewy body dementia | Neurodegenerative disease, the second most common form of dementia. According to some reports, it occurs in 30% of patients.
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| Parkinson's disease |  A chronic disease characterized by the death of neurons that produce dopamine, a substance necessary for the transmission of nerve impulses. In this case, Lewy bodies are formed in the nerve cells (see above). The main manifestation of Parkinson's disease is movement disorders, but when degenerative changes in the brain spread, symptoms of dementia can occur. | The main diagnostic method is examination by a neurologist. Positron emission tomography is sometimes done to detect low levels of dopamine in the brain. Other tests (blood tests, CT scans, MRIs) are used to rule out other neurological diseases. |
| Huntington's disease (Huntington's chorea) | An inherited disease in which the body synthesizes a mutant mHTT protein. It is toxic to nerve cells. Huntington's chorea can develop at any age. It is detected both in 2-year-old children and in people over 80 years old. Most often, the first symptoms appear at the age of 30-50. The disease is characterized by movement disorders and mental disorders. |
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| Vascular dementia |  The death of brain cells occurs as a result of impaired cerebral circulation. Violation of blood flow leads to the fact that neurons stop receiving the required amount of oxygen and die. This occurs with stroke and cerebrovascular disease. |
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| Alcoholic dementia |  It occurs as a result of damage to ethyl alcohol and products of its decay of brain tissue and cerebral vessels. Alcoholic dementia often develops after an attack of delirium tremens or acute alcoholic encephalopathy. |
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| Volumetric formations in the cranial cavity: brain tumors, abscesses (abscesses), hematomas. |  Volumetric formations inside the skull squeeze the brain, disrupt blood circulation in the cerebral vessels. Because of this, the process of atrophy gradually begins. |
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| Hydrocephalus (dropsy of the brain) |  Dementia can develop with a special form of hydrocephalus - normotensive (without increasing intracranial pressure). Another name for this disease is Hakim-Adams syndrome. Pathology occurs as a result of a violation of the outflow and absorption of cerebrospinal fluid. |
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| Pick's disease |  Chronic progressive disease characterized by atrophy of the cortex of the frontal and temporal lobes of the brain. The causes of the disease are not fully known. Risk factors:
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| Amyotrophic lateral sclerosis |  Chronic incurable disease, during which the motor neurons of the brain and spinal cord are destroyed. The causes of amyotrophic lateral sclerosis are unknown. Sometimes it occurs as a result of a mutation of one of the genes. The main symptom of the disease is paralysis of various muscles, but dementia can also occur. |
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| Spinocerebellar degeneration | A group of diseases in which degeneration processes develop in the cerebellum, brain stem, spinal cord. The main manifestation is impaired coordination of movements. In most cases, spinocerebellar degeneration is hereditary. |
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| Hallerworden-Spatz disease | A rare (3 patients per million) hereditary neurodegenerative disease in which iron is deposited in the brain. A child is born sick if both parents are sick. |
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| Infectious diseases |
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| HIV-associated dementia | Caused by the human immunodeficiency virus. Scientists do not yet know how the virus damages the brain. | Blood test for HIV. |
| Viral encephalitis |  Encephalitis is an inflammation of the substance of the brain. Viral encephalitis can lead to the development of dementia. Symptoms:
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| Folic acid deficiency |  Deficiency of folic acid (vitamin B 9) in the body can occur as a result of its insufficient content in food or impaired absorption in various diseases and pathological conditions (the most common cause is alcohol abuse). Vitamin B 9 deficiency is accompanied by various symptoms. |
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| Pellagra (vitamin B 3 deficiency) |  Vitamin B 3 (vitamin PP, niacin) is necessary for the synthesis of ATP (adenosine triphosphate) molecules - the main carriers of energy in the body. The brain is one of the most active “consumers” of ATP. Pellagra is often referred to as "Three D disease" because its main manifestations are dermatitis (skin lesions), diarrhea, and dementia. | The diagnosis is established mainly on the basis of the patient's complaints and clinical examination data. |
| Other diseases and pathological conditions |
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| Down Syndrome |  Chromosomal disease. People with Down syndrome usually develop Alzheimer's disease at a young age. | Diagnosis of Down syndrome before birth:
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| Post-traumatic dementia |  It occurs after suffering head injuries, especially if they have occurred repeatedly (for example, this is often the case in some sports). There is evidence that a single head injury increases the risk of developing Alzheimer's disease in the future. |
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| Some drug interactions | Some drugs, when used simultaneously, can cause symptoms of dementia. | |
| Depression | Dementia can occur with a depressive disorder and vice versa. | |
| Mixed dementia | It occurs as a result of a combination of two or three different factors. For example, Alzheimer's disease can be associated with vascular dementia or Lewy body dementia. | |
In this disease, Lewy bodies, plaques composed of the protein alpha-synuclein, accumulate in the neurons of the brain. Atrophy of the brain occurs.Dementia manifestations
Symptoms that require medical attention:- Memory impairment... The patient does not remember what happened recently, immediately forgets the name of the person with whom he was just introduced, asks the same thing several times, does not remember what he did or said a few minutes ago.
- Difficulty completing simple, familiar tasks... For example, a housewife who has been cooking all her life is no longer able to cook dinner, she cannot remember what ingredients are needed, in what order they should be dipped into the pan.
- Communication problems... The patient forgets familiar words or uses them incorrectly, has difficulty finding the right words during a conversation.
- Violation of orientation on the ground... A person with dementia may follow the usual route to the store and not find their way back home.
- Shortsightedness... For example, if you leave the patient to sit with a small child, he can forget about it and leave home.
- Violation of abstract thinking... This is most clearly manifested when working with numbers, for example, in various transactions with money.
- Violation of the arrangement of things... The patient often puts things in the wrong places - for example, he can leave the car keys in the refrigerator. Moreover, he constantly forgets about it.
- Sudden mood swings... Many people with dementia become emotionally unstable.
- Personality changes... The person becomes overly irritable, suspicious, or begins to constantly fear something. He becomes extremely stubborn and practically unable to change his mind. Everything new, unfamiliar is perceived as a threat.
- Behavior changes... Many patients become selfish, rude, arrogant. They always prioritize their interests. They can do eccentric things. They often show an increased interest in young people of the opposite sex.
- Decline in initiative... A person becomes lack of initiative, does not show interest in new beginnings, proposals of other people. Sometimes the patient becomes completely indifferent to what is happening around.
| Easy | Moderate | Heavy |
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Dementia stages (WHO classification, source:
| Early | Average | Late |
| The disease develops gradually, so patients and their relatives often do not notice its symptoms and do not go to the doctor in time. Symptoms:
| Symptoms of the disease become more pronounced:
| At this stage, the patient is almost completely dependent on loved ones and needs constant care. Symptoms:
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Dementia diagnosis
Neurologists and psychiatrists are involved in the diagnosis and treatment of dementia. The doctor first talks to the patient and suggests simple tests to help assess memory and cognition. The person is asked about well-known facts, asked to explain the meanings of simple words and to draw something. It is important that during the conversation, the specialist doctor adheres to standardized methods, and does not focus only on his impressions of the patient's mental abilities - they are far from always objective.
Cognitive tests
Cognitive tests are now used when dementia is suspected and have been tested many times and can indicate cognitive impairment with high accuracy. Most of them were created in the 1970s and have changed little since then. The first list of ten simple questions was developed by Henry Hodkins, a geriatrics specialist at London Hospital. Hodkins' technique has been called the abbreviated mental test score (AMTS).
Test questions:
- What is your age?
- What time is it down to the hour?
- Repeat the address that I will now show you.
- What is the year now?
- What hospital and what city are we in now?
- Will you be able to recognize two people you have seen before (for example, a doctor, a nurse)?
- What is your date of birth?
- In what year did the Great Patriotic War begin (you can ask about any other well-known date)?
- What is the name of our current president (or other famous person)?
- Count in reverse order from 20 to 1.
GPCOG test
This test is simpler than AMTS and has fewer questions. It allows for express diagnostics of cognitive abilities and, if necessary, refer the patient for further examination.
One of the tasks that the subject must complete during the GPCOG test is to draw a dial on a circle, roughly observing the distance between the divisions, and then mark a certain time on it.
If the test is carried out online, the doctor simply notes on the web page which questions the patient answers correctly, and then the program automatically gives the result.
The second part of the GPCOG test is a conversation with a relative of the patient (can be done over the phone).
The doctor asks 6 questions about how the patient's condition has changed over the past 5-10 years, to which you can answer "yes", "no" or "I do not know":
- Are there more problems with remembering recent events, things that the patient uses?
- Has it become more difficult to remember the conversations that took place a few days ago?
- Has it become more difficult to find the right words while communicating?
- Has it become more difficult to manage money, manage your personal or family budget?
- Has it become more difficult to take your medications on time and correctly on your own?
- Has it become more difficult for the patient to use public or private transport (this does not mean problems that have arisen due to other reasons, for example, due to injuries)?
The patient is examined by a neurologist and, if necessary, by other specialists.
The laboratory and instrumental tests that are most often used when dementia is suspected are listed above when considering the causes.
Dementia treatment
Treatment for dementia depends on the cause. With degenerative processes in the brain, nerve cells die and cannot be restored. The process is irreversible, the disease is constantly progressing. Therefore, in Alzheimer's disease and other degenerative diseases, a complete cure is impossible - at least today such drugs do not exist. The main task of the doctor is to slow down pathological processes in the brain, to prevent further growth of disturbances in the cognitive sphere.
If the processes of degeneration in the brain do not occur, then the symptoms of dementia may be reversible. For example, restoration of cognitive function is possible after craniocerebral trauma, hypovitaminosis.
Dementia symptoms rarely come on suddenly. In most cases, they build up gradually. For a long time, dementia is preceded by cognitive impairments, which cannot yet be called dementia - they are relatively mild and do not lead to problems in everyday life. But over time, they build up to the point of dementia.
If these violations are identified in the early stages and appropriate measures are taken, it will help to delay the onset of dementia, reduce or prevent a decrease in working capacity and quality of life.
Dementia Care
People with advanced dementia need constant care. The disease greatly changes the life of not only the patient himself, but also those who are nearby, caring for him. These people experience heightened emotional and physical stress. It takes a lot of patience to look after a relative, who at any time can do something inadequate, create danger for himself and others (for example, throw an unextinguished match on the floor, leave the tap with water open, turn on the gas stove and forget about it), react with violent emotions to any little thing. Because of this, patients around the world are often discriminated against, especially in nursing homes, where they are looked after by strangers, often insufficiently informed and do not fully understand what dementia is. Sometimes even medical personnel behave quite rudely with patients and their relatives. The situation will improve if society becomes more aware of dementia, this knowledge will help to treat such patients with greater understanding.
Prevention of dementia
Dementia can develop for a variety of reasons, some of which are not even known to science. Not all of them can be eliminated. But there are risk factors that you can well influence. Basic steps to prevent dementia:
- Quitting smoking and drinking alcohol.
- Healthy eating... Useful vegetables, fruits, nuts, cereals, olive oil, lean meats (chicken breast, lean pork, beef), fish, seafood. Excessive consumption of animal fats should be avoided.
- Fight overweight... Try to monitor your weight, keep it normal.
- Moderate physical activity... Exercise has a positive effect on the state of the cardiovascular and nervous system.
- Try to engage in mental activity... For example, a hobby like playing chess can reduce the risk of dementia. It is also useful to solve crosswords, solve different puzzles.
- Avoid head injuries.
- Avoid infections... In the spring, it is necessary to follow the recommendations for the prevention of tick-borne encephalitis, which are carried by ticks.
- If you are over 40 years old, have a blood sugar and cholesterol test done annually. This will help to timely identify diabetes mellitus, atherosclerosis, prevent vascular dementia and many other health problems.
- Avoid psycho-emotional overwork, stress... Try to get enough sleep and rest.
- Monitor your blood pressure... If it rises periodically, consult a doctor.
- When the first symptoms of disturbances from the nervous system appear, immediately contact a neurologist.
Even with a high level of development of medicine, humanity suffers from many diseases that are still incurable and lead to the death of the patient. One of these ailments is dementia.
Worldwide, the incidence of it is approximately 35.6 million people, and forecasts in this regard are disappointing - it is expected that in 15 years the number of patients will double. Most of the cases are reported in Western countries.
But it is possible that the reason for this lies in the usual ignorance of the domestic population about this disease.
What is this disease
Dementia is cognitive disorder, memorization of information, reasonable thinking, logic, personality change can also occur. People call this phenomenon dementia.
Its cause is damage to brain cells, the emergence of degenerative processes in them, which leads to the disintegration of mental functions.
Causes of dementia
Most often, dementia is experienced by the elderly, ranging from 60 years of age and older.
But it is also not uncommon for young people to get sick.
Causes dementia : traumatic brain injury, illness, toxins that lead to the destruction of brain cells, drug addiction, drug and Internet addiction, bigotry, shopaholism, gambling addiction, unhealthy food addiction.
Diseases Causing Dementia
As for diseases leading to dementia, then to them relate:
Classification
Dementia is classified in several ways.
Severity
Dementia by severity it happens:
- Lightweight. The ability for independence, criticism, and compliance with the rules of hygiene is preserved, although social activity has already been noticeably disrupted. The patient feels lethargic, quickly gets tired of mental stress, cannot concentrate, loses motivation and interest in everything that surrounds him. Current events are quickly forgotten, mood often changes.
- Moderate. The symptoms of the disease become more obvious, memory and the ability to navigate even in a well-known area are severely impaired, the ability to use household appliances is lost. The patient's personality changes, aggression and irritability appear, and in some cases, on the contrary, apathy. Questions about their own nutrition and hygiene are neglected, and causeless anxiety appears. The patient stops recognizing familiar faces. Leaving a person alone in such a state is not possible, because he can harm himself.
- Heavy. Degradation of personality occurs, the patient ceases to understand what he is being told, perceives his relatives as absolutely strangers, cannot eat and even swallow on his own. Involuntary urination and defecation occurs, the patient spends most of the time in bed and needs care.
By localization
Localization of the lesion of the head brain:
- Cortical dementia- the cerebral cortex is affected. The causes of the disease are Alzheimer's disease, alcoholism.
- Subcortical- subcortical structures are affected.
- Cortical-subcortical.
- Multifocal- with the formation of many lesions.
By types
By the way the disease proceeds it happens:
- Lacunar dementia- characterized by loss of memory, mood swings, sentimentality and increased tearfulness.
- Alzheimer's type dementia- spatial orientation is disturbed, a delusional state, neuropsychological disorders, depression due to their inadequacy occurs.
- Total dementia- abstract thinking, attention, perception and memory are severely disturbed. Shyness, politeness, a sense of duty disappear, the patient's personality is destroyed.
- Mixed dementia- combines the symptoms of primary degenerative disorders accompanying Alzheimer's disease and vascular dementia.
How does the disease manifest
In fact, the symptoms of dementia at the first stage are very difficult to notice, because its symptoms are not very pronounced.
Therefore, few people seek medical help at the onset of the disease, the symptoms of dementia are aggravated, the patient's condition worsens.
But if you know the symptoms of vascular dementia and take timely action in relation to a sick relative, then there will be a much better chance that he will be cured and return to normal life.
To the main symptoms of the disease include such:
- memory impairment, both short-term and long-term, return to the level of development of early childhood;
- the ability for criticality, abstract thinking disappears, there is a violation of speech, movements and perception;
- there is a sudden loss of dressing skills, personal hygiene;
- social maladjustment appears in the family and at work;
- the ability to orient in space is lost.
Signs for the factors that caused the disease
Symptoms vary depending on what caused dementia.
So, senile dementia, resulting from Alzheimer's disease, almost imperceptible at first and the symptoms are blurred. If a person works, then the manifestation of the disease may be the loss of professional skills.
Forgetfulness appears, depression, fears, sudden anxiety, apathy may occur.
The patient's speech may be simplified, or the words in the sentences will be incorrectly selected. If a person drives a car, he will have problems with recognizing road signs.
Over time, he becomes incapable of communicating with others.
If the cause of dementia repeated micro-strokes, then the disease develops "stepwise", the patient's condition improves, then again falls into decline.
By keeping your blood pressure under control, you can sometimes prevent another stroke, which can significantly improve your condition.
Dementia, AIDS-related, at first proceeds imperceptibly, but gradually progresses.
At the same time, being a consequence Creutzfeldt-Jakob disease, dementia within a year goes to the third degree of severity and leads to death.
Vascular dementia has such symptoms: epileptic seizures, impaired walking, which becomes slow, shuffling, the patient's instability on his legs is noted, which often leads to his falls.
Also a characteristic symptom of vascular dementia disease is uncontrolled urination. The retreat of the disease is often noted, but this is temporary.
It also happens that the patient's condition is restored, but not to the level that preceded the stroke.
Mostly senile (senile) dementia progressing and its symptoms are becoming more and more pronounced. There is apathy, depression, difficulties with solving everyday issues.
The patient becomes completely helpless, cannot take a shower, get dressed, or prepare food on his own.
Developing senile dementia due to Pick's disease has its own special signs and symptoms, - manifested by passive behavior, disappearance 
ability to critical, impulsiveness.
In behavior, rudeness, hypersexuality, foul language begin to appear, a disorder of will and drives is observed.
At the same time, basic skills, such as the ability to count, write, habitual actions at work, persist for a long time. Also, the patient can use his memory longer.
Diagnostics
To diagnose dementia, the doctor interviews the patient and his relatives asking simple questions and trying to figure out the state of the patient's intelligence.
Relatives, in turn, can talk about the symptoms of dementia they have noticed.
Also a biochemical blood test is performed, it turns out whether the cause of dementia may be the medication previously taken by the patient. To rule out a brain tumor, stroke, or hydrocephalus, computed tomography or magnetic resonance imaging is prescribed.
If the doctor suspects that senile dementia is due to Alzheimer's disease and all the symptoms point to it, he prescribe a brain biopsy, which will detect the destruction of nerve cells, the study of cerebrospinal fluid and positron emission tomography.
If senile vascular dementia manifests its symptoms, in many cases the drug and reviews to which are in our article will help. For circulatory disorders in neurology, the drug Vinpocetine is widely used, reviews of which are in one article.
Treatment methods
Dementia today is an incurable disease. In rare cases, it is possible to defeat her. But if you find it in the early stages, then the chances of success will be much greater.
Treatment depends on the cause of the disease. For example, with Alzheimer's, the use of the drug donepezil (aricept) sometimes helps, which slows the progression of the disease by a year or more.
Ibuprofen also helps, but only if started during the first stage of dementia.
Dementia is incurable, which is caused by repeated micro-strokes. But there is a possibility of slowing down its development, or even stopping it. To do this, it is necessary to carry out treatment of high blood pressure or diabetes mellitus, which provoke attacks.
Bye that no medicine has been invented to help with signs of dementia caused by AIDS and Creutzfeldt-Jakob disease.
Signs of dementia in the elderly resulting from Parkinson's disease, is not cured by the drugs invented against it, and in some cases even worsens the patient's condition.
With a severe degree of dementia, characterized by emotional outbursts and an agitated state, antipsychotics are used, such as and. But these drugs often cause side effects.
As a result of the use of many types of medicines that are used for colds, insomnia, as well as from tranquilizers and antidepressants, the patient's condition worsens.
At the same time, large clocks, calendars, communication with familiar people and the support of those who care about them help people with dementia to navigate in time.
Also shown regular activity with small loads, a joyful environment, a stable and simple daily routine. Relatives should be tactful in relation to the patient, but it is not recommended to treat him like a child. In no case should you scold him for mistakes.
Moving to a new place, new furniture, repairs badly affects the patient's condition.
Preventive measures
In the course of a number of studies, scientists have found that people who speak two languages are much later exposed to senile dementia than those who know only one language.
Prevents the onset of dementia food that includes antioxidants: vitamin B12, E, folic acid. Their content is quite high in fresh vegetables, nuts and fish.
Increases the risk the development of the disease diabetes and hypertension, so you need to monitor your health. Alcoholism and smoking also provoke the disease, and often the first signs of dementia appear for this very reason.
Also prevention of senile dementia includes: Getting an education, solving puzzles, setting and achieving life goals, as well as walking and jogging are the keys to health, both physical and mental.
It has also been observed that having a family in a person, it significantly prevents the development of senile dementia in him. 
From all of the above, it is logical to conclude that it is much easier to prevent the signs of vascular dementia than to cure it, especially given that this disease is not particularly treatable.
At the same time, methods of preventing the disease are not difficult and are available to everyone.
That's why take care of your health from youth, do not get carried away with bad habits and try to constantly develop - this will contribute to the fact that you will meet old age in your right mind and in good health.
Video: Vascular Dementia - How to Maintain Memory and Mind
(dementia) is a condition (often progressive) in which a person has a persistent violation of thought processes.
This is expressed in the loss of memory, loss of basic skills, abilities and knowledge and, as a result, complete degradation.
The disease is not independent, but is considered only a symptom of some neurological and mental pathologies. It occurs against the background of complete and irreversible destruction of the structure of the brain and cannot be completely cured.
Dementia does not necessarily manifest itself with age, and lately it has become more and more “younger”. The term "early dementia" means the onset of the disease in people over the age of 35, and sometimes a little younger.
Fortunately, the pathology is not very common: there are about 48 million patients registered in the world, and young people make up only 15-20% of this figure.Having completely given up smoking, alcohol, observing a competent diet, playing sports or any other physical activity, you can not only prolong your youth, but also insure yourself against many terrible diseases.
Regular brain training can help you overcome dementia.
It can be solving crosswords, memorizing poetry, intellectual and logic games, puzzles, etc.
It is important to keep track of your weight, blood pressure, cholesterol and glucose levels in your body.
If dementia is not hereditary, then these tips can help you avoid it:
- Refusal of bad habits, significantly reduces the risk of illness.
- Proper nutrition, exercise, dieting will not only prolong an active life, but also increase the body's defenses.
- Exercising the brain is just as important as the body.
- By regularly passing all the necessary tests, you can detect any disease in time.
The percentage of the population suffering from the diagnosis "Dementia" is growing every year. To date, 47.5 million cases have been officially registered. By 2050, it is predicted that the number of patients will actually triple.
The manifestations of the disease affect not only people who have been diagnosed with this diagnosis, but also relatives who provide them with care around the clock.
Let's figure out what kind of disease this is - dementia. And how to resist it.
Dementia: Description of the disease
Dementia is a progressive, chronic brain disorder and is an acquired mental disorder leading to disability.In the course of the disease, changes in all higher cognitive functions are noted:
- memory;
- thinking;
- attention;
- the ability to navigate in space;
- assimilation of new information.
Degradation occurs in dementia to a greater extent than in normal aging.
And also often the disease is accompanied by emotional changes:
- irritability;
- depression conditions;
- increased anxiety;
- social maladjustment;
- decreased self-esteem;
- lack of motivation;
- indifference to what is happening around.
For reference!
In most cases, dementia starts irreversible processes. But if the cause of the disease is established in time and it is eliminated, then the treatment will give positive results and delay the onset of the severe stage.
Dementia in the elderly
The largest percentage of patients with this diagnosis are elderly people. This category includes women and men in the 65 to 74 age group.
Representatives of this sample are referred to as "presenile dementia" or "presenile dementia", that is, presenile dementia. In most cases, the causes of abnormalities in the elderly are disorders of the vascular system and atrophic processes occurring in the cells of the brain.
Senile dementia or senile dementia belongs to the generation over 75 years old. Quite often, this age is characterized by mixed dementia, where several factors that caused the disease are combined. The disease of mixed genesis is quite difficult to treat. This is due to the concomitant pathology.
According to statistics of age-related dementia, women are more susceptible. This observation is associated with a longer life expectancy. And also an important role is played by the hormonal characteristics of women of advanced age.
The clinical picture of dementia in an elderly person depends on:
- from the state of the body to the onset of the manifestation of primary symptoms;
- from the factors that caused the disease;
- on the intensity of the development of deviations.
Alcohol abuse leads to malfunction of all body systems. Although European scientists have concluded that moderate consumption of natural wine in the amount of 300 grams per week reduces the risk of dementia.
Treatment
Dementia is completely incurable.Therapy means:
- slowing down the process of cell death;
- relieving symptoms;
- psychological assistance in adaptation;
- life extension with the diagnosis.
- improve the state of memory, thinking, attention, the ability to navigate in space;
- to minimize the manifestation of disorders in the patient's behavior;
- improve the quality of life.
- drug therapy;
- treatment at the physical level (the use of gymnastics, occupational therapy, massage sessions, taking therapeutic baths, classes with a speech therapist);
- socio- and psychotherapy (working with a psychologist, both the patient and the people who take care of him, counseling on providing appropriate care, as well as working with cognitive functions).
- neurotrophics (improve brain nutrition);
- neuroprotectors (slow down atrophic processes);
- antidepressants.
Close people are advised to ensure that the patient adheres to a clear daily routine, daily allocating time for training mental activity, moderate physical activity and quality rest. It is advisable to do physical activity (walks, exercises, swimming) together with the patient. By keeping company together, you can give prompts in time, as well as provide a good mood and give a feeling of acceptance and support.
Particular attention should be paid to the nutrition of the patient. The diet must be replenished with foods that lower cholesterol levels in the body:
- different types of nuts;
- legumes;
- barley;
- avocado;
- blueberry;
- vegetable oils.
- seafood;
- lean meats;
- sauerkraut;
- fermented milk products.
Serve boiled or steamed dishes better. Give up salt to the maximum. It is important to give the patient about one and a half liters of clean water to drink a day.
Living with a diagnosis
If you turn to a specialist when the first symptoms of dementia appear, then the treatment will be effective. A person will be able to lead a habitual way of life for a long time, dealing with household issues. In no case should you self-medicate without consulting a doctor.Dementia requires ongoing treatment. Therefore, close people of the patient need to be patient and help in everything. It is important to protect it from stressful situations and provide proper care.
Dementia Is a clinical syndrome characterized by loss of memory , as well as other functions of thinking. This phenomenon occurs in the case of chronic degenerative brain lesions of a progressive nature. However, dementia is characterized not only by changes in thought processes, but also by the manifestation of behavioral disorders, as well as changes in a person's personality.
It is important to understand that from oligophrenia or congenital dementia differs, first of all, in that it occurs as a result of illness or damage to the brain. Generally, dementia is a condition common in older people. Due to natural aging in the body, malfunctions of various systems begin to occur. The neuropsychic sphere is characterized by cognitive , behavioral , emotional violations. Dementia is a cognitive impairment. However, if we consider this condition, guided by its external manifestations, then patients with dementia are also characterized by emotional disorders (condition ,), behavioral disorders (too frequent awakening at night, lost hygiene skills). In general, a person with dementia gradually degrades as a person.
Dementia is a severe and, as a rule, irreversible disorder that very noticeably affects the normal life of a person, destroying his social activity. Because dementia is common in older patients, it is also called senile dementia or senile marasmus ... According to research by specialists, approximately 5% of people who are already 65 years old suffer from certain manifestations of this condition. The state of dementia in elderly patients is considered not to be a consequence of aging, which cannot be avoided, but as age-related diseases, some of which (about 15%) are treatable.
Dementia symptoms
Dementia is characterized by its manifestation from many sides simultaneously: changes occur in speeches , memory , thinking , attention sick. These and other functions of the body are disturbed relatively evenly. Even the initial stage of dementia is characterized by very significant impairments, which will certainly affect a person as a person and a professional. In a state of dementia, a person not only loses the ability to demonstrate previously acquired skills, but also loses the ability to acquire new skills. Another important sign of dementia is the relatively stable manifestation of these disorders. All violations are manifested regardless of the state of the person's consciousness.
The very first manifestations of this condition may not be particularly noticeable: even doctors with experience are not always able to determine the onset of the development of the disease. As a rule, first of all, various manifestations of changes in a person's behavior begin to alert his family and friends. At the initial stage, these may be certain difficulties with resourcefulness, signs of irritability and forgetfulness, indifference to things previously interesting to a person, the inability to work at full strength. Over time, the changes become even more noticeable. The patient shows absent-mindedness, becomes inattentive, cannot think and understand as easily as before. Memory disorders are also noted: the most difficult thing for a patient to remember current events. Changes in mood are very clearly manifested, moreover, most often a person becomes apathetic, sometimes cries. Being in society, a person can show deviations from general norms of behavior. Not alien to patients with dementia and or delusional ideas, in some cases they can suffer and manifestation. With all the changes described, the person himself cannot adequately assess the changes that have occurred to him, he does not notice that he is behaving in a different way than before. However, in some cases, at the very first manifestations of dementia, a person fixes changes in his own abilities and general condition, and this worries him greatly.
In the case of progression of the described changes, patients eventually lose almost all mental abilities. In most cases, there are speech disorders - it is very difficult for a person to select words in a conversation, he begins to make mistakes in their pronunciation, does not understand the speech with which others are addressing him. After a certain period of time, these symptoms are added disorders of the functioning of the pelvic organs , the patient's reactivity decreases. If at the first stage of the disease the patient may have an increased, then later his need for food is significantly reduced, and as a result, the state sets in cachexia ... Voluntary movements are poorly coordinated. If the patient has a concomitant ailment that is accompanied by febrile condition, or a disorder provoke the onset of confusion. As a result, there may be stupor or coma ... The described degradation process can last from several months to several years.
Such violations of human behavior are the result of damage to his nervous system. All other disorders occurring arise as a reaction to the onset of dementia. So, in order to hide disturbances in memory, the patient may show too much pedantry. His dissatisfaction in response to the need for restrictions in life is expressed by irritability and bad mood.
Due to degenerative diseases, a person can be in a state of complete decortication - not to understand what is happening around, not to speak, not to show interest in food, although at the same time to swallow the food put in his mouth. In a person in this state, the muscles of the limbs and face will be tense, tendon reflexes, grasping and sucking reflexes will be increased.
Forms of dementia
It is customary to distinguish between the state of dementia according to the severity of the development of the disease. As the main criterion for such a distinction, the degree of dependence of a person on the departure of others is taken into account.
Capable of mild dementia cognitive impairment is manifested by a deterioration in a person's professional abilities and a decrease in his social activity. As a result, the patient's interest in the outside world as a whole weakens. However, in this state, a person serves himself independently and maintains a clear orientation in his own home.
At moderate dementia the next stage of cognitive disorders is manifested. The patient already needs periodic care, because he cannot cope with most household appliances, it is difficult for him to open the lock with a key. The surrounding people are forced to constantly prompt him certain actions, but still the patient can serve himself independently and retains the ability to carry out personal hygiene.
At severe dementia a person is completely maladjusted to the environment and directly depends on the help of other people, and he needs it when performing the simplest actions (eating, dressing, hygiene).
Dementia causes
The reasons for the development of senile dementia are varied. Thus, pathological disorders that negatively affect cells sometimes occur directly in the brain. As a rule, neurons die due to the presence of deposits that are detrimental to their functioning, or due to their poor nutrition due to poor blood circulation. In this case, the disease has organic character (primary dementia). This condition occurs in about 90% of cases.
Due to the deterioration in the functioning of the brain, a number of other diseases can appear - malignant tumors , infections , deterioration metabolism ... The course of such diseases negatively affects the functioning of the nervous system and, as a consequence, secondary dementia manifests itself. This condition occurs in about 10% of cases.
Dementia diagnosis
To make a correct diagnosis, it is important, first of all, to correctly determine the nature of dementia. This directly affects the purpose of the method of treating the disease. The most common causes of primary dementia are neurodegenerative changes (for example, ) and vascular nature (for example, hemorrhagic ,cerebral infarction ).
The onset of secondary dementia is mainly provoked by cardiovascular disease , excessive addiction to alcohol , violations metabolism ... In this case, the dementia may disappear after the cause of the dementia is healed.
When making a diagnosis, the doctor first of all conducts a detailed conversation with the patient in order to find out whether the patient really has reduced intellectual performance and personality changes. In the process of clinical and psychological assessment of the patient's condition, the doctor conducts a study aimed at determining the condition gnostic function , memory , intelligence , substantive actions , speeches , attention ... At the same time, it is important to take into account in the process of research the stories of the patient's close people who have constant contact with him. Such information contributes to an objective assessment.
Long-term testing is required to fully confirm the presence of dementia symptoms. There are also specially designed scales for assessing dementia.
It is important to distinguish dementia from a number of mental disorders. So, if among the symptoms inherent in the patient is observed, nervousness, sleep disturbances, then, assuming the absence of changes in mental activity, the doctor may assume the presence of a mental illness. In this case, it is important to take into account that mental disorders in middle-aged and elderly people are the consequences of either organic brain damage or depressive psychosis.
When making a diagnosis, the doctor takes into account that patients with dementia are very rarely able to adequately assess their condition and are not inclined to note the degradation of their own mind. The only exceptions are patients with early dementia. Consequently, the patient's own assessment of his condition cannot be decisive for a specialist.
After diagnosing a patient with a state of dementia, the doctor prescribes a number of other examinations in order to identify signs of diseases of a neurological or therapeutic nature, which makes it possible to correctly classify dementia. The study includes computed tomography, EEG, MRI,. Also toxic metabolic products are being investigated. In some cases, it is necessary to monitor the patient for a certain amount of time to make a diagnosis.
Dementia treatment
There is an opinion about the ineffectiveness of dementia treatment due to the irreversibility of age-related changes. However, this statement is only partially true, because not all types of dementia are irreversible. The most important point is the exclusion of attempts at self-medication and the appointment of therapy only after a thorough examination and diagnosis.
To date, in the process of treating dementia, drug therapy is used by prescribing drugs to the patient that improve connections between neurons and stimulate the process blood circulation in the brain ... It is important to constantly monitor blood pressure, reduce mental and physical stress (early stage of the disease), provide food with foods rich in natural antioxidants. In the case of conduct disorders, we use antidepressants and antipsychotics .
With the right approach to the treatment of vascular factors in the elderly, the progression of the disease can be noticeably halted.
The doctors
Medicines
Prevention of dementia
To prevent the onset of dementia, measures are used to reduce the risk of this disease to some extent. It is important to monitor the state of the level cholesterol and - it shouldn't be high. Should not be allowed to develop ... An active social life, regular intellectual activity, and an active lifestyle are an important factor in the prevention of dementia. Prevention of vascular dementia involves quitting smoking, drinking too much alcohol, salt and fatty foods. It is important to control blood sugar and avoid head injuries.
Diet, nutrition for dementia
List of sources
- Damulin I.V. Alzheimer's Disease and Vascular Dementia / Ed. Yakh-but N.N. M., 2002.
- Damulin I.V., Parfenov V.A., Skoromets A.A. and others. Circulatory disorders in the brain and spinal cord. Diseases of the Nervous System: A Guide for Physicians. Vol. 1. Ed. N.N. Yakhno. 4th ed., Rev. and add. M .: JSC "Medicine Publishing House", 2005;
- Levin O.S. Modern approaches to the diagnosis and treatment of dementia // Handbook of an outpatient doctor. - 2007. - No. 1
- Damulin I.V. Cognitive disorders: modern aspects of diagnosis and treatment. - M., 2005.
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