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Dementia (dementia) results from damage to the brain that can be caused by many neurodegenerative diseases, eventually degenerating nervous tissue. What diseases can cause dementia? Dementia diagnosis and treatment.

Dementia( dementia ) causes disturbed higher cortical (cognitive) functions: memory, thinking, orientation, understanding, counting , Learning, Language and Assessment. Dementia is often associated with behavioral, psychotic, and mood disorders, and appropriate symptomatic treatment must therefore be implemented.

Dementia is not a normal symptom of aging.

Dementia may appear in the course of neurodegenerative, infectious and vascular diseases. Most cases of neurodegenerative dementia are caused by Alzheimer's disease, which causes Dementia of the Alzheimer Type (DAT). It is believed to be responsible for more than half of all dementia among people aged 65 and over.

Dementia can also be caused by vascular disease. Usually, we are dealing with multi-infarct dementia - after several strokes, when each subsequent stroke is followed by abrupt and permanent deterioration in the functioning of the sick person. If the stroke has been single, but has resulted in a significant loss of several important cognitive functions, "sudden" dementia - vascular dementia with an acute onset - may occur.

Some researchers also talk about pseudo-dementia - this is a situation when depression is misdiagnosed as dementia, which gives very similar symptoms in elderly people. When depression is correctly diagnosed and treated appropriately, the patient usually regains mental alertness.

What is dementia?

Dementia is a decrease in mental performance of varying intensity - it is not a specific disease entity, but it can occur as a result of many factors that damage the brain. According to the World He alth Organization (ICD-10), a dementia syndrome is a symptom complex caused by a brain disease, usually chronic or progressive, and clinically characterized by numerous disorders of higher cortical functions,such as memory, thinking, orientation, understanding, counting, learning, language and evaluation. Moreover, cognitive disorders are often accompanied or even preceded by emotional, behavioral and motivation disorders. Such an image cannot be accompanied by a disturbance of consciousness. Consciousness disorders in the presence of dementia constitute a separate diagnostic category.

Memory impairment manifests itself mainly in the area of ​​learning new information, although in more advanced dementia the reproduction of previously acquired information may also be impaired. The presence of memory disorders should also be confirmed - if possible - by the results of neuropsychological examination or psychometric tests assessing cognitive processes. Disturbances in other cognitive functions are manifested by impairment of the ability to make assessments, thinking, planning and organizing the course of complex activities, and a general weakening of the information processing process. The presence of these disorders should also be confirmed - if possible - by the results of neuropsychological examination or psychometric tests assessing cognitive processes. At the same time, the orientation in place is maintained, there is also: emotional lability, irritability, apathy, or primitiveness in social interactions, and all these symptoms are present for at least six months.

According to the DSM-IV, however, dementia is a symptom complex of cognitive processes including - in addition to memory disorders - deficits in at least two of the following cognitive functions: speech (aphasia), intentional complex motor activity (apraxia), the ability to recognize and identify objects (agnosia) and disorders of planning, initiating, controlling and correcting the course of complex behaviors (disorders of executive functions). Cognitive deficits should be deep enough to interfere with professional activity, social functioning and the performance of daily activities.

Important

American scientists studying mice with memory problems found some improvement after giving them caffeinated coffee. According to the researchers, coffee apparently contains some ingredient that by combining with caffeine reduces the level of beta-amyloid in the brain - an abnormal protein that is likely caused, among others, by Alzheimer's disease.

Dementia: causes

  • Alzheimer's disease - causes Alzheimer's dementia
  • Pick's disease and related disorders leading to the degeneration of the temporal and frontal lobes
  • Parkinson's disease
  • with Lewy's bodies
  • Huntington's disease
  • diseaseCreuzfeldt-Jakob
  • neuroborreliosis
  • HIV infection or full-blown AIDS can also cause dementia-like neuropsychological disorders
  • alcohol abuse
  • avitaminosis B12
  • hyperthyroidism
  • stroke

Dementia: Symptoms

  • problems with short-term memory, while remembering past events
  • forgetting names, names of items
  • communication problems, aphasia
  • addiction to other people's help in everyday activities, apraxia

Dementia: diagnosis

Tests to diagnose dementia:

  • computed tomography (excluding brain tumors and aneurysms)
  • thyroid testing
  • morphology towards anemia
  • liver failure test
  • magnetic resonance imaging
  • positron emission tomography - a difficult to access test that allows for an accurate diagnosis of the disease
  • genetic research

Dementia: treatment

A dozen or so years ago it was claimed that there are no cures for dementia. Today it is known that pharmacotherapy can improve the quality of life of patients, although there is no possibility of a complete cure. In this disease, drugs are used that affect the disruption of the acetylcholine pathway - cholinesterase inhibitors that inhibit the breakdown of acetylcholine. These drugs include donepezil, rivastigmine, and galantamine, NMDA antagonists (memantine). Vitamin E, selegiline, Ginko biloba extracts are used as supporting substances.

Therapy for people suffering from dementia also involves stimulating the brain - intellectual exercises are used for this purpose. A combination of cognitive therapy (memory training, reality orientation), reminiscence therapy (evoking memories using stimulating materials), validation therapy (stimulating correct social behavior, patient identity, reducing anxiety, anxiety, improving well-being), occupational therapy (strengthening skills still owned by the patient, recreating those that were recently lost, improving activity), environmental therapy (creating a friendly and safe environment).

Dementia: prognosis

Dementia may be progressive, recurrent, or stable. In 10-15% of patients, dementia is reversible - this applies to dementia caused, for example, by syphilis of the nervous system, hypoxia, vitamin B12 deficiency, hypothyroidism - it all depends on the speed of therapeutic intervention and the course of treatment of the disease.primary. Too late diagnosis of dementia, and therefore late treatment, may leave behind permanent memory loss.

In the case of primary degenerative dementias, the disease slowly progresses, making the patient completely dependent on the help of the environment.

About the authorAgnieszka Paculanka Editor for over twenty years, writing about he alth and beauty. Participant of scientific and training workshops for journalists from the Quo vadis medicina? and specialist seminars for journalists from the Medicinaria series organized by the Journalists for He alth Association.

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Neurology