Dementia is a decline in mental ability that usually progresses slowly , where there is a disturbance of memory , thought, judgment and ability to focus , and personality deterioration can occur .
At a young age , dementia may occur suddenly if severe injury , disease or toxic substances ( eg carbon monoxide ) causing the destruction of brain cells .
But dementia usually occurs slowly and attack aged over 60 years .
But dementia is not part of the normal aging process . Along with age , the changes in the brain can cause a loss of some memory ( especially short-term memory ) and a decrease in some learning abilities . These changes do not affect the normal function .
Forgotten in the elderly is not a sign of dementia or early-stage Alzheimer's disease .
Dementia is a decline in mental abilities are more serious , the more and more severe .
In normal aging , a person may forget the things that detail ; but a person with dementia may forget the whole event has just occurred .
CAUSE
The most frequent cause of dementia is Alzheimer's disease .
The cause of Alzheimer's disease is unknown , but is thought to involve genetic factors , because the disease seems to be found in some families and are caused or influenced by some specific gene abnormality .
In Alzheimer's disease , some parts of the brain decline , resulting in cell damage and reduced response to a chemical signal channel in the brain .
Found in the brain of abnormal tissue ( called senile plaques and tangled nerve fibers ) and abnormal proteins , which can be seen at autopsy .
Dementia Lewy figure closely resembles Alzheimer's disease , but have differences in the microscopic changes that occur in the brain .
2nd most common cause of dementia is a stroke that row.
Single stroke is small and causes mild weakness or weaknesses that arise slowly . This small strokes gradually cause damage to brain tissue , brain regions that were damaged due to blockage of blood flow is called infarction .
Dementia is derived from several small strokes called multi - infarct dementia . The majority of sufferers have high blood pressure or diabetes , both of which cause damage to blood vessels in the brain .
Dementia can also occur after a person experienced a brain injury or cardiac arrest .
Other causes of dementia are :
- Pick disease
- Parkinson's disease
- AIDS
- Creutzfeldt- Jakob Disease
Normal pressure hydrocephalus occurs when the fluid that normally surrounds the brain and protect it from injury , failed to properly absorbed .
Hydrocephalus is an unusual cause of dementia , which not only leads to loss of mental function but also occurred urine incontinence and walking abnormalities .
People who suffer repeated head injuries ( eg boxers ) pugilistika often experience dementia ( progressive chronic traumatic encephalopathy ) ; some of them also suffer from hydrocephalus .
Elderly people who suffer from depression also experience pseudodemensia .
They rarely eat and sleep and often complain about reduced memory ; whereas the true dementia , memory loss sufferers often disown them .
SYMPTOMS
Dementia usually begins slowly and progressively become more severe , so that the state did not at first realize .
There was a decline in memory , the ability to remember the time and ability to recognize people , places and objects .
Patients have difficulty in finding and using the right words and the abstract thinking ( eg in the use of numbers ) .
Often a change in personality .
Dementia due to Alzheimer's disease usually begins subtly .
The initial symptoms are usually oblivious to the events that had just occurred ; but could also started as depression , fear , anxiety , decreased emotional or other personality changes .
There is a change in the pattern of speaking lightly ; people use words more simply, using words that are not appropriate or not able to find the right words .
Inability to interpret the signs could lead to difficulties in driving.
In the end people can not run a social function .
Dementia due to minor stroke have a disease with such a pattern down the stairs .
Symptoms worsen suddenly , then somewhat improved and will further deteriorate again when the next stroke occurs .
Controlling high blood pressure and diabetes can sometimes prevent subsequent stroke and occasionally happen healing light .
Some people can hide their flaws well .
They avoid complex activity ( such as reading or working ) .
Patients who do not succeed in changing their lives can experience frustration because of his inability to perform daily tasks .
Patients forget to perform the essential duties or wrong in doing its job .
Distinguishing Delirium With Dementia
Delirium
|
Demensia
|
Occurs suddenly
|
Occurs slowly
|
Lasted for several weeks
|
can be settled
|
Associated with the use of drugs or drug withdrawal symptoms, severe disease, metabolic disorders
|
Can without disease
|
Almost always worse at night
|
Often worse at night
|
Not being able to focus
|
Attention 'wandering'
|
Fluctuating alertness of lethargy into agitation
|
Preparedness is often reduced
|
Orientation to the environment varies
|
Orientation to the environment disturbed
|
Its language is slow, often not understood and not appropriate
|
Sometimes having trouble finding the right words that
|
Mixed memory, confusion
|
Lost his memory, especially for recent events occurring
|
Diagnosis
The diagnosis of dementia is made based on a thorough assessment , taking into account patient age , family history , the beginning and the development of symptoms and the presence of other diseases ( eg, high blood pressure or diabetes ) .
Standard blood chemistry examination .
CT scan and MRI examination is intended to determine the presence of a tumor , hydrocephalus or stroke .
If on an older memories setbacks occur gradually , it is thought to cause Alzheimer's disease .
Diagnosis of Alzheimer's disease proved only if performed an autopsy on the brain , which indicates the number of nerve cells are lost . The remaining cells appear chaotic and scattered throughout the brain tissue plaques composed of amyloid (a type of abnormal proteins ) .
Diagnostic methods used to diagnose this disease is the examination of the lumbar puncture and PET ( positron emission tomography ) , which is a specific brain skening pemerisaan .
TREATMENT
Most cases of dementia can not be cured .
Takrin drugs help people with Alzheimer's disease , but cause serious side effects .
Takrin has been replaced by donepezil , which cause fewer side effects and slow the progression of Alzheimer's disease for 1 year or more .
Ibuprofen can also slow the course of the disease .
These drugs are best if given at an early stage .
Dementia due to stroke in a row can not be cured , but its development can be slowed or even halted by treating high blood pressure or diabetes -related stroke .
If memory loss are due to depression , given anti -depressants .
If diagnosed early , the normal -pressure hydrocephalus dementia because it can sometimes be overcome by removing excess fluid in the brain through the drainage hose ( shunting ) .
To control the agitation and explosive behavior , which can accompany advanced stages of dementia , often digunakanobat anti -psychosis ( eg tioridazin and haloperidol ) . But these drugs are less effective and cause serious side effects .
Effective anti - psychotic drugs given to patients who experience hallucinations or paranoia .
Helping people with dementia and their families :
1 . Maintaining a familiar environment will help patients have a fixed orientation . Calendar huge , bright light , wall clock with large numbers or radio can also help people stay oriented .
2 . Hiding car keys and installing detectors on doors can help prevent the occurrence of an accident in people who love to walk around .
3 . Undergoing bathing , eating , sleeping and other routine activities , can provide a sense of order to the patient .
4 . Scold or punish people will not help , it will even make things worse .
5 . Enlist the help of organizations that provide social services and care , would be very helpful .
Prognosis
Development of dementia in each person is different .
AIDS dementia usually begins as a vague but growing steadily for several months or years .
While dementia because Ceutzfeldt - Jakob disease typically causes severe dementia and death often occurs within 1 year .
In the most advanced stages of dementia , a decline in brain function almost complete .
Patients become more attractive and not able to control her behavior. Moods change often and happy walk around ( wandering ) .
In the end the patient is unable to follow a conversation and can lose the ability to speak .
