Dementia

CNS disease

1. DEMENTIA

2. INTRODUCTION Cognition is that operation of the mind process by which we become aware of objects of thought and perception, including all aspects of perceiving, thinking and remembering. Organic brain syndrome is general term referring to many physical disorders that cause impaired mental function.

3. DEMENTIA Dementia is a loss of mental skills that affects daily life. It can cause problems with memory, think and plan. Usually dementia gets worse over time.

4. ETIOLOGY Neurodegenerative conditions – 60-80 %- alzhiemers , down syndrome , parkinsons diseses . Vascular diseases Bacterial conditions – meningitis, encephalitis Advanced age is a risk factor . Environmental factors: metals and toxins. Excessive amount of metal ions, such as zinc and copper, in brain .

5. Head injury Stroke Brain tumor Vascular dementia (also called multi-infarct dementia) – resulting from brain cell death caused by conditions such as cerebrovascular disease Injury – post-traumatic dementia is directly related to brain cell death caused by injury . Prion diseases – for instance, CJD (Creutzfeldt-Jakob disease). HIV infection – how the virus damages brain cells is not certain, but it is known to occur. Reversible factors – some dementias can be treated by reversing the effects of underlying causes, including medication interactions, depression, vitamin deficiencies, and thyroid abnormalities.

6. Dementia stages Mild cognitive impairment:   Characterized by general forgetfulness. This affects many people as they age but it only progresses to dementia for some. Mild dementia:   People with mild dementia will experience cognitive impairments that occasionally impact their daily life. Symptoms include memory loss, confusion, personality changes, getting lost, and difficulty in planning and carrying out tasks .

7. Moderate dementia:   Daily life becomes more challenging, and the individual may need more help. Symptoms are similar to mild dementia but increased. Individuals may need help getting dressed and combing their hair. They may also show significant changes in personality; for instance, becoming suspicious or agitated for no reason. There are also likely to be sleep disturbances.

8. Severe dementia:   At this stage, symptoms have worsened considerably. There may be a loss of ability to communicate, and the individual might need full-time care. Simple tasks, such as sitting and holding one’s head up become impossible. Bladder control may be lost.

9. Alzheimer’s disease The most common type of dementia, Alzheimer’s disease makes up 60 to 80 percent of dementia cases. Vascular dementia . This type of dementia is caused by reduced blood flow in the brain. It may be the result of plaque buildup in arteries that feed blood to the brain or a stroke

10. Lewy body dementia . Protein deposits in nerve cells prevent the brain from sending chemical signals. This results in lost messages, delayed reactions, and memory loss. Parkinson’s disease dementia . Individuals with advanced Parkinson’s disease may develop dementia. Symptoms of this particular type of dementia include problems with reasoning and judgment, as well as increased irritability, paranoia, and depression.

11. Frontotemporal dementia Several types of dementia fall into this category. They’re each affected by changes in the front and side parts of the brain. Symptoms include difficulty with language and behavior, as well as loss of inhibitions. Huntington’s disease It is characterized by specific types of uncontrolled movements but also includes dementia .

12. DIAGNOSIS Medical history A physical examination Mental status exam Laboratory tests Thyroid hormone tests to check for an underactive thyroid. Vitamin B12 blood test to look for a vitamin deficiency. Other lab tests that may be done include: Complete blood count (CBC) to look for infections. ALT or AST blood tests to check liver function. Chemistry screen. This test checks the level of electrolytes in the blood and checks kidney function. Glucose test to check the level of sugar in the blood . HIV testing to look for AIDS. Erythrocyte sedimentation rate blood test. It looks for signs of inflammation in the body. Toxicology screen. This test examines blood, urine, or hair to look for drugs that could be causing problems. Antinuclear antibodies blood test to diagnose autoimmune diseases. Testing, such as a lead test, to look for heavy metals in the blood. A lumbar puncture to test for certain proteins in the spinal fluid. This test may also be done to rule out other causes of symptoms. CT MRI EEG

13. MANAGEMENT Medications used in treating the Alzheimer’s diseases are, Tacrine hydrochloride ( cognex ) Donepezil hydrochloride (Aricept) Antipsychotic agents Risperidone Quetiapine Olanzapine Anticonvulsant to control seizures. Antidepressant agents and mood stabilizers Low doses of the selective serotonin reuptake inhibitors and other newer anti-depressive agents should be considered

14. NURSING INTERVENTION Daily routine Nutrition and body weight Personal hygiene Toilet habits and incontinence Accidents Fluid management Moods and emotions Wandering Disturbed sleep Interpersonal relationship

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