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Dementia - A clinical syndrome, which is characterized by loss of memory As well as other functions of thinking. This phenomenon occurs in case of chronic degenerative brain lesions developing. However, dementia is characterized by not only a change in thought processes, but also a manifestation of disturbances in behavior and changes in personality.
It is important to understand that mental retardation or idiocy Dementia is characterized primarily in that the disease is caused by a brain injury. Usually dementia is a condition specific to the elderly. Due to the natural aging of the body begin to arise malfunctions of various systems. For the neuro-psychiatric characterized cognitive . behavioral . emotional violations. For cognitive disorders such as dementia refers. However, if we consider this state, guided by its external manifestations, the person with dementia characterized as emotional disturbances (state depression . apathy ), Behavioral problems (too frequent awakenings during the night, lost hygiene skills). In general, people with dementia gradually degrades as a person.
Dementia - severe and usually irreversible disorder is very noticeable effect on normal human life, destroying his social activism. Given that the characteristic of dementia in elderly patients, it is also called senile dementia or senile marasmus . According to research experts, about 5% of people who have turned 65 years old, suffer from certain manifestations of this condition. Status of dementia in elderly patients is not considered to be a consequence of aging, which can not be avoided, and age-related diseases, some of which (about 15%) amenable to therapy.
The symptoms of dementia
For dementia, is characterized by its manifestation along with many sides: changes occur in speeches . memory . thinking . attention patient. These and other features of the body violated relatively evenly. Even the initial stage of dementia, is characterized by very significant violations, which certainly affects the person as a person and a professional. In a state of dementia a person not only loses the ability to be previously acquired skills, but also lose the opportunity to acquire new skills. Another important feature of dementia is relatively stable manifestation of such disorder. All violations occur regardless of the state in which resides consciousness.
The earliest manifestation of this condition may not be particularly noticeable that even doctors with experience is not always a virtue to determine the onset of disease . Typically, the first manifestation of a variety of changes in human behavior begin to guard his family and loved ones . At the initial stage it may be some difficulty with resourcefulness, signs of irritability and forgetfulness, indifference to the interests before human things, the inability to operate at full capacity . Over time, the changes become more noticeable . The patient displays confusion, become inattentive, can not think and understand as easily as before . Marked and memory disorders: the most difficult patient to remember current events . Very pronounced changes in mood, and most often the person becomes apathetic, sometimes crying . Staying in society, a person can be deviations from the general rules of conduct . Not alien to patients with dementia and paranoid or delusions, in some cases, they may suffer and manifestation hallucinations . With all the changes described the man himself can not adequately assess the changes occurred to him, he does not notice that behaves differently than before. However, in some cases, the first manifestations of dementia a person commits a change to their own abilities and general condition, and that he was severely troubled.
In the event of progression of these changes, patients eventually lose almost all mental abilities. In most cases the speech disorder - A person is very difficult to pick up words in a conversation, he starts to make mistakes in their pronunciation, does not understand it, to which it is addressed others. After a certain period of time the data added to signs disorders of the pelvic organs functioning , The patient is lowered reactivity. If the first stage of the disease the patient may have an increased appetite, then later his need for food is significantly reduced, and eventually there comes a state cachexia . Movement of the arbitrary nature of poorly coordinated. In the presence of concomitant disease in a patient, which is accompanied by febrile or disorder metabolism provoke confusion. As a result, it 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 the defeat of his nervous system. All other occurring disorders occur as a reaction to the emergence of dementia. So to cover up violations of memory, the patient may be too strong a pedantry. His displeasure in response to the need for restrictions in life expressed irritability and low mood.
As a result of degenerative diseases a person can remain in a state of complete decortication - Do not understand what is happening around, not saying do not show interest in food, although it posited swallowed food into his mouth. A person in such a state will be tense muscles of the limbs and face, increased tendon reflexes, grasping and sucking reflexes.
The forms of dementia
To distinguish a state of dementia according to the severity of the disease. As the main criterion for this distinction is taken into account the degree of man's dependence on the care of others.
Able mild dementia cognitive impairment manifested worsening of professional abilities and decrease its social activity. Because of this waning interest of the patient to the outside world as a whole. However, in this condition the person maintains itself independently and maintains a clear focus in their own home.
At moderate dementia It appears next stage of cognitive disorders. The patient has required periodic maintenance, because he can not cope with the majority of household appliances, it is difficult to open the key lock. Ambient to constantly prompt him to certain actions, yet the patient can take care of themselves independently, and retains the ability to carry out personal hygiene.
At severe dementia People completely maladaptive for the environment and depends on the help of others, and needs it when performing simple actions (eating, dressing, hygiene).
Causes of dementia
The reasons because of which is the development of senile dementia, various. Thus, pathological disorders, affecting the cells sometimes occur directly in the brain. Normally, neurons die because of the presence of sediments, harmful to their operation, either because of their weak supply due to poor circulation. In this case, the disease is organic character (dementia primary). This condition occurs in about 90% of cases.
Due to the deterioration of brain function may appear a number of other diseases - Malignant tumor . infection , Worsening Metabolism . During such diseases adversely affects the nervous system and, consequently, the dementia manifests secondary. This condition occurs in approximately 10% of cases.
Diagnosis of dementia
To avoid misdiagnosis, it is important to first correctly identify the nature of dementia. This directly affects the purpose of treatment of disease. The most widespread manifestations of the primary causes of dementia are considered to change the neurodegenerative nature (for example, Alzheimer's disease ) And the vascular nature (e.g., hemorrhagic stroke . cerebral infarction ).
The emergence of a secondary dementia generally provoke cardiovascular diseases Excessive fascination with alcohol , Violations Metabolism . In this case, dementia may disappear after treatment of the reasons on which it arose.
The physician first conducting a detailed conversation with the patient to find out whether the patient decreased intellectual performance and personality changes are taking place. In the course of the clinical and psychological evaluation of the patient the doctor is conducting a study aimed at determining the status gnostic function . memory . intelligence . subject actions . speeches . attention . It is important to take into account during the study patient stories of loved ones who have regular contact with him. Such information contributes to an objective assessment.
In order to fully ascertain the symptoms of dementia, it takes a long examination. There are specially designed rating scale dementias.
It is important to distinguish dementia from a number of disorders of mental health. So, if some inherent patient symptoms observed fatigue , Nervousness, sleep disturbances, then, assuming no change in mental activity, your doctor may suggest the presence of mental illness. In this case, it is important to consider that mental disorders in middle-aged and elderly people - are consequences or organic brain damage, depression or psychosis.
The physician takes into account that patients with dementia are very rarely able to adequately assess their condition and not inclined to celebrate the degradation of his own mind. The only exceptions are patients with dementia in the early stages. Consequently, its own assessment of the patient's condition can not be decisive for the expert.
After diagnosing the patient's state of dementia doctor prescribes a number of other surveys in order to detect signs of neurological disease or therapeutic nature, which allows to correctly classify dementia. The study includes a CT scan, EEG, MRI, lumbar puncture . It also investigates the toxic products of metabolism. In some cases, the diagnosis requires a certain time to carry out observation of the patient.
Treatment of dementia
There is a perception of the ineffectiveness of the treatment of dementia due to the irreversibility of the age-related changes. However, this statement is true only in part because irreversible are not all varieties of dementia. The most important point is to eliminate the attempts of self and purpose of therapy only after a thorough examination and diagnosis.
To date, the treatment of dementia drug therapy used by assigning drugs to the patient, which improves connections between neurons and stimulate the blood circulation in the brain . What is important is the constant control of blood pressure, reduction of mental and physical loads of character (an early stage of the disease), nutrition foods rich in natural antioxidants. In the case of conduct disorder used antidepressants and neuroleptics .
With the right approach to the treatment of vascular factors in the elderly can significantly halt the progression of the disease.
Prevention of dementia
For the prevention of dementia apply measures to some extent reduce the risk of symptoms of the disease. It is important to monitor the state level Cholesterol and Homocysteine - It should not be high. We should not allow the development of hypertension . An important factor in the prevention of dementia is an active social life, regular intellectual activity, active lifestyle. Measures for the prevention of vascular dementia type suggested quitting smoking, excessive alcohol consumption, salt and fatty foods. It is important to control blood sugar, to avoid head injuries.
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