Description dementia

Dementia is a term that denotes a serious mental disorder that arises in the course of human life after the completion of the development of the cognitive functions.

Under the term cognitive function includes a wide variety of mental functions, the most important are the memory, intellect,motivation.

In the definition, it is important that this is a disease which arises after the completion of the development of cognitive function, which is a basic difference from the state of so-called. Mental retardation, which occurs in humans the primary cognitive impairment, ie before the end of their development.

About dementia we talk in person over two years, with the development of cognitive functions has already occurred. Under poor development of cognitive functions occurs disease before the second year of life, which is referred to as mental retardation.Determination of the second year of life as the boundary between mental retardation and dementia is not artificial, but in general.

What is important is the loss of cognitive functions (cognitive) from the state of premorbid personality. Premorbid personality of a person before the onset of the disease. The drop then begins to interfere with all the activities of the patient. The main problems are picked up in the ability to work, study and live independently.


Risk factors for dementia

One of the key risk factor is age. Generally it can be said that with age, the risk of impairment of the patient with dementia. In the children’s age, dementia is a very rare disease, whereas if we take into account patients older than 65 years, we can see that as much as 5% of them are suffering from dementia.

From the above 5% of the number of affected people is nearly 60% of people affected byAlzheimer’s disease. Identify other risk factors is complicated because, as stated above, dementia know the whole series and more, with the most common dementia in general, Alzheimer’s dementia, their exact etiopathogenesis of the disease (although it has collected the whole set of partial knowledge about this disease, comprehensive view still missing) .


prevention of dementia

From the foregoing that certain preventive measures are difficult. For vascular dementia can perhaps with some exaggeration see a healthy lifestyle as a form of prevention.

Signs and symptoms of dementia

The first symptom that a patient with dementia usually appear first, forgetfulness. Forgetfulness may be total or only partial (the patient does not remember new information).

Another symptom is loss of judgment and reasoning skills.

Some types of dementia are then characterized by a disorder of spatial orientation and imagination, resulting in daily life that the patient wanders in places that normally knew.

A special problem is then called. Anamnesic disorientation when the patient has a disorder of short term memory, so you remember where they are currently located, and is therefore disoriented place.

Another group of disorders are known. Disorders of executive function, which will show the inability of the patient to perform complex tasks (the cook forgets to cook even the simplest dishes).

Gradually reduces the intellectual performance – we talk about. Deterioration of intellect.Deterioration of intellect steadily progresses until the patient is not able to even the simplest reasoning.

Besides the above mentioned disorders will damage a number of other mental functions. Emotive disorders manifest themselves so that demented patient reacts emotionally so that its response was disproportionate situation. It may appear emotional flatness, dull euphoria. The patient may suffer from depression, mania, etc.

Conduct disorders may be present and functioning as varying degrees of aggression, agitation, bizarre behavior, etc. Furthermore, this sleep disorder.

Dementia is in terms of its origin very broad concept in medicine is therefore divided into dementia atrophic-degenerative (thereto include Alzheimer’s disease, cortical Lewy body disease, dementia in Parkinson’s disease, frontal and frontotemporal dementias, including Pick’s disease, Huntington’s disease , progressive supranuclear palsy, etc.).

The second group are secondary or symptomatic dementia: vascular dementia with sudden onset, multi-infarct dementia, mainly subcortical vascular dementia (dementia Biswangerova).

The third group are then other dementias, e.g. dementia infectious: progressive paralysis, AIDS dementia.

Alzheimer’s disease is atrophic-degenerative disease which manifests with a progressive deterioration of intellect and developing other cognitive funkcí.V It is currently incurable disease.Physicians distinguish two forms of Alzheimer’s disease, in the form of early-onset (symptoms of dementia appear before the 65th year the patient), and form with late onset (symptoms appear after the 65th year of life).

The disease manifests itself essentially as a classical dementia, forgetfulness first appears, then the patient does not know where it is located and strays. Picking up other disorders leading to a complete breakdown of the patient’s personality. The patient no longer has a preview of the disease (ie. That she did not realize his illness). Furthermore, the patient becomes totally dependent on those around him, and after some time dying. The length of a patient’s life is on average 5-8 years, but there are known cases of survival over 10 years.

Dementia of ischemic etiology such -vaskulární dementia, which plays a major role in the onset of the infarction of brain tissue. These attacks are in addition multiple. It is estimated that, in order for patient developed dementia of this type must be affected at least 100 ml of brain tissue infarction. This may not necessarily apply, because it is important infarct location: if a heart attack is located in a strategic location of the brain, then just affection about 50 ml of brain tissue.

Infarction occurs, so that an interruption of the supply of oxygen and other substances brain tissue.Brain tissue is in addition to oxygen sensitive. Afferent blood vessels that supply oxygen provided, may be affected by thrombosis, embolism or cerebral hemorrhage.

Dementia of ischemic vascular etiologies make up about 15-30% of all dementia along with Alzheimer’s dementia (60% of all dementias), the most common types.


treatment of dementia

Treatment of dementia is very complicated. As an example we can take the treatment of Alzheimer’s dementia. For this treatment it is particularly important in its complexity. It comprises, first of methods of biological and nonbiological.

Non-biological treatment involves providing basic patient care, which are responsible for caregivers (professional caregivers or family members). In this part of the treatment is a physician consultant and managing overall treatment.

The important part is the work alzheimerovských companies that provide assistance and advice to carers and patients themselves.

Non-biological treatment includes reeducation (znovunaučení) normal daily activities. An important aspect of treatment is that the patient should be as much confronted with the reality (each room calendar with a marked date, clocks, signs, such as that room in the house, etc.).

Biologic therapies are based on known pathogenetic mechanisms, and its listing in relation to them far beyond the scope of this text. When studying Alzheimer’s disease, it was found that there is an important neurotransmitter system damping, and thus acetylcholine system. This downturn is primarily meant to decrease levels of the neurotransmitter (acetylcholine), and this treatment is trying to correct.

One possibility is to supply the body precursor to acetylcholine (precursor substance from which the body itself can produce acetylcholine). Thus serves precursor to acetylcholine, lecithin.

Further, it then called. Acetylcholinesterase inhibitors such as donepezil (Aricept preparation) andrivastigmine (Exelon preparation). Acetylcholinesterase is an enzyme which cleaves the synaptic cleft acetylcholine. Inhibitors of preventing it, and therefore increases the concentration of acetylcholine.

Alzheimer’s disease, inter alia, causes the brain tissue accumulates oxygen free radicals, which further deplete brain. Therefore doctor serves scavengers, substances that absorb these free radicals. These include vitamin C, ginkgo biloba extract 761 E, selenium and the like.

It is also used a number of drugs, e.g. substances that complement the missing nerve growth factors(selegiline), as neuroprotective active substances such as propentofylline, as excitatory amino acid receptors, calcium channels etc.


How can I help myself

The patient himself can not influence your status, importance, on the contrary help relatives and doctors.


complications of dementia

Within dementia may occur injuries further in Alzheimer’s dementia is pneumonia, as it can be a relapse aphasia outages etc.

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