Dementia of various origins. Dementia

Dementia is acquired dementia, characterized by degradation of thinking, memory, behavior. The manifestations of dementia are very diverse. A person loses previously acquired household and professional skills, his interests fade away, thinking becomes illogical. In the most severe cases, a person is not able to realize what is happening to him, where he is, ceases to recognize anyone and needs constant outside care.

Depending on the level social adaptation and the need for outside help, there are several forms of dementia: mild, moderate and severe.

Senile (senile) dementia

Mental changes that develop in senile dementia are associated with irreversible changes in the brain. These changes occur at the cellular level, neurons die due to lack of nutrition. This condition is called primary dementia. If there is a disease due to which the nervous system has suffered, the disease is called secondary dementia. Such diseases include Huntington's disease, spastic pseudosclerosis (Creutzfeldt-Jakob disease), etc. Also, alcoholism, drug addiction, (especially in boxers), can also cause dementia. infectious diseases.

Symptoms of senile dementia

At mild form dementia, the social activity of a person decreases, patients are forced to leave their jobs, it becomes harder for them to contact people, apathy appears. This condition can lead to depression, which often masks the initial manifestations of dementia. At the same time, a person is able to fully serve himself.

Moderate dementia is a more severe stage of the disease. Sick people almost completely lose interest in the world around them. There is a loss of habitual skills (they can no longer turn on the TV or stove on their own). Hygienic skills are still preserved, patients can control their physiological needs. Such people need control and help from loved ones or a nurse.

In a severe form of dementia (this is its last stage), patients become insane, it is impossible for them to explain anything. Absolutely all skills are lost, even the simplest ones (patients are not able to hold a spoon, brush their teeth). Patients require constant care. Often, patients can resist attempts to help them, which greatly complicates the life of their loved ones.

Vascular dementia

This kind of dementia deserves special attention, since pathological processes in the brain develop very slowly, and long time a person may not know that the disease has already begun.

Violation brain activity occurs due to violations of blood flow in the vessels of the brain. Due to lack of oxygen and nutrients, brain cells begin to die. With the death of a small number of neurons, the symptoms of the disease do not appear, since other brain cells take over part of the functions of the dead neurons. But when a large area of ​​the brain is damaged, manifestations of dementia begin.

One of the most common causes of vascular dementia is, and it doesn’t matter if the ischemic (thrombosis of cerebral vessels) or hemorrhagic (hemorrhage) type has a violation cerebral circulation. Older people often suffer from diseases that increase the risk of developing dementia: hypertension, atherosclerosis of blood vessels, arrhythmias.

The manifestations of vascular dementia are usually difficult to identify. People usually talk about this form of dementia if its symptoms appeared after a stroke or heart attack.
Impaired thinking and memory depend on which area of ​​the brain is damaged.

Dementia treatment

Unfortunately, dementia is irreversible because the changes in the brain that caused it are irreversible.

Patients need quality care, communication, doing what they love. While maintaining a normal life, patients have the opportunity to maintain their brain functions much longer and slow down the progression of the disease. Patients need a good diet rich in antioxidants, vitamin therapy, moderate mental stress on early stage diseases (reading, retelling and memorization of what was read).

Treating conditions that cause dementia can help slow the progression of dementia. Usually, patients need to be monitored by a cardiologist and a neurologist to prescribe adequate therapy for cardiovascular diseases.

Help slow the progression of the disease drugs that improve inter neural connections(Memantine, anticholinesterase agents), as well as ensuring normal blood circulation and metabolic processes in brain cells (Glycine).

Patients suffering from dementia should be monitored by a doctor constantly, since the progression of the disease is inevitable, and treatment may need to be adjusted. Self-treatment of dementia is impossible.

Dementia is a test not only for the patients themselves, but also for their loved ones. In many cases, the duration of a relatively full life of a sick person depends on the correct behavior and adequate assessment by relatives of the need for treatment.

Which doctor to contact

Manifestations of dementia are treated by a neurologist. Patients are also consulted by a cardiologist. If severe mental disorders occur, the help of a psychiatrist is required. Often such patients end up in psychiatric boarding schools.

The problem of dementia (vascular dementia), considered in the program "Live healthy!":

Acquired dementia, which most often affects the elderly, is called dementia (from Latin “madness”). This pathology is not congenital, but acquired. Before the disease, a person is able to think logically and serve himself, but partially loses these opportunities.

Dementia - what is it?

It is important to understand when dementia sets in, that it is a disease that is caused by damage to the brain. Dementia affects people of all ages, not just old people, and the number of cases is steadily increasing. Unlike other deviations, for example, oligophrenia, this syndrome is acquired and does not indicate an underdevelopment of the psyche. Dementia is a severe disorder of nervous activity, as a result of which the patient loses acquired skills and knowledge, and cannot comprehend new ones. There is a breakdown of the mental functions of a healthy person.

Dementia in psychology

Often the syndrome develops as a result of other diseases (Parkinson, Pick, Alzheimer, etc.), injuries. The disorder originates in the cerebral cortex and may have various forms by severity and course: mild, moderate and severe. If there is a concomitant disease and it progresses, dementia itself develops, the disease depersonalizes the patient. The patient loses most of his thinking, ceases to know the world around him, and interest in life fades away. The syndrome manifests itself in many ways: memory, speech, logic are disturbed, depressive states appear.

Dementia - causes

This syndrome occurs as a result of organic brain damage after an injury or some kind of disease (sometimes several at once). More than 200 can provoke his illness. pathological conditions. In specific forms of dementia, disturbances in the cerebral cortex are the leading mechanism of the disease. In other cases, damage to the central nervous system is a consequence of this syndrome.

The most common causes of dementia are:

• Alzheimer's disease (up to 65% of all cases);
• vascular damage caused by atherosclerosis, arterial hypertension, violation of the circulation and properties of blood;
• alcohol abuse and drug addiction;
• Parkinson's disease;
• Pick's disease;
• traumatic brain injury;
• endocrine diseases (problems with the thyroid gland,);
• autoimmune diseases ( multiple sclerosis, lupus erythematosus);
• infections (AIDS, chronic meningitis, encephalitis, etc.);
• diabetes;
• severe illness internal organs;
• a consequence of complications of hemodialysis (blood purification),
• severe renal or hepatic failure.

Dementia - symptoms

There are three stages of the disease, so each of them has its own symptoms:

1. Main symptom this disease- Progressive memory loss. Obvious signs of dementia are sudden irritability, cruelty, slovenliness, regression in a person's behavior.
2. Secondary signs of the syndrome: amnestic memory disorders, when the patient ceases to recognize himself in the mirror, confuses the right and left hand and so on.
3. At the last stage, it begins to rise muscle tone, which can lead to a vegetative state and death.

Depending on the degree of the disease, its symptoms and the patient's reaction are expressed in different ways:

1. With mild dementia, he is critical of his condition and is able to take care of himself.
2. With a moderate degree of damage, there is a decrease in intelligence and difficulties in everyday behavior.
3. Severe dementia - what is it? The syndrome means a complete disintegration of the personality, when an adult cannot even relieve himself and eat on his own.

How to avoid dementia?

Senile dementia is one of the leading causes of disability in the elderly. The development of the syndrome is not thought about in youth, while the first signs of degradation may appear as early as 55-60 years. When wondering how to prevent dementia long before its possible manifestation, you need to introduce a few rules and good habits into your life:

• giving up alcohol and smoking;
• proper nutrition(daily intake of the required amount of vitamins, the exclusion of fast food and fatty foods);
• moderate physical exercise;
• intellectual activity;
• peace of mind (should avoid stress, do not succumb to irritation);
• prevention of vitamin D deficiency - its lack in the body leads to the development of Alzheimer's disease and subsequent dementia.

Types of dementia

The manifestation of the syndrome depends on the affected parts of the brain, pathological processes, the presence of concomitant or primary diseases, and the age of the patient. According to localization, dementia disease is divided into several types:

1. Cortical, which is formed when the cerebral cortex is damaged. It is divided into subtypes: frontal (the frontal lobes suffer) and frontotemporal (damage to the frontotemporal lobe).
2. subcortical or subcortical in which subcortical structures are affected.
3. Cortical-subcortical(there are both types of lesions described above).
4. Multifocal when there are numerous lesions in the brain.

senile dementia

Age-related dementia is a common pathology that affects people old age. Due to a lack of nutrition, the neurons in the brain die, and this leads to irreversible changes. At the initial stage of the development of the syndrome, a person may not understand that he was struck by dementia, that this is a disease that can lead to complete insanity. The first signs of the disease are a decline and fatigue. Other harbingers: slowing down of intellectual activity, difficulties in elementary actions, mood swings.

Alcoholic dementia

The disease does not necessarily affect the elderly. With prolonged - from 15 years - alcohol abuse, alcoholic dementia occurs, the symptoms of which are: social degradation, loss of moral values, decreased mental abilities, absent-mindedness, memory disorder, impaired functioning of internal organs, atrophic changes in the brain. Personal degradation is usually the last stage in the development of alcoholism. Up to 20% of all patients acquired this diagnosis as a result of alcohol abuse.

The danger of ethyl alcohol is that it disrupts the work of neurotransmitters responsible for emotions. Alcohol abuse affects the internal organs, the walls of blood vessels, and the brain. Dementia of this type appears after a long-term damage to neurons with ethyl alcohol. And usually the development of the disease is observed in the third stage of addiction, when a person loses control over the quality and quantity of alcohol consumed.

organic dementia

One of the causes of acquired dementia is brain damage as a result of traumatic brain injuries, inflammation and bruises. Also, the impetus for development can be vascular diseases, AIDS, syphilis, etc. organic dementia- a disease that can be total, when all forms of cognitive activity (thinking, attention, memory, etc.) suffer, and partial (partial). In the second case, separate sides are affected cognitive process with the relative preservation of critical thinking and social behavior.

Schizophrenic dementia

Different diseases associated with dementia show specific symptoms. In schizophrenia, the syndrome is characterized by an insignificant decrease in intelligence, but the appearance of apathy, inadequacy, the formation of psychosis and paranoia. The period of exacerbation begins against the background of an oppressed emotional state. This is followed by disorientation in space. Schizophrenic dementia is dementia in which memory remains unchanged for a long time, but purposefulness is absent. The patient's behavior is characterized as strange and helpless.

How to deal with people with dementia?

With this disease, the prognosis is doubtful. The main difficulty is frequent changes in personality and behavior. And main question that worries relatives of patients: how to help a patient with dementia. There are individual treatment programs and social rehabilitation measures. It is important to understand and distinguish that dementia is such a pattern of behavior, and not a pathology. It is important for those around you to tune in to positive interaction, because it depends on them how the patient will maintain contact with the outside world. It is recommended to follow simple advice regarding the patient:

• formulate questions clearly, speak slowly and clearly;
• give hints if a person can not cope, be able to wait;
• capture the attention of the patient;
• divide actions into a chain of simple steps;
• communicate in a positive way.

How to treat dementia?

For effective treatment dementia syndrome should be diagnosed as early as possible, and treatment tactics depend on the diagnosis. There is no clear recommendation for the treatment of senile dementia, as each person is different. But proper care, taking strengthening drugs and drugs that normalize brain function can significantly reduce the level of degradation and even completely stop dementia. With proper therapy, deviations in cognitive functions are reversible.

1. It is possible to achieve a reduction in the manifestations of the disease even with the help of the normalization of nutrition and regimen (for example, in the case of alcoholic dementia).
2. Prevent death nerve cells and eliminate the symptoms of the disease and medication. The basis of therapy includes drugs to improve nervous processes, normalize blood circulation in the vessels and drugs that strengthen neural connections in the brain.
3. Patients need not only medication, but also psychological help. Psychosocial therapy has proven itself well, positively influencing the patient's mood and improving cognitive abilities impaired during the course of the disease. Contact with loved ones, animals, music therapy has a beneficial effect on the general condition of the patient.

Dementia (or dementia)- a word of Latin origin, it means "madness". This disorder is more common in older people (from 60-65 years old). The disease is steadily progressing, completely transforming the human personality. But sometimes the disease can develop suddenly and rapidly due to local death of brain cells.

Dementia, what is it, why does a sick person lose the ability to think, evaluate the world around him? Who is guilty of total loss the interest of life, the bygone memory, the death of logic and speech abilities? What to expect from the disease - degradation and depression or a successful recovery?

Dementia (or dementia) is an irreversible mental disorder.

The impetus for the development of pathology is the emergence of a certain situation, as a result of which mass death of brain cells begins. The diagnosis of dementia is modern world more and more often - according to statistics, about 50 million people suffer from this disease and this figure is growing every year.

More than 250 different pathologies can provoke dementia. The disease develops not only due to aging of the body.

Dementia can be either a separate (independent) disease or become a sign (consequence) of a serious illness.

The most common causes of the disorder include:

1. Alzheimer's disease (the most common cause, dementia develops in 65-70% of cases). Neurodegenerative disease, popularly known as "senile insanity".
2. Diseases that cause damage to blood vessels. These are: atherosclerosis, hypertension, thromboembolism, arterial thrombosis, ischemic attacks, stroke.
3. Long-term abuse of psychotropic substances, drugs, alcohol.
4. Parkinson's disease (or idiopathic syndrome). A neurological disorder that slowly progresses in which parts of the brain are affected.
5. Severe traumatic brain injury.
6. Endocrine diseases: Cushing's syndrome (hypercorticism), diabetes mellitus, autoimmune thyroiditis, thyrotoxicosis, hypoparathyroidism.
7. Pick's disease. Chronic disorder of the central nervous system, leading to atrophy and destruction (destruction) of the cerebral cortex.
8. Autoimmune pathologies: lupus erythematosus, scleroderma, multiple sclerosis, systemic vasculitis, phospholipid syndrome, sarcoidosis.
9. Severe infectious diseases affecting brain structures (neuroinfections): meningitis, encephalitis, toxoplasmosis, cerebral cysticercosis, trichinosis, cerebral abscess, poliomyelitis, HIV encephalitis and AIDS, neurosyphilis.
10. The consequences of hemodialysis (blood purification), which caused various complications.
11. Severe diseases of internal organs (liver, kidney failure).

Varieties of pathology

Dementia is a disease characterized by a richness of manifestations and the nature of the course. The disease has many types, the characteristic manifestations depend on many factors: which parts of the brain are damaged, the age of the patient, the presence of concomitant pathologies.

According to the degree of localization of the process, the classification of dementia is as follows:

• cortical (the cerebral cortex is affected), this pathology has its own subtypes: frontotemporal (frontotemporal lobes suffer) and frontal (frontal lobes are affected);
• subcortical (subcortical) with the involvement of subcortical structures in the degradation process;
• cortical-subcortical, including both of the above types;
• multifocal with the formation of numerous areas of damage in the brain.

Also, dementia has several forms, which are determined depending on the causes that provoked the disease:

Vascular. The causes of the disease are a persistent violation of cerebral circulation, causing degradation of blood vessels and brain tissues. The culprits of vascular dementia are numerous vascular diseases. Patients with diabetes mellitus who have had a stroke and heart attack are at risk.

Pathology of this type is typical for people of the older age category (65-75 years). It is noticed that men suffer from vascular dementia 2 times less often than women.

Senile (senile dementia). The second most common pathology. It also, like vascular, manifests itself in old age. This type of disease is characterized by rapid progression, which leads to the complete disintegration of the mental warehouse of a person. The patient has persistent progressive memory impairment.

According to statistics, the peak of senile dementia falls on a period of 65-70 years. The culprit of the disease is the death of neurons in the brain. This disease is very insidious, it does not immediately make itself felt. The very first signs (fatigue and decreased attention) are attributed to fatigue.

The alarm should be sounded when a noticeable weakening of the intellect, changeability of mood and difficulty in performing elementary actions are mixed with the symptoms.

Alcoholic. What is alcoholic brain dementia? Dementia threatens not only the elderly. If a person abuses alcohol for a long time (from 10 years), he runs the risk of dementia.

In 20% of cases, alcoholism provokes the development of pathology. The main symptoms of alcoholic dementia are:

• the fall of morality;
• disorder of attention and memory;
• loss of mental abilities;
• social degradation of the individual;
• loss of all moral values.

Ethyl alcohol is the strongest poison for the body, it is detrimental to neurotransmitters responsible for the emotional component of the psyche. Gradually, all parts of the brain atrophy. Most often, alcoholic dementia occurs when a person is diagnosed with stage III alcoholism.

organic. The syndrome of dementia of the organic type develops due to severe physical injuries of the head, bruises, and infectious lesions of the brain. This pathology has two types:

1. Total, affecting all components responsible for the ability to know. This is memory, thinking, concentration, attention.
2. Partial (or partial), destructive part of the cognitive ability of the individual. But thinking remains intact.

Schizophrenic. Pathology that develops due to existing mental illnesses. In schizophrenic dementia, some part of intelligence and memory is retained. The main symptoms are the formation of persistent apathy towards everything, the inadequacy of behavioral reactions, the manifestation of disorientation and psychosis.

The exacerbation of schizophrenic dementia occurs simultaneously with a sharp depression of the psycho-emotional state of the patient. With a paroxysm (peak) of the disease, a person begins to behave inappropriately and falls into complete helplessness.

How to recognize the disease

Dementia quietly and imperceptibly sneaks up on a person, without declaring itself at first. Symptoms of brain dementia begin to appear only after a sharp, visible deterioration in a person’s condition..

Relapse and obvious signs of the disease occur after some kind of nervous shock of a person (change of scenery, tragic event) or after the diagnosis and treatment of a somatic disease.

Initial signs of the disease

The very first and most pronounced common symptom of dementia is the loss of cognitive function in a person. At first, the patient ceases to desire something, becomes apathetic, and then ceases to try to learn something new.

The human brain, which constantly needs new experiences and discoveries, begins to atrophy. The first signs of the disease include other symptoms. Human:

• cannot remember recent events;
• quickly forgets everything that happened to him during the day;
• unable to remember simple telephone numbers;
• ceases to navigate, does not find the way home, does not remember the address and apartment number.

progressive dementia

With the gradual development of the disease, the personality retains only memories of firmly memorized data. A person forgets the names of loved ones, does not recognize them, cannot say where he worked, studied. Events and memories of personal life are also erased. Sometimes patients cannot remember the name and even recognize themselves in the mirror..

The disorder develops gradually, slowly erasing the habitual skills of the individual. A feature of the disease is the exacerbation of all inherent qualities of character and temperament:

• the thrifty becomes a gloomy miser;
• cheerful and good-natured turns into a fussy, always irritable person;
• a pedantic and obligatory person becomes a notorious, constantly dissatisfied egocentric.

A patient with dementia shows coldness towards all the once loved people, now he willingly goes to any conflict, sometimes provoking quarrels himself. As the disorder progresses, the personality shows more and more uncleanliness, slovenliness. Patients can drag into the house everything that they find in the garbage heap, start vagrancy.

The ability to think logically and adequately assess situations gradually fades away. Speech skills go out, grow thin vocabulary. Often patients stop communicating altogether. Severe delusional disorders, ridiculous desires, ideas come to replace them. Emotionally, there is depression, anxiety, cruelty, aggressiveness.

Disease in the last stage

Dementia in the last stage is marked by a strong increase in muscle tone, convulsive conditions are possible. Such symptoms gradually cause a persistent autonomic disorder that can lead to death. The patient becomes completely helpless, unable to even eat and relieve personal needs on his own.

How to treat pathology

For effective relief of the disease, treatment should begin as early as possible. The methods and tactics of therapy depend on many factors: the age of the patient, the presence of additional diseases, the type and type of disorder.

Dementia is an incurable disease. But in 10-15% of cases, the progression of dementia can be corrected and stopped.

There are no clear recommendations and ways of treating the disease. Each case of the disease is too individual. The main task of therapy is to stop the progression of the disease and relieve (mitigate) the accompanying symptoms. Treatment takes place in two stages:

1. Medical. The basis drug therapy taking drugs that inhibit the death of brain cells is laid. Medicines are selected that strengthen blood vessels and neural connections of the brain, normalize blood circulation and improve nervous processes.
2. Psychological. Patients with dementia are in great need of help and support from loved ones. Psychosocial adjustment is aimed at improving and restoring the patient's cognitive functions. Beneficial assistance in the general rehabilitation of a patient with dementia is made by the normalization of the mode of life (nutrition, sleep), music therapy, communication with animals.

An important question that worries the patient's relatives is how to make his life easier. For relatives of the patient, it is important to realize that dementia is a kind of behavioral model.. People around you need to tune in to optimistic interaction.

It depends on relatives whether the patient will keep contact with reality. To do this, you need to follow the following simple recommendations:

1. Give prompt hints.
2. Don't get irritated and learn to wait.
3. Talk to the patient in a loud and slow tone.
4. Communicate only in a positive mood.
5. Clearly and clearly formulate questions without complicating them.
6. Break down actions for the patient into a chain of subsequent simple steps.

How not to let the disease on the threshold

Is it possible to avoid a fatal disease? It is quite possible to prevent the onset of dementia. There is no need for rare medicines and some magical potions. Just learn and follow these helpful tips:

1. Give up smoking and alcohol abuse.
2. Organize and maintain peace of mind. Try to avoid stress and anxiety.
3. Do not self-medicate. Take medication strictly only as prescribed by your doctor.
4. Monitor your blood levels (sugar, cholesterol). Their pathological indicators directly affect the state of the brain.
5. Promote healthy circulation. Daily walks, moderate physical exercises, classes in the pool.
6. Get your diet in order. Include nuts, seafood, raw fruits and vegetables in your regular menu. Such food especially "loves" the brain.
7. Train your brain! Try to constantly increase the intellectual level, because dementia occurs as a result of prolonged “calmness” and weakening of brain functions. Crossword puzzles, complex puzzles, reading, going to theater performances and classical music concerts are an excellent help.

Such simple rules are an excellent "simulator" for brain activity and clarity of thought. By following the list of these recommendations, a person is guaranteed to remain sane and have a clear memory until old age.

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Alzheimer's dementia is a type of senile dementia. The condition develops against the background degenerative changes in the structure of the brain, leading to a gradual violation of the functionality of the organ, the disintegration of the personality. According to statistics, this form of dementia accounts for 60% of all registered cases of senile dementia. Years pass from the moment the first signs of organic problems appear to the development of a complete clinical picture. On average, a significant deterioration in the patient's quality of life occurs 8-10 years after the detection of a pre-dementia condition.

Dementia of the Alzheimer's type is one of the types of senile dementia, which develops against the background of degenerative changes in the structure of the brain, leading to the disintegration of the personality.

What is Alzheimer's dementia

The definition refers to a pathology that leads to the development of a special form of senile dementia. It occurs against the background of degenerative processes in the brain, characteristic of Alzheimer's disease. The patient has problems with the perception and processing of information, memory, control of emotions. The picture is complemented by obvious cognitive impairments. Usually, persistent symptoms occur in people over 65 years of age, but under the influence of a number of external and internal factors its early development is possible.

Mandatory signs of senile dementia of the Alzheimer's type:

• short-term memory suffers - problems with remembering recent events, dates, conversations, people;
• perception changes - the understanding of conversations addressed to the patient or simply going in the background is disturbed;
• memory for common events is dulled - the victim forgets the names of objects, hardly selects words, does not remember the names of loved ones and the dates of important events;
• speech disorders - a decrease in literacy, clarity of articulation, repetition of the same words or phrases due to the rapid forgetting of what has already been said;
• violation of the functions of reading and writing;
• mood swings, irritability, apathy, feeling restless;
• problems with orientation even in the usual habitat, poor coordination.

An obligatory sign of senile dementia of the Alzheimer's type are mood swings.

With all these disorders, the patient retains a clear consciousness, there are no signs of confusion. The victim is more comfortable alone, the company of other people, even the closest, gives him discomfort. The persistence of these signs for six months makes it possible to suspect dementia of the Alzheimer's type. The diagnostics carried out excludes the presence of other diseases that can provoke such a clinical picture.

How is dementia different from Alzheimer's disease?

Senile dementia is one of the clinical manifestations degenerative brain damage. For this reason, there are no differences between dementia and Alzheimer's disease, and it is not entirely correct to separate the concepts. Sometimes age-related pathology proceeds for a long time without obvious signs of personality change, but in any case they gradually increase. Alzheimer's disease and senile dementia are closely related. The main thing is to learn to distinguish them from other CNS lesions that follow a similar scenario.

The difference between Alzheimer's dementia and Pick's disease

Pick's disease is a very rare disease of the central nervous system, which is characterized by a chronic progressive course. It affects the cerebral cortex, leading to tissue destruction. Unlike Alzheimer's disease, this pathology manifests itself more malignantly and aggressively - the patient's life span rarely exceeds 5-7 years.

The main difference is the fact that memory impairments are not observed or they are minimal.

Even with Pick's disease, patients often experience hallucinations. Personality changes are pronounced already in the initial stages, and in Alzheimer's this manifests itself only in the later stages. They are accompanied by bouts of extreme excitement, aggression, foul language and even delirium.

Stages of dementia of the Alzheimer's type

Senile dementia in Alzheimer's develops gradually, passing through three stages, each of which is characterized by a special clinical picture. A correct assessment of the manifestations in 90% of cases leads to the correct diagnosis, an adequate assessment of the stage of the disease and the prognosis for the patient. For dementia in Alzheimer's disease with late and early onset, all common features are characteristic. The only difference is that in the first case, symptoms occur after 65 or even 75 years, and in the second - up to 65 years. With an early onset of pathology, the symptoms progress much faster than with a late one.

The only difference between dementia of the Alzheimer's type and Alzheimer's disease is that in the first case, symptoms occur after 65 or even 75 years, and in the second - up to 65 years.

Early stage

Symptoms are mild, but already attract the attention of the patient or others. Often they are detected by neurologists or doctors of a different profile during a person’s examination for a different reason, a physical examination. Personality changes are minor. Timely start complex therapy allows you to slow down the rate of spread of brain damage, slow down the development of pathology.

The clinical picture of the early stage of dementia in Alzheimer's:

• the appearance of problems with orientation in familiar terrain;
• repeating the same question several times, even if you receive an answer to it;
• the desire to constantly tell the same stories, retell the events already described before this;
• difficulties with solving simple mathematical problems, leading to problems in the financial sector. Already at an early stage of Alzheimer's, patients are unable to pay in the store, perform the usual banking operations;
• a decrease in the speed of performing simple household actions that were previously performed automatically;
• the inability to draw conclusions in some situation, to correctly assess the state of affairs, to summarize what has been read or heard;
• loss of interest in activities that used to be a great pleasure - work, hobbies, study, sports, care for pets or a garden plot;
• forgetting information related to everyday life. Victims are forced to keep a diary so that their schedule does not fail. Many experience constant problems due to the loss of small things.

The clinical picture of the early stage of dementia in Alzheimer's is to reduce the speed of performing simple household activities that were previously performed automatically.

Early manifestations of Alzheimer's disease do not turn a person into a disabled person, but already to an insignificant extent reduce the quality of his life. When working in a hazardous industry or the need to constantly manage transport, already at this stage it is worth thinking about changing the type of activity.

Moderate

Even with the most careful care and complex treatment Alzheimer's disease will progress. This will manifest itself in the exacerbation of basic clinical manifestations, the addition of new alarming signs, and the aggravation of domestic and social problems.

The period of transition from the initial stage averages from 5 to 10 years.

For moderate severity of dementia of the Alzheimer's type, the following symptoms are characteristic:

• short-term memory is significantly reduced. Sometimes the problem reaches such an extent that the patient cannot remember a sequence of 2-3 words;
• the ability to lead a normal life without outside help is lost due to the loss of basic skills. He forgets the rules for using household appliances, dishes, hygiene products. Often victims of dementia on the background of Alzheimer's disease stop recognizing ordinary things, forget their name, purpose;
• social ties are broken. The patient ceases to recognize relatives and friends;
• there are signs of apathy or depressive disorders. Sometimes patients become irritable, quick-tempered, aggressive;
• there are manifestations characteristic of confusion. Often, with dementia against the background of Alzheimer's, patients have crazy ideas, megalomania develops;
• performing any sequential actions causes difficulties even under the control of outsiders;
• frequent manifestations of hypersexuality, pathologically liberated behavior against the background of the disappearance of moral boundaries in the mind;
• eating disorders in the form of bulimia, complete refusal of food or certain food groups;
• "vagrancy syndrome", in which the patient leaves home, disappearing for several hours or days.

For moderate severity of dementia of the Alzheimer's type, it is characteristic that a person completely refuses food.

At this stage, the patient already needs constant external control. In its absence, the patient poses a danger to himself and others. If possible, it is recommended that a person with dementia on the background of Alzheimer's be given leeway that provides positive influence on his psyche.

Severe degree

The last stage of senile dementia as a result of a degenerative lesion of the brain. Often such a patient is not enough care from relatives, he needs the help of medical personnel.

Clinical manifestations of severe dementia in Alzheimer's disease:

• loss of the ability to speak coherently or pronounce at least individual words;
• severe or complete limitation of motor activity - the patient cannot leave the bed without assistance, eat or drink on his own;
• inability to control natural physiological processes - involuntary emptying Bladder, intestines;
• the development of paralysis, leading to the inability to swallow;
• weight loss;
• the appearance of rashes, suppuration, irritation on the skin;
• serious mental disorders;
• high risk of developing seizures;
• almost all the time the patient sleeps or is in a sleepy state.

Patients with severe dementia of the Alzheimer's type often die from complications associated with forced position. Sometimes they fall into a coma against the background of massive damage to the central nervous system, which ends in death.

Diagnostics

The diagnosis of dementia associated with Alzheimer's disease begins with a visit to a neurologist. The doctor collects a general and family history, conducts an examination, psychological and neuropsychological tests. Additionally, the specialist interviews relatives of the patient in order to assess the degree of damage to the central nervous system.

To confirm the preliminary diagnosis, the following approaches are used:

• MRI or CT;
• general and biochemical analyzes blood;
• blood for glucose levels, the presence of vitamins B9 and B12;
• EEG - to exclude other diagnoses at an early stage of dementia or to establish the degree of brain damage in subsequent ones;
• biochemical analysis of cerebrospinal fluid.

As an auxiliary approach, the study of genetic material for the presence of mutated genes is increasingly being used. Additionally check the functionality thyroid gland do an ECG to assess general condition patient.

Treatment

The principles and methods of therapy in each individual case are selected individually. They should be directed not only to the treatment of dementia of the Alzheimer's type, but also to the causes of its development - degenerative damage to nerve tissues. An integrated approach is based on taking medications that stimulate cerebral circulation and metabolism in the brain. It is complemented by physiotherapy, physiotherapy exercises, dietetics.

Additionally, measures are being taken to combat concomitant pathological factors - atherosclerosis, obesity, hypertension, diabetes mellitus, and depression. For general positive impact vitamins, antioxidants, homeopathic remedies are used on the body. In moderate and severe stages of Alzheimer's, pathogenetic drugs are used.

Like the underlying disease itself, Alzheimer's dementia is incurable. Timely initiation of treatment increases the patient's life, improves its quality indicators, facilitates the existence of the patient's relatives.

At a certain stage, even such actions cease to bring the desired result, due to which the personality of the victim completely changes, he literally ceases to be himself.

Dementia of the Alzheimer's type is senile dementia.

The phenomenon was first described by a doctor, by whose name the disease later got its name. They studied the brain of a patient with early signs senile dementia.

After the autopsy, it turned out that the brain cells were changed in a degenerative way.

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According to statistics, up to 60% of cases of organic dementia are associated with.

Dementia of the Alzheimer's type is characterized by a primary degenerative process in the work of neurons. Without timely and competent treatment, dementia leads to the complete disintegration of the personality.

Early-onset dementia of the Alzheimer's type occurs in people before the age of 65. If the disease occurs at the age of 70 years and older, then Alzheimer's type dementia with a late onset is diagnosed.

It has been established that an average of 10 years pass from the first signs of the disease to absolute senile dementia. At the same time, months and even years can pass from the onset of the disease to the appearance of the first mild symptoms.

Risk factors

A certain hierarchy has been deduced, according to which the risk factors for the occurrence of dementia of the Alzheimer's type are manifested:

• age limit of 80 years;
• hereditary factor associated with the presence of relatives suffering from a similar disease;
• hypertension;
• atherosclerosis;
• hypodynamia;
• diabetes mellitus of all types;
• obesity of varying degrees;
• chronic hypoxia;
• low degree of education, due to the underdevelopment of the intellectual sphere;
• women are more susceptible to the disease.

Each of the above factors may be key to the onset of Alzheimer's disease. If there is a combination of factors, then the risk increases significantly.

The reasons

The morphological basis of dementia is represented by severe organic lesion central nervous system. So, the cause of the disease can be any damage to the brain, resulting in the death of cells of the cerebral cortex.

Dementia can occur as a result of:

• lupus erythematosus;
• complications of hemodialysis;
• endocrine disorders;
• autoimmune failures

In the case of mixed dementia, several factors come into play.

Symptoms of Alzheimer's dementia

Signs of an obligate intravital disease:

• dementia syndrome;
• cognitive disorders associated with a violation of speech and mnemonic functions, a decrease in motor activity and the work of the intellectual sphere;
• the adaptive function with respect to social and professional ties decreases;
• the progressive nature of the disease, the course of which in the initial stage is almost imperceptible;
• exclusion of the relationship of symptoms with other mental disorders.

These symptoms contribute to the diagnosis with a 90% probability. An accurate conclusion is possible only after an autopsy and a detailed study of the patient's cerebral cortex.

stages

There are three stages in the development of the disease:

Diagnostics

A study using medical technology allows you to identify brain atrophy and its severity.

If necessary, and to eliminate possible doubts when making a diagnosis, the doctor may prescribe additional methods research:

• blood chemistry;
• blood test for folic acid and vitamin B12;
• study of thyroid function;
• determination of the composition of the liquor;
• identification of genetic disorders;
• pupillary response to the introduction of mydriatics.

The difficulty in making a diagnosis, as a rule, lies in the fact that many of the symptoms of Alzheimer's dementia are similar to other diseases. For this reason, other disorders are initially excluded, and only then they come to conclusions about the presence of Alzheimer's disease.

Treatment

The main goal of the treatment of Alzheimer's dementia is to reduce the severity of symptoms and slow the progression of the disease, stabilizing this process.

The effectiveness of treatment directly depends on how comorbidities that have a negative impact on dementia are treated:

• hypertension;
• atherosclerosis;
• obesity;
• diabetes.

Therapy of the disease should be comprehensive and include the following drugs:

• homeopathy;
• nootropic compounds;
• medicines that improve blood circulation;
• stimulants of the central nervous system;
• phosphatidylcholine, which activates the activity of mediators and cells of the cerebral cortex;
• actovegin, saturated with glucose and aimed at increasing the energy potential of the brain.

At the stage of extended manifestations in drug therapy include inhibitors. With their help, it is possible to increase the social adaptability of the patient.

The prognosis of the disease is unfavorable due to the fact that dementia of the Alzheimer's type is steadily progressing. As a result, a person becomes severely disabled and dies.

Prevention

So arranged by nature that with age human body consumes resources both physically and intellectually. Therefore, the main recommendations regarding dementia of the Alzheimer's type and its prevention are as follows:

• engaging in affordable sports, regular feasible physical activity;
• as a hobby, have a summer cottage, engage in crop or floriculture;
• free up time for travel;
• begin to study or consolidate existing skills in foreign languages;
• devote time to solving crossword puzzles;
• memorize songs and poems.

Preventive measures for the development of the physical and intellectual sphere are of paramount importance.

Dementia of the Alzheimer's type is a progressive disease. occurs quite often and the reason for this is age-related features. The risk group is people over 60 years of age.

Alzheimer's disease can be associated with other diseases, which is why timely treatment is so important. health care and an integrated approach to treatment.