Dementia syndrome Symptoms. Elder Dementia

Dementia is a persistent decrease in human cognitive activity, as well as the loss of previously learned knowledge and practical skills. It is also characterized by the impossibility of acquiring new knowledge. Disease Dementia is madness, expressed in the decay of mental functions, which occurs due to brain lesions. The disease should be differentiated from oligophrenia - congenital or acquired infant dementia, which is underdevelopment of the psyche.

WHO data is up to 35.6 million people with dementia. It is assumed that this figure will double by 2030, and by 2050 it will triple.

Demation reasons

Disease Dementia overtakes mostly older people. It may appear not only in old age, as well as in youth during injuries, inflammatory diseases brain, strokes, exposure to toxins. In the youth, the disease overcomes as a result of addictive behavior, expressed in a deviant desire to escape from reality through artificial change mental stateAnd in old age is manifested as a sedenie dementia.

Dementia acts as an independent phenomenon, and the sign, Parkinson's disease. Often, the dementia includes vascular changes passing in the brain. Dementia is certainly reflected in the human life, while changing the usual way as a patient and others.

The ethiology of dementia is very difficult to systematize, however, it is distinguished by vascular, degenerative, post-traumatic, old and some other types of disease.

Dementia symptoms

Before the disease, a person is quite adequate, knows how to produce logical, the simplest operations, serves itself independently. With the beginning of the development of the disease, these functions are completely or partially lost.

Early dementia is celebrated bad mood, welded, narrowing interest, as well as a horizon. Patients are peculiar, lethargy, cavity, misintermettility, lack of self-criticality, aggressiveness, malice, impulsiveness, irritability.

The symptoms of the disease are multifaceted and these are not only depressive states, but also violations of logic, speech, memory. Such changes are reflected in the professional activities of a person suffering from dementia. Often they leave work, need nurse and supervision from relatives. In case of disease, cognitive functions suffer. Sometimes the loss of short-term memory performs the only symptom. Symptoms exist in time intervals. They are divided into early, intermediate, late.

Behavioral and personal changes are developing at an early or late stage. Focal deficient syndromes or motors appear at various stages of the disease, it all depends on the type of dementia. Often early symptoms There are a vascular dementia and much later in Alzheimer's disease. Hallucinations, manic states, manifest themselves in 10% of patients. Frequency of convulsive seizures appears at all stages of the disease.

Signs of dementia

The first signs of the manifest stage are the progressive memory disorders, as well as the reaction of the individual on the cognitive deficit in the form of irritability, depression, impulsivity.

The patient's behavior is filled with regressiveness: frequent fees "on the road", slope, stereotype, rigidity (rigidity, hardness). In the future, memory disorders cease to be realized. Amnesia extends to all habitual actions, and patients stop shaving, wash, dress. Lastly, professional memory is violated.

Patients may complain about headaches, nausea, dizziness. The conversation with the patient reveals noticeable violations of attention, unstable fixation of the view, stereotypical movements. Sometimes a dementia disease manifests as amnesian disorientation. Patients leave home and cannot find it, forget the name, surname, year of birth, are unable to predict the consequences of actions. Disorientation is replaced by the safety of memory. The parietal or manifest acute course indicates the presence of a vascular component ().

The second stage includes amnistic disorders in the complex with the accession of such states as Akalkulia, Apraquession, Agrafy, Alexia, Afaja. Patients are confused by the left and right side, unable to call parts of the body. An autoagneosis appears, they do not recognize themselves in the mirror. The handwriting changes, as well as the nature of the painting. Rarely appear short-term episodes of psychosis and epileptic seizures. Muscle rigidity, stiffness, parkinsonic manifestations increase.

The third stage is Marantic. Muscular tone is often enhanced. Patients are in a state of vegetative coma.

Stage Dementia

Three stages of dementia are distinguished: light, moderate, heavy. For easy Stage Significant disorders of the intellectual sphere are characteristic, but the critical attitude of the patient to its own state is preserved. The patient can live independently, as well as perform household activities.

A moderate stage is observed by the presence of more coarse intellectual disorders and a decrease in the critical perception of the disease. Patients experience difficulties in the use of household appliances (washing machine, stove, TV), as well as door locks, telephone, latches.

Heavy dementia is characterized by the full defense of the person. Patients are unable to comply with the rules of hygiene, to make food independently. Severe dementia in an elderly person needs hourly observation.

Alzheimer's Dementation

Alzheimer's disease is celebrated by half of all patients with dementia. In women, the disease is distributed twice as often. Statistics have evidence that the diseases are subject to 5% of patients who have reached 65 years of age, there are data on cases of occurrence from 28 years, however, often dementia with Alzheimer's disease is manifested from 50 years. The disease is observed by protectivity: increasing negative and positive symptoms. Duration of the disease from 2 to 10 years.

Early dementia in Alzheimer's disease includes the defeat of temporal, parietal areas, as well as hypothalamic nuclei. Early stages are characterized by a kind of change of facial expressions, referred to as "Alzheimer's amazement". Visually, this is manifested in open eyes, in surprised facial expressions, in a rare flashing, in a bad orientation in an unfamiliar place. There are difficulties with the score and writing. In general, the success of social functioning is reduced.

Oligophrenia and Dementia

Oligophrenia is a persistent underdevelopment of complex forms of mental activities arising in the earliest stages of personality development due to the defeat of the Central nervous system. The disease is diagnosed from 1.5 - 2 years. And during the dementia there is an intelligent defect acquired after birth. It is diagnosed in 60-65 years. This is distinguished by these diseases.

Oligophrenia includes groups of persistent intellectual disorders, which are due to intrauterine underdevelopment of the brain, as well as a violation in the formation of early postnatal ontogenesis. Thus, it is a manifestation of early disconnection of the brain with underdevelopment frontal shares brain.

The main features are early deadlines The lesions of the central nervous system, as well as the predominance of the intellectual total insufficiency of abstract forms of thinking. Intelligent defect comes in combination with speech violations, motility, perception, memory, emotional sphere, attention, arbitrary forms of behavior. The underdevelopment of cognitive activity is noted in the insufficiency of the development of logical thinking, as well as in impaired inertia of generalization, mobility mental processes, comparison of phenomena and objects of surrounding significant features; In the impossibility of awareness of the figurative meaning of metaphor and proverbs.

Diagnosis of Dementia

The diagnosis is established in the presence of reduction in memory, control over the motives, emotions, reducing other cognitive functions, as well as confirmation of atrophy for EEG, CT or in neurological research.

Diagnosis of the disease is carried out under clarity of consciousness, in the absence, as well as in the absence of confusion and delicacy. The ICB-10 criterion makes it possible to be diagnosed when social deadaption is preserved up to six months and includes disorders of attention, thinking, memory.

Diagnostics of dementia includes intellectual-e-disorders, as well as skills disorders that are manifested in everyday life and at work. Clinical picture highlights various forms Dementia: partial dementia (dismissal), total dementia (diffuse), partial changes (lacunar). In the nature, the following types of dementia are distinguished: pseudoorganic, organic, post-pop, post-traumatic, etc.

Dementia is capable of being a manifestation of many diseases: peak and alzheimer diseases, vascular brain pathology, chronic exogenous and endogenous intoxication. The disease may also be a consequence of vascular brain pathology or general intoxication, degenerative brain damage or traumatic.

Dementia Treatment

The treatment of dementia includes the limited use of neuroleptics and tranquilizers due to the development of intoxication. Their application is effective in the period acute psychosis And only in minimal doses.

Cognitive deficit is eliminated by nootrops, cholinesterase inhibitors, megavitamin therapy (Vitamins B5, B2, B12, E). Tested drugs among cholinesterase inhibitors are tunner, rivastigmine, Donezil, Fizostigmin, Galanamin. Among the anti-parkinsonic drugs are most effective. Periodic therapy with insignificant doses of Cavinton (Sermion) and Angianovin affects the vascular disease. To means that affect the processes of long-term and short-term memory are related to somatotropin, oxytocin, prefimon.

Medicines for Dementia Risperidone (Risperdal) and ZaPakex (Olanzapine) can help patients cope with violations in behavior and psychosis.

Elderly dementia is treated only by specialists who prescribe medicines. Self-treatment is unacceptable. If the patient is no longer working, then it is important for him to communicate more often with relatives, and of course being busy love. This will help to move progressive phenomena. In the event of mental disorders, antidepressants are taken. Troubleshooting speech, memory, thinking processes We carry out those drugs like Arisept, Acatinol, Reminil, Exsenol, Neuromidin.

Dementia help includes high-quality palliative treatment, concentrated on personality, as well as specialized medical treatment. Palliative care aims to improve the quality of life of patients and facilitating the symptoms of the disease.

The disability during the dementia is medium, as well as severely given without specifying the period of re-examination. The patient is drawn up 1 group of disability.

Dementia - how to behave with a relative? First of all, it is positive to communicate with a sick relative. Talk only in polite, pleasant tone, but at the same time clearly and confident. Starting the conversation, attract the attention of the patient with his name. Always clear your thoughts clearly simple words. Speak always slowly, encouraging tone. Clearly ask simple questions requiring unambiguous answers: Yes, no. With complex issues - let's hint. Be patient with sick, let's think of him. If necessary, repeat the question. Try to help your relative remember a specific date, time, native names. It is very difficult to be understood. Do not react to reproaches, dins. Praise the patient, take care of the sequence of its routine of the day. Break up learning to any action by steps. Remember with sick old good times. This calms down. It is important full nutrition, drinking mode, regular movement.

Alas, in symptoms it last stage Dementia. My mom is in the same condition last weekLies for half a year. Today was a doctor, advised to give a sedative - mother-in-law and piracetam, attached, because The process is irreversible. Very hard and physically, and morally to watch, as the native man suffers.

Mom's permanent swearing - she is 90 years old and the door closes for 3 hours, and do not come out of the house, and another

one recipe does not happen. It is very hard when you have to hold a psychiatric examination of parents. But my practice has shown that there is no other way out. In 80 years, Mom stopped learning her husband, threw things from the balcony, refused to go home. I put forward the accusations that this is my husband, and not her and he threatens to kill her. Ultimately, she took her an ambulance from the street and she fell into psychiatric hospital. I was looking for several days. Unfortunately, such clinics do not give to the hands of patients of discharge, so I can not say anything, but for two years there is no attacks. The only one now every 40 days we go to the dispensary for sleeping pills. From other medicines, except arithon, it refuses. She has a problem due to frequent hypertensive crises.

Hello, I wanted to ask your advice too. My granny is 74 years old. She forgets what the conversation was about, if you interrupt it. I forget that I ate or what did. Constantly asks to take her home, although she is at home. It is because of this very upset and worries. There are attacks of depression. She constantly speaks of the same moments from the past. Some of them it recalls in a distorted form. Recently, she constantly loses things and accuses my sister in this. When I say that this is not the case, it is offended (reacts a bit aggressively). Granny walks badly, legs swell and blue, so maybe it is associated with vessels. What advise to take? What do doctors contact? Thanks in advance.

• Hello, Katerina. Your grandmother needs the help of a neurologist.

Hello. Please advise what to do. Mom was put in the hospital in intensive care, after a two-week stay, they are prescribed with a diagnosis of asthma. After the treatment, the mother goes badly, but this is not the main thing, the behavior has changed. Lost interest in life. Questions answers unequivocally: yes, no, anyway. I have already passed a week after discharge, my mother practically sleeps, and and my sister, too. Requests first to raise it, five minutes later put and so all the time. In the request, there are no sympathy. I do not know what could happen during your hospital stay, but at home we found black bruises in the abdomen and knee. Mama was not allowed to eat, they did not say that we were every day, and we were not allowed to go to the ward. Maybe on the background of stress, the disease is dementia, Mom 80 years old. The hospital was quite adequate, vital.

• Hello, Galina. For the development of dementia, any disease can serve as the degeneration and death of the cerebral cortex cells, including asthma in adulthood.

Good day! Mom is diagnosed with Alzheimer. She is 75 years old. Problems with memory for my observations were manifested 8 years ago. After the loss of the spouse and with forced temporary (due to repair) accommodation in another apartment. Now she has an average dementia dementia. The failures in memory (in time, in space), sometimes the complexity in the expression of thoughts, in handling the phone, television with a telephone, have problems with hearing. But the question in her desire to blame anyone in the fact that she "disappear" things, such as keys, wallet, clock, pills. She got taped with the fact that the documents are at my brother (she lives with him). The rest she panic is hiding, it loses. Brother nervous. My objections that this is her sick brain says so, and not she herself, he objects. Since her charges sound in periods of her calm condition and are not like nervous nonsense. He has a feeling that she says in a light mind. He is offended, annoyed and trying to find out with her relationship, reports it. He really is so many efforts to her tranquility and comfort, but in response unfair accusations. I can add that in the rest of the mother as "God's dandelion" kind quiet humble. But I am very afraid that the brother is not quite true estimating its condition, can provoke a faster deterioration of its condition. Are there any medical confirmations to my arguments? I would like to support mom and brother to help. But I do not know how.

• Natalia! I have recently been in confusion about the similar state of my mother. I live in another city, in the suburbs, it is 270 km from me, the Pope did not become in 2010. Lives alone and in last year The process goes on increasing. All as you describe, aggressiveness appeared, reproaches. I go to her every 12 -14 days for three to four days. I can not pick up yet, I live in a studio apartment with my husband. I do not know what to do. I am very sympathetic to your brother. He is worse than all. Even if he is patient and polite with her, his psyche will suffer. Mom will simply bring him to the handle, and the mother will not suffer from it, she lives in his illusory world. You do not scold him, he is really very hard. I call my mom every day not one time, and she finds me to reproach, although it was not so, like you. And when I live coming, I have in a tense condition, and constantly on control. Live with such patients - abnormally. I have a familiar psychiatrist, so he says that all psychiatrists with age, too, with a shift. And your brother is not a psychiatrist, but an ordinary person. I can not advise anything, myself shared my problem. I do not know what to do.

  • Yes, Marina, you are absolutely right, we live with my mother together, she has the same disease. This is true, real torture live with such a patient, albeit relatives, man. I already feel that I have a little more, and I have problems (except for a sick heart, dystonia and vessel problems). But what to do?

    • Hello all friends in misfortune ... I have the same problem with my mother, plus stroke, plus a foot fracture, and then only worse. What can I say: it is necessary to save yourself, to run as far as possible, change the apartment ... I do not know what else, otherwise you will be drunk. I am 40 years old, and I'm already ruins because of all this.

      • Valentine, well, tips you! "Run, to save, change the apartment." This is your mother in general! Which raised you and put the soul. And you on the garbage? How do you know that the old age will be with you. God forbid you health, of course. But there are such advice to write

        • Rita, you are right in that we have a debt to parents. But it is impossible to judge those who do not have enough strength. Not everyone can be sincerely with a prayer for God for help to contact. This is what the old man of Paisius Svyatogorets says about the parents: a certain layman said to the Starta: - The father, my parents are all hryuchut, and I barely pass it. What should I do? - Well, blessed, you, when I was in the cradle, the day and night of the honeycomb. They then took you on her arms and caressed gently and with love. Would you like to you if they were thinking to send you to any educational institution in order to relax them? True, God now gives you the opportunity to return - at least partially - the parents of the parents behavior, similar to the one that was once with them in relation to you, "the old man answered. Many people do not tolerate the tests, but complain. Some it applies even to parents. And what are the parents to blame? .... Make as much good for your grandparents and grandmothers! And most of all helps ... the greatest reciprocation, in my opinion, is spiritual our prosperity. When we succeed in spiritually, we help close to extremely. First, because they get the right to Divine help. Know if the person does not behave in spiritual, then spiritual laws will begin to act. And that's what happens: God will take His love from a lackless person to recover from him in this life what he should. One layman was complained by the elder on the difficulties he encountered in his family due to the grumble of his parents, because of the wives of his wife and the ugly behavior of children. The elder saw things somewhat differently: - God burns difficulties as a ruble for our disgrace in childhood. Lovely grandfather and grandmother (father and mother), but we have forgotten that they have been dissatisfied with us when we were small. We already do not remember how because of us they did not have time to sleep, nor relax, because They lived in constant troubles, taking care of us. Now, in turn, we must endure senile grinding and take care of parents with the same love that they surrounded us in our infancy. God finally gives us the opportunity to "repay" our children's grinding. And this is true. If we do not agree with this, we will find a great debtor.

Dementia - persistent violation of higher nervous activity, accompanied by the loss of acquired knowledge and skills and decline in learning ability. Currently, there are more than 35 million patients with dementia in the world. It develops as a result of brain lesions, against the background of which there is a marked decay of mental functions, which, in general, makes it possible to distinguish this disease from mental retardation, congenital or acquired form of dementia.

What kind of disease is why dementia occurs more often at an older age, as well as what symptoms and first signs are characteristic of it - let's look at further.

Dementia - What is this disease?

Dementia is madness, expressing in the decay of mental functions, which occurs because of the brain damage. The disease should be differentiated from oligophrenia - congenital or acquired infant dementia, which is underdevelopment of the psyche.

With dementia patients are not capable of awareness of what happens to themThe disease literally "erases" everything from their memory, which accumulated in it during the previous years of life.

Manifested by the demenation syndrome multifaceted. These are violations of speech, logic, memory, unfortunate depressive states. People suffering from dementia are forced to leave work because they need constant treatment and supervision. The disease changes the life of not only the patient, but also his loved ones.

Depending on the degree of illness, the symptoms and the patient's response is expressed in different ways:

• When dementia is a mild degree, it critically refers to his state and is able to take care of himself.
• With a moderate degree of lesion, there is a decrease in intelligence and difficulty in domestic behavior.
• Heavy dementia - what is it? The syndrome indicates a complete disintelligence of the person when an adult cannot even even sing and eat.

Classification

Taking into account the preemptive defeat of certain areas of the brain, there are four types of dementia:

1. Cork dementia. It suffers mostly bark of large hemispheres. There is observed in alcoholism, alzheimer's disease and peak disease (front and temporal dementia).
2. Subcounty dementia. Suffer subcortical structures. Accompanied by neurological impairment (trembling limbs, muscle stiffness, gait disorders, etc.). It occurs at, Huntington diseases and hemorrhages in a white substance.
3. Corto-subcortical dementia is a mixed type of lesion characteristic of pathology caused by vascular disorders.
4. Multifocal dementia is a pathology characterized by multiple foci of lesions in all departments of the central nervous system.

Elder Dementia

The senile (senile) Dementia (Dementia) is pronounced dementia, manifested at the age of 65 and older. The disease is most often caused by rapid atrophy of the cerebral cortex cells. First of all, the patient slows down the reaction rate, mental activity and worsen short-term memory.

Changes in psyche, developing with senile dementia, are associated with irreversible changes in the brain.

1. These changes occur at the cellular level, neurons die due to lack of food. This condition is called primary dementia.
2. If there is a disease, because of which the nervous system was injured, the disease is called secondary. Such diseases include Alzheimer's disease, genton disease, spastic pseudosclerosis (Crazfeld-Jacob's disease), etc.

Shenyl dementia, being among mental diseasesIs the disease most common among the elderly. Elder dementia in women is almost three times more often compared to the exposure to her men. In most cases, the age of patients is 65-75 years, on average in women the disease is developing in 75 years, in men - in 74 years.

Vascular dementia

Under the vascular dementia is a violation of thought acts, which is caused by the problems of blood circulation in the brain vessels. In this case, such disorders greatly affect the patient's lifestyle, its activity in society.

Such a form of the disease occurs, as a rule, after stroke or heart attack. Vascular dementia - what is it? This is a whole complex of signs that are characterized by a deterioration in the behavioral and mental abilities of a person after the lesion of the brain vessels. With mixed vascular dementia, the forecast is the most unfavorable, as it affects several pathological processes.

At the same time, as a rule, separately consider dementia developing after vascular disasters, such as:

• Hemorrhagic stroke (vessel break).
• (blockage of the vessel with the cessation or worsening of blood circulation in a specific area).

Most often vascular dementia arises and hypertensive disease, less likely - when hard sugar diabetes and some rheumatic diseases are even less likely - in embolism and thrombosis due to skeletal injuries, increasing blood clotting and peripheral veins diseases.

Patients of old age should control their main diseases that can cause dementia. These include:

• hypertension or hypotension,
• atherosclerosis,
• ischemia
• sugar diabetes, etc.

Dementia contributes to a sedentary lifestyle, lack of oxygen, destructive habits.

Dementia Alzheimer Type

The most common type of dementia. It refers to the organic dementia (a group of dementive syndromes developing against the background of organic changes in the brain, such as diseases of the brain vessels, cranial and brain injuries, senile or syphilitic psychosis).

In addition, this disease is pretty intertwined with the types of dementia with Levi Tales (syndrome, in which the death of the brain cells occurs due to the levie cells formed in neurons), having many common symptoms with them.

Dementia in children

Dementia development is associated with the influence on the body of a child of various factors that can cause disorders in the functioning of the brain. Sometimes the disease is present since the birth of the baby, but manifests itself as the child grows.

In children allocate:

• residual organic dementia
• progressive.

These species are separated depending on the nature of the pathogenetic mechanisms. Under meningitis, a residual-organic form may appear, it occurs with significant brain injuries, and the poisoning of the CNS by medicines.

The progressive type is considered an independent disease, which may be part of the structure of hereditary-degenerative defects and diseases of the central nervous system, as well as lesions of the brain vessels.

When dementia, a child can develop a depressive state. Most often, it is typical early stages of the disease. The progressive disease worsens the mental and physical abilities of children. If you do not work on a slowdown in the disease, the child may lose a significant part of the skills, including household.

With any type of dementia close, native and households follow With understanding, refer to the patient. After all, he is not to blame that it creates inadequate things sometime, it makes a disease. We yourself should think about preventive measuresSo that the disease in the future does not struck us.

The reasons

Already after 20 years, the human brain begins to lose nervous cells. Therefore, small problems with short-term memory for the elderly are quite normal. A person can forget where he put the keys from the car, what is the name of the person with whom he introduced a visit a month ago.

Such age-related changes Everyone happens. Usually they do not lead to problems in everyday life. With dementia, the disorder is much stronger.

The most common causes of dementia are:

• alzheimer's disease (up to 65% of all cases);
• damage to vessels caused by atherosclerosis, violation of circulation and blood properties;
• abuse of alcohol and drug addiction;
• parkinson's disease;
• peak disease;
• card and brain injuries;
• endocrine diseases (problems with thyroid gland, Cushing syndrome);
• autoimmune diseases ( multiple sclerosis, lupus erythematosus);
• infections (AIDS, chronic, encephalitis, etc.);
• diabetes;
• heavy Diseases internal organs;
• corollary complication of hemodialysis (blood purification),
• serious renal or liver failure.

In some cases, dementia is developing as a result of the impact of several reasons. The classic example of such pathology are senile (seenile) mixed dementia.

Risk factors include:

• age over 65 years;
• hypertension;
• elevated level lipids in the blood;
• obesity of any extent;
• lack of physical activity;
• lack of intellectual activity for a long time (from 3 years);
• low estrogen level (applies only to women's semi) and etc.

First signs

The first signs of dementia are the narrowing of the horizons and personal interests, the change in the nature of the patient. Patients develop aggression, malice, anxiety, apathy. A person becomes impulsive and irritable.

The first signs to which you need to pay attention to:

• The first symptom of the disease of any typology is a memory disorder that quickly progresses.
• The reaction of the individual on the surrounding validity becomes irritable, impulsive.
• The behavior of a person is filled with regression: rigidity (cruelty), stereotype, slope.
• Patients cease to wash and dress, professional memory is disturbed.

These symptoms rarely signal others about the impending disease, they are written off on the circumstances or on a bad mood.

Stages

In accordance with the possibilities of social adaptation of the patient, there are three dementia degrees. In cases where the disease that caused dementia has a steadily progressive course, often talk about the dementia stage.

Easy

The disease develops gradually, so patients and their relatives often do not notice his symptoms and do not appeal to the doctor.

For a light stage, significant disorders of the intellectual sphere are characteristic, but the critical attitude of the patient to its own state is preserved. The patient can live independently, as well as perform household activities.

Moderate

A moderate stage is observed by the presence of more coarse intellectual disorders and a decrease in the critical perception of the disease. Patients experience difficulties in the use of household appliances (washing machine, stove, TV), as well as door locks, telephone, latches.

Heavy dementia

At this stage, the patient almost completely depends on the close and needs constant care.

Symptoms:

• full loss of orientation in time and space;
• the patient is difficult to recognize relatives, friends;
• permanent care is required late stages The patient cannot have himself and perform the simplest hygienic procedures;
• improverage behavior, the patient may become aggressive.

Symptoms of dementia

For dementia, its manifestation is characterized simultaneously from many sides: changes occur in speech, memory, thinking, the patient's attention. These, as well as other functions of the body are violated relatively uniformly. 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 people not only loses the ability show earlier acquired skills, but also loses the opportunity Get new skills.

Symptoms:

1. Memory problems. Everything begins with forgetfulness: a person does not remember where he put one or another thing, what he had just said what was happening five minutes ago (fixing amnesia). At the same time, the patient remembers in all details what was many years ago, both in his life and in politics. And if something forgotten something, almost involuntarily begins to include fragments of fiction.
2. Thinking disorders. There is a slowdown in the tempo of thinking, as well as a decrease in the ability to logical thinking and abstraction. Patients lose the ability to generalize and solve problems. Their speech is a thorough and stereotypical character, its poorness is observed, and in the progression of the disease, it is not at all. Dementia is also characterized by the possible advent of delusional ideas in patients, often with ridiculous and primitive content.
3. Speech. First gets difficult to pick up needed words, then a "jam" can come on the same words. In later cases, it becomes intermittent, suggestions do not end. With a good hearing, it does not understand the speech facing it.

The characteristic cognitive disorders include:

• memory worsening, forgetfulness (most often, this is noticed by people close to patient);
• difficulty communication (for example, problems with the selection of words and definitions);
• obviously deterioration of the ability to solve logical tasks;
• problems with decision-making and planning of their actions (disorganization);
• coordination violations (gait, fall oats);
• disorders of motor functions (inaccuracy of movements);
• disorientation in space;
• violations of consciousness.

Psychological disorders:

• , depressed condition;
• unmotivated sense of anxiety or fear;
• personality changes;
• behavior unacceptable in society (constant or episodic);
• pathological arousal;
• paranoid nonsense (experience);
• hallucinations (visual, auditory, etc.).

Psychoses - hallucinations, manic states or - arise from about 10% of patients with dementia, although in a significant percentage of patients the emergence of these symptoms is temporary.

Diagnostics

Snapshot of the brain normally (left) and during dementia (right)

The manifestations of dementia treats a neurologist. Patients also advises a cardiologist. If severe occurs mental disordersThe help of a psychiatrist is required. Often such patients find themselves in psychiatric boarding schools.

The patient must go comprehensive examinationwhich includes:

• conversation with a psychologist and, if required, with a psychiatrist;
• demation tests (brief valuation scale mental status, "Fab", "BLD" and others) Electricencephalography
• tool diagnostics (blood tests for HIV, syphilis, hormone level thyroid gland; Electricencephalography, CT and MRI brain and others).

When diagnosing a diagnosis, the doctor takes into account that patients with dementia are very rarely adequate to assess their condition and are not inclined to celebrate their degradation of their own mind. Exception are only patients with dementia on early stages. Consequently, its own assessment of the patient of his condition can not be decisive for a specialist.

Treatment

How to treat dementia? Currently, most varieties of dementia are considered incurable. Nevertheless, therapeutic techniques have been developed that allow you to control a significant part of the manifestations of this disorder.

The disease completely changes the character of a person and his desire, so one of the main components of therapy is harmony in the family and in relation to loved ones. At any age, help and support is needed, sympathy for loved ones. If the situation around the patient is unfavorable, then to achieve any progress and improve the condition is very hard.

When appointing medicinal preparations Need to remember the rules that must be observed not to harm the health of the patient:

• All medicines have their own side effectsthat you need to consider.
• The patient will need help and control for regular and timely reception of medicines.
• The same drug can act differently at different stages, so therapy needs periodic correction.
• Many of the drugs can be dangerous if they are taken in large quantities.
• Separate drugs can be badly combined with each other.

Patients with dementia are low-chargeed, they are difficult to interest new to compensate somehow lost skills. It is important when treating to understand that this is an irreversible disease, that is, incurable. Therefore, there is a question about the adaptation of the patient for life, as well as high-quality care for it. Many are dedicated to a certain period of time to care for patients, looking for nurses, dismissed from work.

Forecast for people with dementia

Dementia usually has a progressive course. However, the pace (speed) of progression varies widely and depends on a number of reasons. Dementia shortens the expected lifespan, but the evaluation assessment varies.

Events providing security and providing relevant existence environment are extremely important in treatment, equally as a guardian help. Some drugs may be useful.

Prevention

In order to prevent the occurrence of this pathological condition, doctors recommend to engage in prevention. What will required for this?

• Follow healthy image Life.
• Refuse harmful habits: Smoking and alcohol.
• Control the level of cholesterol in the blood.
• Four feed.
• Control blood sugar levels.
• In a timely manner to treat arising ailments.
• To pay time to intelligent classes (reading, solidifying crosswords and so on).

This is all about dementia in the elderly: what is this disease, what is its main symptoms and signs of men and women, is there a treatment. Be healthy!

Dementia in medicine is called acquired dementia, which most often develops in the elderly people. Before her manifestation, a person is able to logically reflect, he has adequate behavior, it is served independently. In the process of the disease, the patient completely or partially loses all listed skills. Dementia is not congenital pathology, it has nothing to do with the dementia of children.

About the disease

Dementia has different reasons occurrence and is represented by the disorder of the functioning of the brain.

It is manifested by constant memory loss and a decrease in trainee, can lead to a complete personal decay. In this disease, a person is lost all knowledge, the acquisition of new skills is given with great difficulty.

The disease is most often susceptible to older people over 60 years old. There are cases of its occurrence in a younger age, which is caused by the disease characterized by a head injury, the hardest intoxication of the body. In this case, the dementia develops as a result of the death of brain cells. Moreover, the disease is characterized by its swiftness leading to death.

The dementia states exclusively the doctor only when symptoms are accompanied by half a year. This period is necessary to assess the resistance of the state. Typically, the patient suffers from scattering, forgetfulness, he is not able to make domestic skills familiar to him.

When dementia in the started position, it is not even able to care for itself. Dementia is prone to versatility, most often the logic, speech, memory, the person manifests an unfortunate depression. First, pathology becomes noticeable only to the nearest surrounding, after a while is obvious to all. The disease dramatically changes the life of not only the patient, but also his loved ones. Pathology can be vascular and elder.

The most important factor in preventing the early progression of the disease is the timely detection of initial symptoms, which allows the diagnosis earlier, which contributes to the beginning of adequate therapy.

Dementia has different symptoms Based on the reasons that cause it. However, signs allowing to determine the pathology at an early stage of development, similar to themselves. To suspect the development of dementia by the following clinical picture:

Often, early signs of dementia are accepted for chronic fatigue, the consequences of frequent stress, trouble. Based on which the diagnosis of dementia is rather difficult. Usually, such a clinical picture is manifested in the people of old age, those who have suffered a stroke, heart attack, cranial injury. The following pathological changes should be the greatest caution:

Even the first signs of dementia have a negative impact on the quality of human vital activity. Over time, weakness is only complicated, sometimes the patient does not feel either thirst or hunger.

Women's Dementia

Medical statistics argue that women are most predisposed to the emergence of the disease rather than a man, which contributes to the neurological and endocrine complex. There are some reasons for this, among which the leading place is given:

Since the initially men's and women's psyche differ significantly to each other, then there are serious differences in the clinic. More wounded women's psyche sometimes does not allow to detect the initial symptoms of pathology.

Emotional instability, sharp mood changes, a tendency to federation, euphoric states can be written off on the traits of a female character. However, these features are also the initial symptoms of women's dementia. At the later stages there is an inability of logical thinking, the loss of household skills, which leads to the complication of life close. Women acquire suspicion, stubbornness, they refuse to assist, show aggression.

Male manifestation

Men often develop vascular dementia, usually manifested in the age period from 60 to 75 years.

This pathology is formed due to impaired blood circulation, which is caused by damage to brain cells. The dementia of vascular nature develops in the presence of diseases of the head vessels. Medicine makes it possible to detect pathology on reduced metabolic indicators with an elevated lipid level.

As a result of damage, nervous cells suffer, which when lacking nutrients Dish. A minor time the patient's body copes with compensation, then the potential is depleted and negative changes affecting speech, memory, thinking. Often, male dementia is accompanied by weakened limbs, the difference between reflexes between the limbs of the right and left side. Men with a given disease suffer from a screaming gait, instability, dizziness. Male dementia is inherent in the following signs:

Dementia manifestations leads to complete loss of skills and intellectual degradation. At this stage, it is impossible to stop the course of the disease, if the closest clinical picture will notice in the man, it is possible to suspend the ray of the disease. The first features include:

• reduced horizons;
• change of character;
• the patient becomes more greedy;
• aggressiveness;
• malice;
• impulsiveness;
• the patient seems to freeze when selecting the necessary word;
• irritability.

Many of these features are written off on the mood of a person who has developed circumstances, however, they say about the impending misfortune.

Symptoms of senile dementia

Elder Dementia is equally manifested as male populationAnd female. The clinical picture of the disease varies from the degree of pathology:

Dementia is a rather severe disease that cannot be treated. Only appeal to primary symptoms It is capable of suspending the progression of pathology for a while.

- This is a slowly developing reduction in mental abilities, in which impaired thinking, memory, ability to teach and concentrate attention occurs. In addition, the dementia is possible personality changes. Sometimes, dementia may occur immediately, if due to the disease, injury or impact toxic substance Cerebral cells die. Usually, the disease develops gradually and begins to manifest people over 60 years old. As the changes in the brain are aging, leading to a certain reduction in short-term memory and learning abilities from most people. Forgetfulness in old age is not necessarily a sign of dementia. If a healthy people Elderly sometimes forget the details, the patients with dementia can absolutely do not remember the recent events.

Vascular dementia

Vascular dementia arises due to the lesion of brain tissues, causing violations of the cerebral circulation. Various vascular diseases: atherosclerosis, arterial hypertension, Ischemia of brain vessels - can cause vascular dementia. Often the cause of the disease becomes a cyst, resulting from the myocardial infarction. Risk factors are diabetes, cardiac pathologies, elevated level of lipids in the blood - hyperlipidemia. The symptom of vascular dementia is a sharp decrease in cerebral circulation. As a rule, the demention of vascular type is diagnosed in the elderly aged 60-75 years, one and a half times more often in men than in women and is half of all dementia cases.

Mechanism for the development of vascular dementia

With damage to the vessels in separate parts of the brain, the nerve cells do not get the oxygen and nutrients necessary for their normal operation, which leads to their death. For a while, the brain is coping with compensation of occurring violations, and they do not appear externally. But when the potential is exhausted, negative changes begin to influence the memory state, speech and thinking. Against the background of these cognitive disorders, the behavior of the patient is changing, and its independence is reduced.

Symptoms of vascular dementia

Usually the diagnosis "Vascular dementia" is put if cognitive impairment preceded an episode of stroke. Often accompanying signs are the symptoms of focal brain lesions: for example, the weakening of the force of the finiteness (hemiparesis), the differences in the reflexes of the left and right finiteness, the appearance of the pathological reflex of Babinsky. Characteristic sign The vascular dementia is considered to be walking - a slow, screaming gait and instability (often the patients themselves are confused and dizziness, complaining of loved ones).

The reason for vascular dementia is a circulatory disorders in the brain. These violations, as well as infarction associated with them (cell death), can occur in various parts of the brain. Therefore, the symptoms of the dementia of vascular type are significantly varied in each individual case. We will list only the most typical.

Dementia caused by the damage to the middle brain is manifested by mezencephalotlamic syndrome. The first of its manifestations is the episodes of confusion, hallucinations. Then the person loses interest in various sides of the daily life, closes in itself, ceases to take care of his appearance, negleces personal hygiene. His psychophysical state is usually characterized by an increase of drowsiness. In some cases, it is noticeable.

The symptom of the dementia caused by the lesion of the hippocampus is taken to be primarily a violation of the ability to keep information about current events in memory (remote memories can be saved).

The infarction in the prefrontal departments of the frontal fraction leads to the general apathy of the patient (apatico-abuliac syndrome). The patient behaves inadequately, not aware of this. It repeats repeats either his own words and deions, or words and deyrences around them.

When localizing violations in subcortical zones, arbitrary activity suffers: the patient is difficult to concentrate on one object or maintain a long time in the same activity; There are problems with planning activities, many things remain unfinished. Another symptom is a violation of information analysis skills, the separation of the main one from the secondary.

Of the stable markers of vascular dementia, we also note the violation of urination observed almost in all patients.

Vascular dementia is manifested not only in cognitive, but also in the emotional sphere. A general reduction in mood, emotional confusity, depression - all this symptoms of the dementia of vascular genesis. The patient decreases self-esteem, loses confidence in itself, the pessimistic forecasts begin to prevail.

Elder Dementia

Elder Dementia (Shenyl Dementia, Shenyl dementia) is a disease that begins in old age and manifests itself a little by the increasing dementia, memory disorder in the type of progressive amnesia leading to the decay of mental activities. Among the psychic diseases developing in the elderly people, senile dementia is the most frequent - 12-35% of all cases of mental illness. Elder dementia is 2-3 times more often in women than men. Most often, the disease progresses between 65-76.

Symptoms of senile dementia

Easy dementia

It begins to forget the current or recent events, but it perfectly remembers everything that has been long. May forget the date, the name, surname, the name of something. Forgets where a subject put. The houses are well oriented well, but in an unfamiliar atmosphere can be confused. Feeling difficulties in solving complex intellectual tasks, financial issues. Appears, negligence.

The man becomes grilling, categorical, greedy. The interest in their hobbies is gradually lost, but new, for example, gathering unnecessary objects (tramp) appear.

Criticism persists, a person feels inconvenience because of his misses, so it closes, narrows the circle of communication. Despite this, the interlocutor can not notice anything: speech, faithful, emotionality is preserved, "beautiful memory" admires; Small inaccuracies remain unnoticed.

Moderate dementia

Forgetfulness turns into the loss of large memory layers. Old man Does not remember the rules for the use of household appliances, it cannot figure out how to open the lock key. Confused in the names of loved ones, their age and degree of kinship. Does not recognize yourself in the mirror. Criticism is almost absent, often ignores personal hygiene, although it is still able to serve himself. Needs constant control and care.

Heavy dementia

Characterized complete loss of memory, orientation in place and time, practical skills. Does not control the pelvic functions, independently does not eat, holds all the time in bed. Need constant care.

Causes of Dementia

Since the main factor in the occurrence of the disease is the heavy organic lesion of the central nervous system, the cause of dementia may be any disease, as a result of which the cells of the cerebral cortex die. Diseases in which the defeat of the central nervous system is the main pathogenetic mechanism is Alzheimer's disease, peak disease, dementia with Levis. In other cases, the death of the cortex of the head central nervous system is secondary and is a complication of the main disease: infection, chronic vascular pathology, injury, systemic lesion of nervous tissue or intoxication.

The main cause of the secondary organic brain lesion leading to the dementia is such vascular disorders as hypertensive disease and atherosclerosis of the brain vessels. Other reasons for the dementia are cranopy and brain injuries, alcoholism, brain tumors, neurosifilis, AIDS, chronic meningitis and viral encephalitis. In addition, dementia may arise due to the complication of hemodialysis, with complications of severe hepatic and renal failure, with severe autoimmune diseases: scarm sclerosis and systemic red lupus, as well as with some endocrine disorders.

Types of dementia

Depending on the localization of the organic defect distinguish four types of dementia:

• Cork dementia - damage to the cortex of large hemispheres of the brain, which is characteristic of alcohol Dementia, Alzheimer's diseases and peak disease.
• Subcounty dementia is the defeat of subcortical structures, specific, for example, for Parkinson's disease.
• Corko-subcortex dementia is a mixed type of lesion, which is typical for pathology caused by vascular disorders.
• Multifocal dementia is a pathology, which is characterized by multiple foci of lesions in all departments of the central nervous system.

Symptoms of dementia

As a rule, the disease develops slowly, so in the initial stages it is impossible to identify dementia. The memory is gradually deteriorating, the ability to recognize places, people and objects. A person becomes difficult to think abstractly and select the necessary words. Frequent symptom Dementia becomes personality changes. The first symptom of dementia caused by Alzheimer's disease is forgetting recent events. Sometimes the disease begins with fears, depression, concern, apathy and other personality changes. Another symptom of dementia is changing speech - a person begins to use words incorrectly or cannot find the necessary words. With the development of the disease, the patient gradually loses the ability to fully communicate with people.

Different people dementia progresses at different speeds. Dementia associated with AIDS is steadily developing for several months or years, and Creitzfeldt's disease - Jacob leads to severe dementia during the year. In the most difficult cases, dementia leads to full disorders of the brain functions. Patients are immersed in themselves and lose the ability to control their behavior. There are sharp change of mood, unmotivated emotional outbreaks. A person can wander without any purpose. We gradually sick dementia are deprived of the ability to maintain a conversation and stop talking.

Treatment of dementia

As a rule, dementia is incurable. In Alzheimer's disease, it sometimes helps a drug distempezyl, which can slow down the development of the disease. Similar effect can have ibuprofen. Dementia, which is caused by repeated micropholes, incurable, but its development can be slowed down, and sometimes even stopped as a result of treating diabetes or elevated arterial pressure. For the treatment of dementia caused by AIDS or Kreitzfeldt - Jacob's disease, until funds are found. If the memory loss is caused by depression, the recommendations of the psychotherapist and the reception of antidepressants can help. In order to weaken emotional outbreaks and excitation that are often accompanied by severe dementia, neuroleptic preparations are often used, for example, haloperidol and sonaches.

Although dementia is a chronic disease and intellectual ability to restore it is impossible, a good effect is given supporting measures. For example, navigate the patient's time can help big hours and calendars. Stable and simple routine of the day, realistic expectations of the surrounding, preserving self-esteem and self-esteem, slow down the development of the disease and can even bring some improvement. Since Dementia progresses, the future should be planned, which requires united efforts to patronage workers, nurses, doctor and family members.

A familiar environment helps the patient. Moving to new house, Moreover, in another city, the change of furniture or simply repairs can have a destructive impact on the patient's psyche. Regular treatment of food, walks, sleep gives a sick feeling of stability. In addition, periodic meetings with familiar people are needed. It is impossible to punish or scold a person suffering from dementia, as this worsens its condition and leads to an increase in the manifestations of the disease.

Questions and answers on the topic "Dementia"

Question: How to be if there are suspicions at the beginning of the dementia close manBut the doctor does not find anything. After all, one thing is to see a patient for 20 minutes at the reception, and the other - to live with him next to and see how problems with your head appear.

Answer: Recognize the symptoms of the upcoming dementia (especially so far insignificant disorders) is really difficult. But do not exclude another opportunity. Older people have worse work over the years, the thinking slows down. This is customary to consider signs of normal aging of the body, and not symptoms of the disease. If the husband's condition really causes you anxiety and you think that it does not get the necessary treatment, try to talk to the head of the department about the possibility of consultation with another doctor or find out about therapeutic establishments, where the husband will be able to undergo a survey. In any case, before contacting the doctor again (besides or another), try to keep a diary for some time, noting the nature of the deviations, the frequency of their manifestation, as well as the situations in which they arise. Perhaps it will help the doctor put a more accurate diagnosis.

Question: What could be the minimum age for the manifestation of dementia?

Answer: In the special literature on the study of the elder dementia, the age of 65 is most often found. It is believed that the symptoms of this disease are more often manifested after 65 years. Although in some cases there is a place and early development This disease. The first insignificant and unobistant, at first glance, the symptoms can arise long before the development of the main symptoms. It is possible to detect them for 6-8 years before the manifestation of the main, already obvious problems with the consciousness and behavior of the patient.

Question: Whether the Tablets "Actovegin" will help with dementia. If you help, how?

Answer: A little will slow down the development of dementia, but no more. They improve the absorption of the brain of nutrients and oxygen, but they themselves understand that the brain affected by old age does not update.

Question: Hello. My mom is 89 years old. Until recently, she, despite age, was in full memory and reason. But recently (2 weeks ago) she had a pinching of a sedlication nerve, were strong pain In the lower back and leg, she almost did not sleep at night. Now the pain has almost passed (we gave her Kathetonal and melaxics). But during the illness, her psyche disorders appeared - she badly recognizes relatives, forgets where it is located, etc. Does the elder dementary develop so suddenly (for 7-10 days)? Are these changes are irreversible? What can be done?

Answer: So suddenly the vascular dementia (dementia) can develop. You should see the psychiatrist and neurologist as soon as possible.

Question: We have a problem with my mother. Age 79 years. Sick diabetes for 15 years. Drinking a big number of medicines. All. With age, obsessive phobias are developing (then someone stealing meat from the refrigerator, the books disappear, things disappear, the father of the father of jealousy, hysterics and scandals) disappear. Invents different stories. That he was beaten, she fell. All the vigorous. It doesn't want to go to the psychiatrist, says - I'm not crazy. Tell me how to help her. Surely there are preparations to help in such situations.

Answer: Hello. Unfortunately, no one can cure your mother, but you can relieve your fate. You can visit to a psychiatrist. To do this, you need to explain my mother that it is not a mad, of course, but the brain of people has the property of the age and this process can and need to slow down significantly. Ask your mother wants to grow old? Medicines who are needed by your mom, for the most part, can be bought only by recipes. And these recipes can be written from the psychiatrist.

Question: Among my relatives were patients with elder dementia. What is the likelihood of the development of mental disorder with me? What is the prevention of senile dementia? Are there any medicines able to prevent the disease?

Answer: Elder dementia relate to diseases with hereditary predisposition, this is especially true of Alzheimer's disease and Dementia with Levy Tales. The risk of developing the disease increases if senile dementia in relatives developed in relatively early age (up to 60-65 years). However, it should be remembered that hereditary predisposition is only the presence of conditions for the development of a particular disease, therefore, even an extremely unfavorable family history is not a sentence. Unfortunately, today there is no consensus on the possibility of specific medicinal prevention of the development of this pathology. Since the risk factors for the development of senile dementia are known, measures to prevent mental disorders, first of all, are aimed at eliminating them, and include: prevention and timely treatment of diseases leading to blood circulation disorders in the brain and hypoxia (hypertension, atherosclerosis, diabetes mellitus) ; dosage physical exercise; Permanent activities of intellectual activity (crosswords can be made, solve puzzles, etc.); refusal of smoking and alcohol; Prevention of obesity.

Question: Unexpectedly appeared untidiness - is it the first sign of senile dementia? Are there any symptoms such as untidiness and slurry?

Answer: Suddenly appeared slope and uncertainty are the symptoms of disorders of the emotional-volitional sphere. These signs are very nonspecific, and are found in many pathologies, such as: deep depression, expressed asthenia (depletion) of the nervous system, psychotic disorders (for example, apathy in schizophrenia), of various kinds of dependence (alcoholism, drug addiction), etc. At the same time, patients with dementia in the early stages of the disease can be quite independent and neat in the habitual home apparatus. Razdiness can be the first sign of dementia only in the case when the development of dementia already in the early stages is accompanied by depression, the depletion of the nervous system or psychotic disorders. This kind of debut is more characteristic of vascular and mixed dementia.

Question: How does dementia flow in children? What is the difference between children's dementia and oligophrenia?

Answer: For the designation of children's dementia, the term is consumed " mental retardation", or oligophrenia. This name is preserved when the patient reaches the age of majority, and this is true, since the dementia that arose in adulthood (For example, post-traumatic dementia) and oligophrenia proceed in different ways. In the first case, we are talking about the degradation of an already formed personality, in the second - about underdevelopment.

- acquired dementia due to organic brain damage. It may be a consequence of a single disease or carry polyethic character (senile or senile dementia). Develops in vascular diseases, alzheimer's disease, injuries, brain neoplasms, alcoholism, drug addiction, CNS infections and some other diseases. Sustainable intelligence disorders, affective disorders and reduction of volitional qualities are observed. The diagnosis is established on the basis of clinical criteria and tool Research (CT, MRI brain). Treatment is carried out etiological form Dementia.

General

Dementia is a persistent violation of higher nervous activity, accompanied by the loss of acquired knowledge and skills and a decrease in learning ability. Currently, there are more than 35 million patients with dementia in the world. The prevalence of the disease increases with age. According to statistics, severe dementia is detected in 5%, light - in 16% of people over 65 years old. Doctors suggest that in the future the number of patients will grow. This is due to an increase in the life expectancy and an improvement in the quality of medical care, which allows to prevent the fatal outcome even with severe injuries and diseases of the brain.

In most cases, it is irreversible acquired by dementism, therefore, the most important task of physicians is the timely diagnosis and treatment of diseases that can cause dementia, as well as the stabilization of the pathological process in patients with already acquired dementia. Dementia treatment is carried out by specialists in the field of psychiatry in cooperation with neurologists, cardiologists and doctors of other specialties.

Causes of Dementia Dementia

Dementia occurs during organic lesions of the brain as a result of injury or illness. Currently allocate more than 200 pathological conditionscapable of provoking the development of dementia. The most common cause of acquired dementia is Alzheimer's disease, its share accounts for 60-70% of the total dementia cases. In second place (about 20%) there are vascular dementia due to hypertensive disease, atherosclerosis and other similar diseases. In patients suffering from senile (seenile) dementia, several diseases provoking acquired by dementia are often revealed.

In young and middle age, dementia may be observed in alcoholism, drug addiction, brain injuries, benign or malignant neoplasms. Some patients acquired dementia is detected at infectious diseases: AIDS, neurosifilis, chronic meningitis or viral encephalitis. Sometimes dementia develops with severe internal organs, endocrine pathology and autoimmune diseases.

Classification of dementia

Taking into account the preemptive defeat of certain areas of the brain, there are four types of dementia:

• Corkdementia. It suffers mostly bark of large hemispheres. There is observed in alcoholism, alzheimer's disease and peak disease (front and temporal dementia).
• Subcorteurdementia. Suffer subcortical structures. Accompanied by neurological impairment (trembling limbs, muscle stiffness, gait disorders, etc.). It occurs during Parkinson's disease, Huntington disease and hemorrhages in a white substance.
• Corko-subcorter Dementia. It is affected by both the bark and subcortical structures. Observed with vascular pathology.
• Multifocal Dementia. In various parts of the century, multiple areas of necrosis and degeneration are formed. Neurological disorders are very diverse and depend on the localization of lesion foci.

Depending on the volume of the lesion, two forms of dementia are distinguished: total and lacunar. With lacunar dementia, structures responsible for certain types of intellectual activity suffer. A leading role in the clinical picture is usually played by short-term memory disorders. Patients forget where they are that planned to do, which agreed on just a few minutes ago. Criticism to its state is preserved, emotional and volitional disorders are poorly pronounced. Signs of asthenia can be detected: tear, emotional instability. Lacooner dementia is observed in many diseases, including initial stage Alzheimer's diseases.

With total dementia there is a gradual decay of the individual. Intellect decreases, learning abilities are lost, the emotional-volitional sphere suffers. The circle of interest is narrowed, shame disappears, becoming insignificant former moral and moral norms. Total dementia develops with volumetric formations and circulatory disorders in frontal fractions.

The high prevalence of dementia in the elderly led to the creation of a classification of sedenie dementia:

• Atrophic (Alzheimerovsky) Type - Provoked primary degeneration of brain neurons.
• Vascular type - The defeat of nerve cells occurs in the second time, due to violations of blood supply to the brain in vascular pathology.
• Mixed type - Mixed dementia - is a combination of atrophic and vascular dementia.

Symptoms of dementia

Clinical manifestations of dementia are determined by the cause of acquired dementia, the size and localization of the affected area. Taking into account the severity of symptoms and patient's abilities to social adaptation, three stages of dementia are distinguished. When dementia is a mild, the patient remains critical to what is happening and to its own state. It saves self-service abilities (can wash, cook, clean the cleaning, wash dishes).

When dementia, a moderate degree of criticism to its state is partially broken. When communicating with patients, a clearly explicit reduction in intelligence. The patient with difficulty serves itself, is difficult when using household appliances and mechanisms: can not respond to the phone call, open or close the door. Need care and care. A severe dementia is accompanied by a complete collapse of the person. The patient can not get dressed, wash, take food or go to the toilet. Permanent observation required.

Clinical Dementia Variants

Dementia Alzheimer Type

Alzheimer's disease was described in 1906 by the German psychiatrist Alois Alzheimer. Until 1977, this diagnosis was exhibited only in cases of early dementia (at the age of 45-65), and with the appearance of symptoms over the age of 65, senile dementia was diagnosed. It was then established that pathogenesis and clinical manifestations Diseases are the same regardless of age. Currently, the diagnosis of Alzheimer's disease is exhibited regardless of the appearance of the first clinical signs acquired dementia. The risk factors include age, the presence of relatives suffering from this disease, atherosclerosis, hypertensive disease, excess weight, diabetes, low motor activity, chronic hypoxia, brain injuries and lack of mental activity throughout life. Women are sick more often.

The first symptom becomes a pronounced violation of short-term memory while preserving criticism to its own state. Subsequently, memory disorder is exacerbated, while there is a "movement back in time" - the patient will first forget the recent events, then what happened in the past. The patient ceases to recognize his children, takes them for long deceased relatives, does not know what he did it in the morning, but it can tell about the events of his childhood in detail, as if they had happened quite recently. At the site of lost memories may occur confabulation. Criticism decreases to its state.

In the deployed stage of Alzheimer's disease, the clinical picture is complemented by emotional-volitional disorders. Patients become grumpy and non-expectant, often demonstrate dissatisfaction with the words and actions of others, annoying from any little things. Subsequently, it is possible that nonsense damage. Patients claim that closely commercially leaving them in dangerous situations, poke the poison in food to poison and take possession of the apartment, they talk about them to spoil the reputation and leave without only members of the family, not only members of the family are involved in the delusional system. But the neighbors, social workers and other people interacting with patients. Other behavioral disorders can be revealed: vagrancy, irrelevant and inadvertent in food and in sex, meaningless disorderly actions (for example, shifting items from place to place). The speech simplifies and impoverished, paraphase arises (the use of other words instead of forgotten).

At the final stage of Alzheimer's disease, nonsense and violation of behavior are leveled due to a pronounced reduction in intellect. Patients become passive, sedentary. Disappears the need for fluid and food. We are practically completely lost. As the disease exacerbates, the ability to chew food and independent walking is gradually lost. Because of the complete helplessness, patients need constant professional care. The lethal exodus occurs as a result of typical complications (pneumonia, bastards, etc.) or the progression of concomitant somatic pathology.

The diagnosis of Alzheimer's disease is exhibited on the basis of clinical symptoms. Treatment is symptomatic. At present, there are no drugs and non-good methods capable of cured patients with Alzheimer's disease. Dementia is steadily progressing and ends with a full decay of mental functions. The average life expectancy after the diagnosis is less than 7 years. The sooner the first symptoms appeared, the faster the dementia is exacerbated.

Vascular dementia

There are two types of vascular dementia - arising after stroke and developed as a result of chronic insufficiency of blood supply to the brain. With post-thessy-acquired dementia in the clinical picture, focal disorders (violations of speech, paresis and paralysis) are usually prevalent. The nature of neurological disorders depends on the localization and size of hemorrhage or a section with impaired blood supply, the quality of treatment in the first hours after stroke and some other factors. With chronic violations of blood supply, the symptoms of dementia are dominated, and neurological symptoms are sufficiently disposable and expressed less brightly.

Most often, vascular dementia occurs during atherosclerosis and hypertension, less often - with severe diabetes mellitus and some rheumatic diseases, even less often - in embolism and thrombosis due to skeletal injuries, increasing blood coagulation and peripheral veins diseases. The probability of the development of acquired dementia increases in disease of cardio-vascular system, smoking and unnecessary weight.

The first sign of the disease becomes difficulty when trying to focus, scattered attention, fast fatigue, some rigidity of mental activity, planning difficulties and reduced ability to analyze. Memory disorders are less dramatically expressed than with Alzheimer's disease. There is some forgetfulness, but with a "push" in the form of a leading issue or a sentence of several options for a response of a patient without difficulty recalls the necessary information. Many patients have emotional instability, the mood is reduced, depression and subdepression are possible.

Neurological disorders include dysarthria, dysphony, gait changes (sharpening, decrease in the length of the step, "sticking" soles to the surface), slowing down movements, cruise of gesticulation and facial expressions. The diagnosis is exhibited on the basis of clinical picture, USDG and MRA brain vessels and other studies. To assess the severity of the main pathology and the preparation of the pathogenetic therapy scheme, patients are sent to consultation to the relevant specialists: therapist, endocrinologist, cardiologist, phlebologist. Treatment - symptomatic therapy, therapy of the main disease. The rate of development of dementia is determined by the peculiarities of the flow of leading pathology.

Alcohol Dementia

The cause of alcohol dementia becomes a long (within 15 or more) abuse of alcoholic beverages. Along with the direct destructive influence of alcohol on brain cell, the development of dementia is due to violation of the activities of various organs and systems, rude exchange disorders and vascular pathology. For alcohol dementia, typical identity changes are characteristic of the loss of moral values, social degradation) in combination with a total decrease in mental abilities (scattered attention, reduction of ability to analyze, planning and abstract thinking, memory disorders).

After a complete abandonment of alcohol and treating alcoholism, partial recovery is possible, however, such cases are very rare. Due to the pronounced pathological thrust to alcohol, a decrease in the volitional qualities and the lack of motivation, most patients fail to stop the reception of ethanol-containing fluids. The prognosis is unfavorable, the cause of death is usually the somatic diseases due to alcohol consumption. Often such patients dying as a result of criminal incidents or accidents.

Diagnosis of Dementia

Diagnosis "Dementia" is exhibited in the presence of five mandatory signs. The first is a memory disorders that are detected on the basis of a conversation with a patient, a special study and a survey of relatives. The second is at least one symptom, indicating the organic lesion of the brain. Among these symptoms - "Three A" syndrome: Afaja (speech violations), apraxia (loss of ability to target actions while maintaining the ability to commit elementary motor acts), agnosia (perception disorders, loss of the ability to recognize words, people and objects while saving touch , hearing and vision); Reducing criticism to its own state and surrounding reality; Personal disorders (unfortunate aggressiveness, rudeness, lack of shame).

The third diagnostic sign of dementia is a violation of family and social adaptation. The fourth is the lack of symptoms characteristic of delirium (orientation loss in place and time, visual hallucinations and nonsense). Fifth - the presence of an organic defect confirmed by instrumental research data (CT and MRI brain). Diagnosis "Dementia" is exhibited only if there are all listed features for six months or more.

Dementia most often has to be differentiated with depressive pseudo-degeneration and functional pseudo-degenerations resulting from avitaminosis. In case of suspected depressive disorder, the psychiatrist takes into account the severity and nature of affective disorders, the presence or absence of daily fluctuations in the mood and the sensation of "painful insension". In suspected Avitaminosis, the doctor studies history (defective nutrition, severe intestinal lesions with long-term diarrhea) and eliminates the symptoms characteristic of a shortage of certain vitamins (anemia for lack of folic acid, polyneuritis with a lack of thiamine, etc.).

Forecast during dementia

The prognosis for dementia is determined by the main disease. With acquired dementia, which arose as a result of accelera and brain injuries or volumetric processes (, hematomas), the process does not progress. It is often observed partial, less often - the total reduction of symptoms caused by the compensatory capabilities of the brain. In the acute period, predict the degree of recovery is very difficult, the outcome of extensive damage can be a good compensation with conservation of workability, and the outcome of a small damage is a severe demention with disability disabilities and vice versa.

With dementia due to progressive diseases, there is a steady aggravation of symptoms. Doctors can only slow down the process by carrying out adequate treatment of the main pathology. The main tasks of therapy in such cases are the preservation of self-service skills and ability to adapt, extending life, ensuring proper care and elimination of unpleasant manifestations of the disease. Death occurs as a result of a serious violation of the vital functions associated with the immobility of the patient, its inability to elementary self-service and the development of complications characteristic of lying patients.