Dementia

Dementia is a global disorder of intellect, memory and personality that significantly disrupts normal daily activities that occur after the development of cognitive functions (after the second year of life). The percentage of patients increases with age, 5% of the population suffers from dementia at the age of 65. Loss of cognitive functions interferes with all activities of the affected person.

• Chronological course of performance decline in an individual:

1. cognitive function affected;
2. behavioral and emotional impairment;
3. activities of daily living affected.

The clinical picture

• forgetfulness;
• spatial imagination and orientation disorder;
• wandering;
• disorders of executive functions (eg cookbooks forget how to cook, etc.);
• reduced intellectual performance;
• amnestic disorientation - a short-term memory disorder in which the sufferer does not remember where he or she is;

We also find dementia:

• emotional disorders ( anxiety , depression );
• behavioral disorders (aggression, restlessness);
• perceptual disorders ( hallucinations );
• sleep disorders ;
• disorders of cortical functions ;
• accessory symptoms - agraph , alexia , anuria , apraxia , agnosis .

Diagnosis

Orientation diagnostics:

• Mini-Mental State Examination (MMSE):

30–27 points – standard;

26–25 points – mild cognitive impairment;

24–10 points – mild to moderate dementia;

9–6 points – moderate to severe dementia;

5–0 points – severe dementia.

Dementia of atrophic-degenerative origin

Alzheimer's disease

Alzheimer's disease

{More detailed information can be found on the pag|M. Alzheimer, clinical picture, treatment}}

Cortical dementia with Lewy bodies

PSymptoms similar to Alzheimer's disease and Parkinson's disease . However, there are also Lewy bodies in the microscopic image.

Symptoms:

• a combination of dementia , parkinsonism and complex visual hallucinations is typical ;
• paranoid-persecution delusions ;
• hypersensitivity to antipsychotics - extrapyramidal manifestations worsen after them !;
• often delirium ;
• fluctuations during the day;
• deficit of attention (!), verbal function and orientation in space.

Dementia in Parkinson's disease

In 10-20% of Parkinson's patients, it has a subcortical character.

Symptoms:

• overall deceleration;
• slow thinking ( bradypsychism );
• difficult to remember new information.

Frontotemporal dementia

Progressive non-fluent aphasia

Left frontal cortex degeneration. Slow development of the disease.

Symptoms:

• have difficulty reading and writing text;
• inability to remember the right word;
• inability to form a grammatically correct sentence;
• truncates words into shapes that sound similar;
• behavioral disorders.

Fluent progressive aphasia

• semantic dementia.

Huntington's disease

AD inheritance, on chromosome 4 - CGA triplet. It starts in 3-5. decade.

Huntington disease (MRI)

Symptoms:

• initially neurological symptomatology - choreatic limb movements , rigidity;
• less pronounced subcortical dementia .

Progressive supranuclear palsy

= Steele-Richardson-Olszewski syndrome It belongs to Parkinson's type diseases.

Symptoms:

• the disabled can only move their eyes horizontally
• ends in death

Secondary (symptomatic) dementia

Other secondary dementia

Metabolic dementia

• dementia in hepatic encephalopathy;
• dementia in uremic encephalopathy;
• pellagra;
• Wilson's disease (hepatolenticular degeneration);
• acute intermittent porphyria .

Dementia intoxication

• Alcohol's most common, simple alcoholic dementia resembles Alzheimer' disease
• Pharmacogenicin which the cause of improper therapy, most are reversible, mainly anticholinergics, some benzodiazepines.
• carbon monoxide .
• drugs.

Traumatic dementia

• posttraumatic
  • extensive contusions;
  • apallic syndrome;
    • traumatic brain stem damage;;
    • failure of basic memory contents (alexia, agrafie)

Other

• dementia based on normotensive hydrocephalus ;
• tumors ( glioblastoma multiforme );
• collagenosis ( SLE ) and others.

Links

Related articles

• https://www.wikiskripta.eu/w/Demence_infek%C4%8Dn%C3%ADho_p%C5%AFvodu

Sources

• BENEŠ, Jiří. Studijní materiály [online]. [cit. 2009]. <http://jirben.wz.cz>.

Literature used

•  AMBLER, Zdeněk. Základy neurologie :  [učebnice pro lékařské fakulty]. 7. edition. Praha : Galén, c2011. ISBN 9788072627073.