From Medicineworld.org: Dementia
DementiaBy Kottapurath Kunjumoideen MD
Causes of Non-remediable dementias:
What symptoms does the patient with dementia have?
Initially there will be lack of interest in work. Forgetfulness is the earliest symptom. Patient can't remember the names properly. Difficulty in handling money and calculation becomes evident. The patient may repeatedly ask the same question, failing to retain the answers. Then he may no longer able to think about a problem or discuss about it. Unreasonable anger, easy crying and aggressiveness may be there. Frequent change in mood becomes evident. There will be difficulty in using a telephone, dressing or walking. The patient has difficulty in speaking. He substitutes words (paraphasia) and sometimes repeats the same sentences (echolalia). In later stages there will be difficulty in walking.
How do you diagnose dementia?
The history is the most important and must be taken from a reliable relative. The time when the symptoms started and how it started must be asked. Systemic diseases, history of trauma, surgery, psychiatric illness, alcohol abuse, exposure to occupational toxins should be ruled out. History of Urinary incontinence and gait disturbance should be asked.
Mini-mental state exam (MMSE) is the most widely used test to screen the cognitive impairment. Diagnosis is mainly based on clinical examination. Brain biopsy should be done for chronic conditions like slow virus disease. Patients with focal disease should undergo MRI and if there is a lesion in MRI, should undergo biopsy
Tests to be done are:
Optional tests include (done wherever necessary)
What are the treatments available for dementia?
Patients with remediable causes of dementia like hypothyroidism, normal pressure hydrocephalus, chronic subdural hematoma should be treated accordingly after consultation with the treating physician. For Alzheimer's disease drugs like rivastigmine are available which gives some improvement. Sedatives can be given for aggressiveness. Patient requires support from the family and friends. He should be taken care 24 hours because he may be disoriented and wander aimlessly.
Did you know?
Dementia is the loss of intellectual abilities like memory, judgment and abstract thinking previously attained, now which is severe enough to interfere with social or occupational functioning. Memory deficit is the most important feature of dementia. Language, calculating abilities, judgment of a situation, problem solving abilities are lost.
The contents of this web page are protected. Legal action may follow for reproduction of materials without permission.