Dementia

Abstract Dementia describes a group of symptoms that are caused by changes in the brains function. Dementia can be classified as many different symptoms. With dementia patients there are two types that are most common, with Alzheimer’s being at the top, and Multi-infarct Dementia also known as vascular dementia. Dementia What exactly is Dementia' Dementia can be defined as the loss of mental functions. The meaning of dementia is “deprived of ones mind” and is a very serious cognitive disorder. Some of these mental functions can be severe enough to interfere with day to day activities. Dementia is not a disease like Alzheimer’s or Parkinson’s, but rather a group of symptoms that are caused by various conditions or group. Dementia symptoms can include changes in personality, behavior and mood. Dementia symptoms also affect the intellectual, social and mental skills that also hinder day to day activities. People with dementia have trouble functioning in familiar places; they are unable to follow simple directions, as well as being disoriented to people, time and place. Some cases of dementia are treatable and curable because the symptoms that cause these are known as pseudo-dementia. . Dementia can be mistaken for other illnesses or mental instabilities. These symptoms can arise from substance abuse, prescription drug abuse, vitamin or hormone imbalances as well as severe depression. These are all treatable and curable types of dementia. Dementia is not a specific disease, but rather a group of symptoms that are caused by changes that occur in the brain. Dementia can also be defined as a group of symptoms that affect intellectual social and mental health skills, which hinder day to day activities. People with dementia have trouble functioning in familiar places, unable to follow simple directions, as well as being disoriented to people, time and place. Dementia is an organic brain syndrome which results in cognitive impairments, and can occur as a result of a variety of neurological diseases. Dementia has a clear clinical picture that is similar to delirium. Delirium is an acute transitory disorder, where as dementia is a long term progressive disorder. The most well known is Alzheimer’s disease (AD), Multi-Infarct dementia (MID), and Huntington’s disease (HD). The clinical scenario of dementia is very similar to delirium. There are stages throughout dementia that have cognitive deterioration that is observed. Most of this paper will placed with information on Alzheimer’s disease as it is the most significant dementing disease, striking over 50% of demented patients today, as well as Multi-Infarct dementia and Huntington’s disease. Alzheimer’s disease was named after Dr. Alois Alzheimer. This doctor discovered in 1906 changes in the brain tissue of a lady who had died of an unusual mental illness. Unpredictable behavior, language changes and memory loss were her symptoms. When Dr. Alzheimer examined her brain, he found many abnormal clumps called amyloidal plaques, as well as tangled fiber bunches called neuro-fibrillary tangles. These are the two main features in Alzheimer’s disease. The last connection of AD is the loss of connections between neurons in the brain. It is said that damage to the brain is usually 10 to 20 years before any problems are seen. Tangles develop deep in the brain, in an area called entorhinal cortex, the plaque forms in other areas. Scientists are still conducting studies to learn more about tangles, plaques and other features of AD. Scientist suspect that genetics play a role in AD, in which it is caused by a number of different gene mutations on chromosomes 21, 14, and 1, with each of these mutations causing abnormal proteins to be formed (NIH, 2009). If only ne of these mutated genes is inherited from a parent, a person is always likely to develop early onset of AD. Alzheimer’s disease affects 5.4 million people a year; usually this disease appears after the age of 60. There are different stages to Alzheimer’s disease; mild, moderate and severe. In the mild stages memory loss, speed of dependent daily activities, mood and personality changes take place. The moderate stages starts to impair language, reasoning and conscious thought. Confusion and memory loss begin to increase, reorganization of family and friends begin as well, there may also be bizarre word phrases or even paraphrasing. Those with AD in this stage maybe unable to learn new things carry out tasks or even handle new situations. The severe stage also known as the final stage, as the plaques and tangles have spread throughout the brain, brain tissue has shrunk a lot as well. This causes complete loss of communication and they become completely dependent on others for their care, over time the body shuts down as they are now completely bed ridden. There are approximately 5.3 million people right now in the U.S. that are living with Alzheimer’s disease. Fact show that someone develops AD about every 70 seconds, and Alzheimer’s is the seventh-leading cause of death in the United States. Having an early diagnosis can be beneficial because treatment in the early stages can help preserve functions for months or years. The early diagnosis also helps families plan for the future, as well as get those with AD into clinical trials. To date there are only four medications that the Food and Drug Administration (FDA) have approved to slow the Alzheimer’s diseases process. Neuoroimaging techniques are becoming more and more standard, while allowing in some instances for a more accurate diagnosis. Over the last fifteen years scientists have witnessed a substantial growth in genetically based research. There is not any one gender that differ in rates for dementia or Alzheimer’s disease as a whole. Multi-Infarct Dementia (MID) is common in the elderly with memory loss. Unlike AD, MID is caused by multiple strokes. These strokes cause the disruption of blood flow to the brain, which in turn leads to damaged brain tissue. MID is the most common form of vascular dementia. The symptoms of MID are close to those of AD, including memory loss as an early sign, followed by impaired judgment. These symptoms often progress to delirium, hallucinations and mood changes (Kantor 2006). There is no treatment available to reverse the brain damage that has been caused by a stroke. Much of the research being done is focused on better ways to prevent, treat and ultimately cure the vascular dementias. Diagnosis for those with MID is poor. Symptoms may begin suddenly, although some with MID improve over short periods of time. MID affects 4 out of 10,000 people, with 10-20% of all dementia’s caused by strokes. MID is found more in men than women, and affects people between the ages of 55-75. Death from MID may occur from heart disease, Pneumonia or strokes. Huntington’s disease (HD) is not like AD or MID. It results from degeneration of brain cells, in certain parts of the brain. The functions that are lost are uncontrolled movements, loss of intellect and emotional disturbances. None of which are similar to AD or MID. HD is passed on from parent to child through mutation of normal genes. HD will stop if the gene is not passed on to the child. Some symptoms are similar to AD and MID, such as mood swings, depression, and difficulty learning new things, remembering and making decisions. As the HD moves forward concentration on tasks become difficult, and a person may have eating and swallowing difficulty. Signs and symptoms of HD usually appear in middle age people. The younger population with HD usually have a more severe case and their symptoms may progress much quicker (Mayo, 2009). Through the course of HD, a jerking uncontrollable movement of limbs, trunk and face occur and there are psychiatric problems that can occur as well. Juvenile HD develops before the age of 20, with rapid progress and produces muscle rigidness in which there is little movement by the patient. There is a 50% chance of a child inheriting HD from the parent. It is estimated that one in every 10,000 people, roughly 30,000 people in the United States have Huntington’s disease. All races and ethnic groups as well as both sexes are affected. There is no treatment for HD. There is however treatment in reducing symptoms and preventing complications. HD usually takes 10 to 30 years to run its full terminal course. Bed ridden patients usually in the final stages often die from complications of Pneumonia and heart failure, as with patients that have Alzheimer’s or Multi-Infarct Dementia. There is an ethical duty by health care professionals to protect life and help rid the suffering, but the stressors have led to breakdowns in the process of applying normal principals to the care of dementia patients. This recurring battle between application and responsibility can give behavior problems, especially in the care of the demented. These can lead to complications by accompanying psychiatric disturbances which in turn increase care-giver burden. References National Institute of Neurological Disorders and Stroke (2009). NINDS Multi-Infarct Dementia Information Page. Retrieved 8/20/2009 from: www.hinds.nih.gov/disorders/mulit_infarct_dementia.htm Jasmin, L. (2008). Multi-Infarct Dementia. Retrieved 8/19/2009 from: www.nlm.nih.gov/medlineplus/ency/article/00746.htm Kantor, D. (2006). 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