1. Symptoms: gradually worsening (months to years) loss in memory and related cognitive functions
    1. Neurocognitive: cognitive problems in a number of areas, ranging from impaired memory and learning to deficits in language and abstract thinking; final stages: intellectual and motor functions may disappear almost completely
    2. Memory and Language:
      1. Retrograde amnesia: loss of memory for events prior to the onset of the illness or the experience of a traumatic event; late stage dementia
      2. Anterograde amnesia: inability to learn or remember new material after a particular point in time; early stage dementia
    3. Verbal Communication: sometimes subtle; may remain verbally fluent until very advanced; retain vocabulary skills and can construct grammatical sentence, but have trouble finding words and naming objects
      1. Aphasia: describes carious types of loss or impairment in language that are caused by brain damage
      2. Apraxia: difficulty performing purposeful movements in response to verbal commands
    4. Perception: problems identifying stimuli- such as visual, auditory or tactile sensations- in their environments (agnosia), but sensory functions are unimpaired
    5. Abstract thinking: bound to concrete interpretations
    6. Judgement/Social Behavior: failure of social judgement and problem solving skills
    7. Personality/Emotion: personality changes, emotional difficulties, and motivational problems; not part of diagnostic criteria; Hallucinations/delusions in at least 20% of dementia cases; may appear apathetic/emotionally flat; faces are less expressive; indifferent to surroundings; depression
    8. Motor behavior: may become agitated, pacing restlessly, or wandering away from familiar surroundings; Late stages may have problems with muscle control from the central nervous system
  2. Diagnosis: measurement of cognitive disorder; more precise from a neuropsychologist; testing may measure sensorimotor, perceptual, and speech functions; may instead use more focused tests towards specific impairments; may have patient copy a drawing
  3. Course and Outcome: downward projector overtime; lifetime disorder
  4. Frequency of Disorder: no obvious differences between prevalence in men and women; dementia in men is more likely to result from vascular disease or secondary to other medical conditions or alcohol abuse
    1. Ages 65 to 69: 1% have dementia
    2. Ages 75 to 79: 6% have dementia
    3. Age 90 and over: 40% have dementia
  5. Etiology: genetic; neurotransmitters: process of chemical transmissions within the brain is disrupted; Viral Infections; Immune system dysfunction; environmental factors
  6. Treatment(s):
    1. Medications: relieve cognitive symptoms by boosting the action of acetylcholine (Ach)
    2. Environmental/Behavioral Management: structured, daily schedule; use of signs and notes for early stage; in late stage tasks such as getting dressed need to be broken down into simple manageable steps;
      1. Knowledge of the environment: clearly labeled rooms and halls
      2. Negotiability: common rooms and dining area should be visible from patients room
      3. Safety and health: secure, but let patient remain active

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