Symptoms: gradually worsening (months to years) loss in memory and related cognitive functions
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
Memory and Language:
Retrograde amnesia: loss of memory for events prior to the onset of the illness or the experience of a traumatic event; late stage dementia
Anterograde amnesia: inability to learn or remember new material after a particular point in time; early stage dementia
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
Aphasia: describes carious types of loss or impairment in language that are caused by brain damage
Apraxia: difficulty performing purposeful movements in response to verbal commands
Perception: problems identifying stimuli- such as visual, auditory or tactile sensations- in their environments (agnosia), but sensory functions are unimpaired
Abstract thinking: bound to concrete interpretations
Judgement/Social Behavior: failure of social judgement and problem solving skills
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
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
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
Course and Outcome: downward projector overtime; lifetime disorder
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
Ages 65 to 69: 1% have dementia
Ages 75 to 79: 6% have dementia
Age 90 and over: 40% have dementia
Etiology: genetic; neurotransmitters: process of chemical transmissions within the brain is disrupted; Viral Infections; Immune system dysfunction; environmental factors
Treatment(s):
Medications: relieve cognitive symptoms by boosting the action of acetylcholine (Ach)
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;
Knowledge of the environment: clearly labeled rooms and halls
Negotiability: common rooms and dining area should be visible from patients room
Safety and health: secure, but let patient remain active
