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Dementias

Definition:

  • Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember, affecting a person’s daily functioning.

Types:

  1. Alzheimer’s Disease (AD):
    • Most common type.
    • Characterized by beta-amyloid plaques and neurofibrillary tangles in the brain.
    • Symptoms: Memory loss, disorientation, mood and behavior changes, confusion about events, time and place.
  2. Vascular Dementia:
    • Caused by conditions that block or reduce blood flow to the brain, leading to brain damage.
    • Symptoms: Impaired judgment or ability to make decisions, plan, or organize.
  3. Lewy Body Dementia (LBD):
    • Involves abnormal deposits of a protein called alpha-synuclein in the brain.
    • Symptoms: Visual hallucinations, sleep disturbances, parkinsonian movement features.
  4. Frontotemporal Dementia:
    • Affects the frontal and temporal lobes of the brain.
    • Symptoms: Changes in personality and behavior, difficulty with language.

Etiology:

  • The exact cause is often unknown.
  • Risk factors: Age, family history, genetics, lifestyle and heart health.

Diagnosis:

  • Comprehensive assessment including medical history, physical and neurological exams.
  • Cognitive and neuropsychological tests.
  • Brain scans (CT, MRI) to rule out other conditions.
  • Biomarkers can also be helpful, especially in AD.

Management:

  • No cure; treatment focuses on managing symptoms.
  • Medications: Cholinesterase inhibitors and memantine for AD, medications to address other symptoms like sleep disturbances, agitation, etc.
  • Non-pharmacological approaches: Cognitive stimulation, occupational therapy, modifying the environment to improve safety and ease caregiver burden.

Prognosis:

  • Progressive and irreversible decline in mental function.
  • Life expectancy varies depending on type and age of onset.

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