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Dementia

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Abino David
Abino David

The document discusses dementia, amnesia, and delirium. It defines dementia as a global impairment of cognitive function affecting memory, visuospatial skills, language, concentration and attention. The most common causes of dementia are Alzheimer's disease and cerebral vascular disease. Delirium is distinguished from dementia by its acute onset, fluctuating course, and clouded consciousness.

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DEMENTIA
 75 year old Retd school teacher.  Memory loss- lost purse, searches for objects - 2 months.  Mental stressor – quarrel with son - 2 months.
AMNESIA  Amnesia is a deficit of memory, i.e., the storage or retrieval of consciously processed information.  Focal lesions in limbic structures.  Anterograde n retrograde amnesia
WHAT IS DEMENTIA?  Global impairment of cognitive function, memory affected in the early stages; visuospatial function, language ability, concentration and attention gets affected gradually.  Acquired and persistent impairment in multiple areas of intellectual function not due to delirium.
 Loss of mental functions.  Usually above 65 yrs  Most common cause- ALZHIEMER`S DISEASE and CEREBRAL VASCULAR DIEASE.
DSM 1V DEFINITION Multiple cognitive deficits memory impairment Aphasia, Apraxia, Agnosia, Disturbance in executive functioning.
CAUSES OF DEMENTIA  Vascular -diffuse small vessel disease  Deg/inherited - Alzheimer`s disease  Neoplastic - secondary deposits  Inflammatory -multiple sclerosis  Infective
 Traumatic -c/c subdural haematoma, post head injury  Toxic/nutritional-alcoholism  Hydrocephalus  Prion`s disease
REVERSIBLE VS IRREVERSIBLE  Reversible – can be corrected infection,SDH,B12 def hypothyroidism,neoplasm hydrocephalus  Irreversible –Alzhiemer`s disease Prion`s disease SSPE
CORTICAL VS SUBCORTICAL CORTICAL (AD) SUBCORTICAL (PD) Normal cognitive processing, Slowing, but correct wrong answers Severe amnesia, recall n Better recognition, improved by recognition affected clues Executive abilities preserved Disproportionately affected Aphasia prominent Normal with dysarthria n less word output Personality intact until late Apathetic n inert Mood normal, sometimes elated Depression
DELIRIUM  Disturbance in the level of consciousness.  Acute disorder of cognition characterized by fluctuating disturbance in attention.  Often reversible  Develops over a short period of time and tends to fluctuate during the course of the day.
DELIRIUM DEMENTIA  Onset - Acute/subacute insidious  Course- Fluctuating stable  Duration - Hrs to days Months to yrs  Consciousness -Clouded Clear  Attention - Impaired normal
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Dementia

  • 2. 75 year old Retd school teacher.  Memory loss- lost purse, searches for objects - 2 months.  Mental stressor – quarrel with son - 2 months.
  • 3. AMNESIA  Amnesia is a deficit of memory, i.e., the storage or retrieval of consciously processed information.  Focal lesions in limbic structures.  Anterograde n retrograde amnesia
  • 4. WHAT IS DEMENTIA?  Global impairment of cognitive function, memory affected in the early stages; visuospatial function, language ability, concentration and attention gets affected gradually.  Acquired and persistent impairment in multiple areas of intellectual function not due to delirium.
  • 5. Loss of mental functions.  Usually above 65 yrs  Most common cause- ALZHIEMER`S DISEASE and CEREBRAL VASCULAR DIEASE.
  • 6. DSM 1V DEFINITION Multiple cognitive deficits memory impairment Aphasia, Apraxia, Agnosia, Disturbance in executive functioning.
  • 7. CAUSES OF DEMENTIA  Vascular -diffuse small vessel disease  Deg/inherited - Alzheimer`s disease  Neoplastic - secondary deposits  Inflammatory -multiple sclerosis  Infective
  • 8. Traumatic -c/c subdural haematoma, post head injury  Toxic/nutritional-alcoholism  Hydrocephalus  Prion`s disease
  • 9. REVERSIBLE VS IRREVERSIBLE  Reversible – can be corrected infection,SDH,B12 def hypothyroidism,neoplasm hydrocephalus  Irreversible –Alzhiemer`s disease Prion`s disease SSPE
  • 10. CORTICAL VS SUBCORTICAL CORTICAL (AD) SUBCORTICAL (PD) Normal cognitive processing, Slowing, but correct wrong answers Severe amnesia, recall n Better recognition, improved by recognition affected clues Executive abilities preserved Disproportionately affected Aphasia prominent Normal with dysarthria n less word output Personality intact until late Apathetic n inert Mood normal, sometimes elated Depression
  • 11. DELIRIUM  Disturbance in the level of consciousness.  Acute disorder of cognition characterized by fluctuating disturbance in attention.  Often reversible  Develops over a short period of time and tends to fluctuate during the course of the day.
  • 12. DELIRIUM DEMENTIA  Onset - Acute/subacute insidious  Course- Fluctuating stable  Duration - Hrs to days Months to yrs  Consciousness -Clouded Clear  Attention - Impaired normal