dementia (including Alzheimer's disease)

Definition

Dementia is a syndrome that affect intelligence, memory, personality and følelsesliv. Dementia may occur in association with other diseases and disappearing here as a rule again, when the underlying condition treated. Most of the dementia, however, because the disease, and it is gradual.

Dementia evolves over several years, where the hit is increasing forgetfulness, confusion and change personality. Even simple things at home can be difficult to perform, and more and more care and support from the environment becomes necessary.

Dementia framework mostly elderly people, 6% of people over 65 years, and 20% of people over 85 years suffer from the disease. However, it is very important to remember that the vast majority of older people are mentally functioning. Many older people are anxious to develop dementia when they forget things, but a slight weakening of short-term memory is quite normal when you come up in years. Although the risk of dementia increases with age, affects the disease also younger. This is called pre-senile dementia and is almost always the type Alzh

Causes and zoning

There are many causes of dementia. You can arrange dementia after, on the condition can be treated (reversible causes) or not (sunk reasons).

Reversible causes of dementia

Vitamin deficiencies. This is usually a lack of vitamin B12.
Depressionin the elderly can give the same symptoms as dementia. Confusion, forgetfulness and emotional fluctuations are examples of this. Depression can be treated, and it is therefore important to distinguish between the two modes.
Bleeding under the hard meningeseasily occurs in the elderly by even minor blow to the head, and may resemble the onset of dementia.
Infection. A blærebetændelse or pneumonia may cause confusion and forgetfulness, especially if the elderly are also dehydrated. Also inflammation of the brain or AIDS may cause dementia.
Medicine. For large doses of medicine, especially the kind that affects the nervous system, can give symptoms of dementia.
Alcohol. Alcohol can both provide a state of confusion and lethargy, reminiscent of dementia, but who ends by alcohol-stop. It can also provide real dementia (see later).
Low blood sugar. This and other metabolic problems, for example. myxødem, can provide a stupor state, reminiscent of dementia.
Brain Tumor. Again, the symptoms may resemble dementia, but if the tumor can be removed, the state in many cases improved.

Actually dementia, where the weakening of memory and intelligence are the main problem, can also be divided into several types. The four most commonly mentioned here:

Alzheimer's disease. This disease represents 60-80% of dementia cases in Denmark and is also the kind seen in younger people. A few cases are hereditary. There are deposits of a particular protein (beta-amyloid), mild reduction in brain size (atrophy) and torsion of nerve fibers. Yet we are not exactly what these findings are of the onset to do, and there is still much research in this area.
Vascular dementia. This type of dementia caused by many small blood clots in the brain, which often have been too small for that person has tagged them. Eventually, there will be such a big part of the brain that no longer works, that symptoms of dementia arise. The mechanism of and reasons for the small lesions are the same as for stroke and TCI.
Borborygmus. Here is hovedsymptomet not dementia, but after some years of disease duration will symptoms of dementia (Lewy body dementia) occur.
Other forms of dementia. There are many other and rarer forms of dementia, of which the commonest is fronto-temporal dementia. In addition, the Wernicke-Korsakoffs syndrome (caused by alcohol) and Creutzfeldt-Jakob disease (rare infection with symptoms of mad cow disease in humans) are often included in this category.

Symptoms of dementia

The first symptom of dementia are usually weakened short-term memory. We forget what has happened to hours or minutes ago, but has no trouble remembering what has happened years ago. This may be the only symptom for a long time, and it is perhaps the only affected themselves, who are aware that something has changed. That lesson may be hard, and there will in the first phase of dementia have a lot of frustration and sadness and some will develop depression. Since this can worsen the symptoms of the

After some time, the surroundings may notice that the more hotheaded and irritable, have easier to tears or does initiativløs and scattered. Emotions and personality changed too, and the dementia may lose social and sexual inhibitions to great discomfort of the surroundings. This is due to the influence of brain frontallap and may be more or less pronounced, depending on the type of dementia.

Fatigue is a dominant symptom, and together with the reduced ability to concentrate may lead to the abandonment of its leisure and its social life gradually. Even television and books are difficult to handle, then missed the action from time to time. Finally, even daily activities as cooking and personal hygiene is not performed.

There are many dangers associated with living alone who contradicted. In addition to meals and personal hygiene skipped, lit candles may be forgotten, the stove be left switched on, etc. You should as relatives upstream pay attention to switch to home care, so that can get the necessary support.

In the final phase of dementia are almost all functions affected. The speech is incoherent, the victims' movements are clumsy or completely inhibited, and we are unable to fend for themselves. As a rule, the affected end to nursing homes in need of care around the clock. However, there are very big difference in how long it takes for the disease is advanced. The time from disease onset to the final stage can last more than a decade.

Precautions and diagnosis

Do we have the suspicion that they themselves or relatives have dementia, you should contact your doctor. The doctor will perform a test, usually MMSE (mini-mental state examination). This is a test where his mental abilities are tested, and you get a very accurate indication of whether there is something wrong. Also made a scan of the brain, where the typical change can be seen. In addition, take a wide range of blood tests to rule out other conditions that may cause symptoms of dementia (see below years

Treatment of dementia

For vascular dementia, treatment is blood thinners. It is important to try to find the cause of blood stoppers, for example. forsnævnet be a neck artery or forkammerflimmer.

In Alzheimer's disease can-acetylcholine esterase inhibitors improved symptoms similar to postpone the disease with 6-12 months you can not stop the development of the disease.

By borborygmus treated all the symptoms with medication, as described in Parkinson's disease.

Much of the treatment will be occupational therapy, home help, support and care from relatives in order to reduce the loss of function of the affected and postponing the need for nursing homes as long as possible.

Preventing dementia

Vascular dementia caused by small blood clots mentioned and may therefore to some extent prevented in the same way as other blood clot diseases.
Ie growers ample exercise and avoiding smoking, fatty diets and obesity. This leads to high blood pressure and the risk of blood clots (see also Atherosclerosis - prevention). Some studies suggest that this may also reduce the risk of Alzhe