2. DEMENTIA
CENTRAL AMERICA HEALTH SCIENCE UNIVERSITY,
BELIZE
18TH NOV 2013
INSTRUCTOR : DR. SURYA SUDARSHAN
PRESENTER : MAHESH SUNDARAM
: SYED ABDUL SAMIE
: GIA K.SHARMA
3. WHAT IS IT :
Dementia Latin word De "without" + ment, means
โmindโ
Definition: It is a loss of brain function that effects
memory, thinking, language, judgement, and behaviour.ย
It is a degenerative (non-reversible) condition. This
means that the damage done to the brain cannot be
treated or stopped.
5. GOALS IN DEMENTIA
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Evaluation and Diagnosis
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Current Therapy for Dementia
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Complications
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Resources for the Caregivers
6. Early Symptoms and Warning Signs
As we get older, many of us become more forgetful โ for example we
might misplace our keys occasionally or find it difficult to find the
right word to describe something. This is normal and isnโt a cause
for concern.
It is important to be able to differentiate between these changes
and the early warning signs of a more serious condition. These early
signs can start to develop as much as twenty years before a
diagnosis is made.
Research carried out at Stanford University in the USA suggests
that a newly developed blood test can identify people most at risk
from developing DEMENTIA disease up to six years before the
symptoms become apparent.
The test measures the levels of a number of proteins in the blood
associated with Alzheimerโs.
8. Diagnosis
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Based on memory loss (both short and long-term),
plus one or more of the following:
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Aphasia โ language problems
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Apraxia โ organisational problems
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Agnosia โ unable to recognise objects or tell their
purpose
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Disturbed executive function โ personality and
inhibition
9. Is it JUST โOld Age?โ
Signs of Dementia
Typical Age
Related Changes
๏จ
Poor judgment and decision making
๏จ
Inability to manage a budget
๏จ
Making a bad decision once in a while
๏จ
Losing track of the date or the
season
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Missing a monthly payment
๏จ
Forgetting which day it is and
remembering later
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Sometimes forgetting which word to use
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Losing things from time to time.
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Difficulty having a conversation
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Misplacing things and being unable
to retrace steps to find them
10. Types of Dementia
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Alzheimerโs โ Most common , Memory, Language,
Visuospatial, Indifferent to Loss
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Lewy Body โ second most common (vivid
hallucinations), Visual hallucinations, delusions,
flucutating mental status
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Fronto-temporal โ shrinking frontal and temporal
lobes, Memory, Marked Personality changes,
Preserved visuospatial
11. TYPES OF DEMENTIA
contโฆ
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Vascular Dementiaโ aka multi-infarct dementia,1530% develop dementia
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Progressive Supranuclear Palsy
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The Rare Birds : Late onset Metabolic Disease
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Other causes: Alcoholism, AIDS, Pickโs disease, etcโฆ
Disease
21. ๏ต
๏ต
๏ต
PROGRESSION
Forgetfulness
๏ต complains
of memory deficits, misplace objects, trouble
word finding, functional
Confusional
๏ต getting
lost, job trouble, language problems, lost objects
denial, anxiety, lost current events, canโt handle finance
other executive functions, withdrawal
Early Dementia
๏ต Need
assistance, canโt use phone reliably, disorientation
to time, place, know family, can feed and toilet with
reminders
22. PROGRESSION
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Middle Dementia
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Late Dementia
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Unaware of surroundings, forget spouseโs name,
loss of recent events of life, personality and
behavior changes, needs help with most ADL
Loss of all verbal abilities, complete incontinence,
no thirst or hunger responses
TIME COURSE
23. DAY TO DAY CARE
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Be Firm, Donโt Rush or Argue
๏ต Now
๏ต
it time toโฆ.., donโt rush or argue
Minimize Distractions
๏ต Decrease
๏ต
Keep It Simple, Keep It Safe
๏ต Cannot
๏ต
follow multi-step commands
Lower Your Standards
๏ต Expect
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noise, remove visual clutter
less from the patient
Establish Routines
๏ต Reassuring,
reduce agitation
24. CARE FOR CAREGIVERS
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Information about progression
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Facilitate Day-to-Day Care
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Stress Reduction Skills
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Support
Risk for depression, illness, fatigue, elder abuse
How to know when you can no longer provide care at
home
25. Economics of Dementia
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2-5 million affected
๏ตWith
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current demographics 10 million by 2030
Expenses
TOTAL $100 Billion
๏ตRanks
๏ต Per
third (Heart disease and Cancer)
Capita
๏ตDirect
$10-25K home, $40-50k NH
๏ตIndirect
๏ตUnpaid
๏ตPaid
$60k
Care
$10-50k
Out of Pocket 65%
26. Consider Hospice/Palliative
Care
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Dementia is a terminal disease. Consider palliative care
referrals and/or referrals to support agencies early on.
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Once patient has progressed and is in the late stages of
the disease, consider a hospice referral to help keep
the patient comfortable and provide ongoing support for
the family.
27. Research
๏ตIn
2013, multiple AD biomarkers are receiving research attention,
including structural and metabolic brain alterations as well as
amyloid and tau protein levels in both the brain and cerebrospinal
fluid (CSF). Lillyโs experimental Alzheimerโs drug (Solanezumab):
๏ตCreated
to attach to protein fragments in the brain before those
fragments clump together to become plaques.
๏ตDIAN
studies โ Alzheimerโs Association has funded 4.2 million for
this study. DIAN is a network of investigators recruiting families
with dominantly inherited AD. These families have rare, inherited
gene mutations that cause young onset, familiar AD.
