E Staging Of Dementia
Progressive dementias are generally staged according to the level of functional impairment, and the same categories may be used to describe the degree of severity of any dementia . The ability to perform a specific function depends on baseline skills, deficits, and the social environment, so the severity of illness should be assessed in the context of past functioning in several domains. Individuals with questionable impairment show borderline functioning in several areas but definite impairment in none. Such individuals are not considered demented, but they should be evaluated over time: some may progress to a dementing disorder, some may return to normal functioning, and others may remain in a questionable state. Individuals with mild impairment are likely to have difficulties with balancing a checkbook, preparing a complex meal, or managing a difficult medication schedule. Those with moderate impairment also have difficulties with simpler food preparation, household cleanup, and yard work and may require assistance with some aspects of self-care . Those whose dementia is severe require considerable assistance with personal care, including feeding, grooming, and toileting. In profound dementia, the patients may become largely oblivious to their surroundings and are almost totally dependent on caregivers. In the terminal phase, patients are generally bed bound, require constant care, and may be susceptible to accidents and infectious diseases, which often prove fatal.
Other Causes Of Reversible Dementia
Other causes of reversible dementia include:
- infections such as HIV and urinary tract infections, which should be ruled out when performing a dementia assessment. Treating the infection may eliminate the dementia symptoms.
- benign brain tumors that place pressure on the hippocampus, prefrontal cortex, or other brain regions involved in short-term memory. In some cases, the benign tumor can be treated and the cognitive impairment reversed.
Access references at visit myamericannurse.com/?p=72396.
Angela Humbel is an undergraduate bachelor of science in nursing student at The Ohio State University in Columbus. Michael Carter is a distinguished professor emeritus at The University of Tennessee Health Science Center in Memphis. Todd B. Monroe is an associate professor at The Ohio State University.and Todd B. Monroe, PhD, RN-BC, FNAP, FGSA, FAAN
Is There Treatment Available
There is not yet a cure for FTD, or any disease modifying treatment. However, various therapies can help with some of the symptoms. Secondary symptoms, such as depression, may be helped by medication.
Knowing more about FTD and why the person is behaving as they are can help people to cope with the disease.
Family members and carers can, with support, develop coping strategies to work around problems rather than trying to change the behaviour of the person with FTD.
Psychological therapies are important to help manage abnormal behaviour.
Speech therapy is of benefit to people with PNFA, particularly in helping to develop alternative communication methods.
The input of an occupational therapist can help improve everyday functioning at home.
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Causes Of Alzheimer’s Disease
Alzheimer’s disease is the most common type of dementia.
Alzheimer’s disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.
Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form “tangles” within brain cells.
Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.
As brain cells become affected in Alzheimer’s, there’s also a decrease in chemical messengers involved in sending messages, or signals, between brain cells.
Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimer’s disease.
Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.
These treatments are not a cure for Alzheimer’s disease, but they do help improve symptoms.
Read more about treatments for dementia.
The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.
The hippocampus is often affected early on in Alzheimer’s disease. This area of the brain is responsible for laying down new memories. That’s why memory problems are one of the earliest symptoms in Alzheimer’s.
Unusual forms of Alzheimer’s disease can start with problems with vision or with language.
Read more about Alzheimer’s disease.
Types Of Reversible Dementia
According to Alzheimer Society Canada, the following are common causes of reversible dementia:
Head Injuries
According to the Alzheimers Association, a traumatic brain injury may increase the risk of developing Alzheimers or another type of dementia years after the injury takes place. Anyone who experiences a head injury, even without a loss of consciousness, should see a medical professional. And if the head injury is severe, such as being ejected from a vehicle and loss of consciousness, someone should call emergency services immediately, experts say. Treatment for head injuries will vary depending on the type of injury, the severity of the injury, the age of the person, and other factors.
Drug and Alcohol Abuse
The Alzheimers Association notes that alcohol abuse can lead to Korsakoff syndrome which affects brain function due to low thiamine levels. Korsakoff syndrome may also occur with AIDS, certain cancers, poor nutrition and other conditions. There is no test for Korsakoff syndrome, but a doctor can make a determination based symptoms and a check-up. Abstaining from alcohol has the potential to recover from Korsakoff syndrome, the Alzheimers Association reports.
Medication Side Effects
Depression
Certain Vitamin and Mineral Deficiencies
Thyroid Issues
Heart Disease
Medical professionals agree that if someone suddenly experiences memory lapses, they should consult their health care provider to learn if it is something that can be reversed.
Categories
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What Causes Frontotemporal Dementia
FTD is caused by brain disease, but why some people get the disease is unknown .
People with FTD can have one of a number of different underlying changes in brain cells. These various cellular changes generally can not be observed during life, but only with a brain autopsy to identify the changes under a microscope. Cellular studies of the brain have shown that there are two types of protein which accumulate in brain cells in FTD tau and TDP-43. These protein accumulations damage and kill brain cells in the frontal and/or temporal lobes. As the disease progresses, these regions show shrinkage detectable on MRI scans.
Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
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What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, the appropriate drugs used to treat those specific conditions are prescribed.
What Are Potentially Treatable Causes Of Dementia
The dementia in treatable conditions may be reversible or partially reversible, even if the underlying disease or damage is not. However, readers should note that if underlying brain damage is extensive or severe, these causes may be classified as irreversible by the individual’s physician.
There is no specific test for dementia. However, dementia may be diagnosed if at least two of the following core mental functions are significantly impaired, according to some researchers:
- Memory
- Attentiveness/focus on a problem or subject
- Reasoning/Judgment
- Visual perception
In some people, the signs and symptoms of dementia are easily recognized in others, they can be very subtle. A careful and thorough evaluation is needed to identify their true cause.
An assessment of dementia symptoms should include a mental status evaluation. This evaluation uses various “pencil and paper,””talking,” and physical tests to identify brain dysfunction. A more thorough type of testing, performed by a psychologist, is called neuropsychologic testing.
Lab tests may be used to identify or rule out possible causes of dementia.
In some cases, imaging studies of the brain may be necessary to detect conditions such as normal pressure hydrocephalus, brain tumor, or infarction or bleeding in the brain.
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Causes Of The Dementia Syndrome
Many different disease states can produce the clinical syndrome of dementia. These can be divided into two groups:
* Reversible * Irreversible
Reversible dementia syndrome
The term reversible or potentially/ partially reversible is used to define a cognitive disorder in which normal or nearly normal function may be restored. The potential to reverse or delay deterioration emphasizes the importance of an early diagnosis of a reversible dementia. The most common causes of reversible dementia are depression, delirium, and drug toxicity. Other causes include normal pressure hydrocephalus, neoplasms, metabolic disorders, trauma, medications and infections.
Irreversible dementia syndrome
The most common causes of irreversible dementia include:
* Alzheimers disease
These account for at least 7080% of all cases.
Less common, and more difficult to recognize clinically, are:
* Dementia of Lewy body type * Picks disease
Patients, especially geriatrics, with irreversible dementia are commonly placed in nursing homes for special care.
Alzheimers disease
Diagnosing Alzheimers disease
Although the prospect of developing a cure is unlikely in the foreseeable future, new symptomatic treatments are becoming available. This further supports the value of early recognition of AD.
AD prognosis
Figure 2. National history of Alzheimers disease
Figure 3. Causes of dementia
International Psychogeriatric Association
Majority Reported Passing Out From Drinking
Scientists examined seven European cohort studies from the U.K., France, Sweden, and Finland to include 131,415 people.
The participants, aged between 18 and 77 years, werent diagnosed with dementia during the years when they reported their alcohol consumption .
At follow-up, an average of 14 years later, they were examined for symptoms of dementia.
Over 96,000 people in this group reported passing out due to alcohol. Of these, over 10,000 reported having lost consciousness from drinking in the past year.
Binge drinking tends to be most problematic among college aged youth and young adults, Dr. Scott Krakower, unit chief of psychiatry at Zucker Hillside Hospital, Glen Oaks, New York, told Healthline.
The moderate drinkers who hadnt passed out while drinking were used as the reference group. Compared with other participants, those who reported alcohol-induced loss of consciousness were more likely to drink hard liquor and beer, rather than wine.
After excluding participants with early or late onset Alzheimers, and cardiovascular conditions to find risk of cognitive impairment, the study authors concluded, The findings of this study suggest that alcohol-induced loss of consciousness, irrespective of overall alcohol consumption, is associated with a subsequent increase in the risk of dementia.
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What Is An Example Of Reversible Dementia
In the literature, the most frequently observed potentially reversible conditions identified in patients with cognitive impairment or dementia are depression, adverse effects of drugs, drug or alcohol abuse, space-occupying lesions, normal pressure hydrocephalus, and metabolic conditions land endocrinal conditions like
Other Causes Of Reversible And Non
Dementia is a mental disorder that is chronic or persistent. A few of the symptoms of this disorder include personality changes, lapses in memory, and impaired capabilities such as reasoning. In short, dementia is not a specific disease but an array of symptoms which can be attributed to a number of causes.
Reversible and non-reversible dementia
Dementia can be caused by various factors. Some of these causes can be treated while others are beyond treatment. The dementia that is treatable is termed reversible dementia and the one that cannot be treated per se is termed irreversible dementia or non-reversible dementia.
- The treatment for reversible dementia aims to delay the progress of the disease and, in certain exceptional cases, can even reverse the symptoms.
- For non-reversible dementia, on the other hand, the treatment is intended to treat certain symptoms such that it makes daily living a little easier and manageable for the patients.
The causes of dementia are what classify the mental disorder as non-reversible or reversible.
Reversible dementia could be due to one of the following causes:
Alcohol consumption
Various forms of dementia are caused by excessive consumption of alcohol either intermittently or consistently. This is because heavy drinking leads to liver disease, malnutrition, or vitamin deficiency, all of which result in damage of the brain.
Cure
Injury to head
Cure
Hydrocephalus
Cure
Parkinsons disease
Vascular dementia
Cure
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Can Low Sodium Levels Cause Permanent Brain Damage
hyponatremiabrainpermanenthyponatremia canirreversible brain damage
In acute hyponatremia, sodium levels drop rapidly resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death. Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage.
One may also ask, can low sodium cause dementia? In sum, hyponatremia increases the risk of dementia, including both AD and non-AD dementia. Severe hyponatremia carries a much higher risk of dementia. Baseline or incident stroke can modify the relationship between hyponatremia and dementia.
Likewise, can low sodium cause altered mental status?
Symptoms range from mild anorexia, headache, and muscle cramps, to significant alteration in mental status including confusion, obtundation, coma, or status epilepticus. Hyponatremia is often seen in association with pulmonary/mediastinal disease or CNS disorders. Hyponatremia is associated with numerous medications.
What happens when sodium levels are low?
Hyponatremia occurs when sodium levels in the blood are too low. Symptoms include lethargy, confusion, and fatigue. It can result from underlying conditions, such as kidney failure, or other factors, such as drinking too much water or taking certain medications.
What Are The Reversible Causes
There are several clearly reversible causes of dementia that are remembered by the mnemonic DEMENTIA:
Drugs , emotional- depression, metabolic , eyes and ears declining, normal pressure hydrocephalus tumor or other space-occupying lesion, infection , anemia .
The major syndromes with progressive dementia include Alzheimer disease , vascular dementia , dementia with lewy bodies and frontotemporal dementia .
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What Is The Treatment For Dementia
Although an individual with dementia should always be under medical care, family members handle much of the day-to-day care. Medical care should focus on optimizing the individual’s health and quality of life while helping family members cope with the many challenges of caring for a loved one with dementia. Medical care depends on the underlying condition, but it most often consists of medications and nondrug treatments such as behavioral therapy.
However, early investigation into the cause of dementia symptoms is urged because, as mentioned previously in the causes of dementia section. There are some conditions that when adequately treated may either limit or reverse dementia.
Are Dementia Senility And Alzheimers Disease The Same Things
- Dementia occurs most commonly in elderly people it used to be called senility and/or senile dementia, and was considered a normal part of aging. Affected people were labeled as demented. The term âsenile dementiaâ is infrequently used in the current medical literature and has been replaced by the term âdementia.â
- âSenile dementia,ââsenility,â and âdementedâ are older outdated terms that incorrectly label people with memory loss, confusion and other symptoms as a normal part of aging.
- Dementia, as defined above, is a constellation of ongoing symptoms that are not part of normal aging that have a large number of different causes, for example, Alzheimerâs disease is the major cause of dementia in individuals but it is only one of many problems that can cause dementia.
Symptoms of dementia vary considerably by the individual and the underlying cause of the dementia. Most people affected by dementia have some of these symptoms. The symptoms may be very obvious, or they may be very subtle and go unrecognized for some time. The first sign of dementia is usually loss of short-term memory. The person repeats what he just said or forgets where she put an object just a few minutes ago. Other symptoms and signs are as follows:
Early dementia symptoms and signs
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Reversible And Irreversible Cognitive Disorders
Often, mental health professionals classify cognitive disorders into two broad categories: those that are irreversible and those that are reversible . Dementias are irreversible, progressive, degenerative disorders that gradually reduce a person’s ability to function in everyday life. A person with dementia cannot regain his or her previous level of functioning, even though some symptoms may be managed through treatment. Examples of irreversible dementias include Alzheimer’s Disease, Lewy Body Dementia, and Dementia caused by the AIDS/HIV virus.
On the other hand, the progression of reversible cognitive disorders can be halted by identifying the cause of the symptoms and properly treating the underlying disorder. With appropriate treatment, a person’s previous level of functioning can be restored. Examples of reversible cognitive disorders are pseudodementia and delirium, which will be described later.
Although amnestic disorder is also included in the cognitive disorders category in the DSM-IV, we will not discuss it here. From our perspective, amnestic disorder more closely aligns with dissociative disorders . So, we will cover amnestic disorders at a later date in another topic center.
Dementia In Elderly: Irreversible And Reversible Causes Of Dementia
Written byMohan GarikiparithiPublished onNovember 4, 2016
Dementia is an umbrella term for memory loss, but there are actually many different types of dementia. For example, it can be vascular dementia or frontotemporal dementia. But, dementia can also be reversible or irreversible.
Reversible dementia refers to types of dementia that can be partially or completely cured through treatment and proper management by targeting the underlying cause. Irreversible dementia is brought on by an incurable cause, so as it progresses the patients ability to care for themselves becomes largely diminished.
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