Dementia - dangerous acquired brain malfunctionwhich has a significant negative impact on the mental abilities of the patient and the quality of his life.
Dementia is considered to be a problem of the older generation, since the vast majority of patients with dementia are in old age.
Moreover, this state not a normal sign of aging and age-related changes, and is considered a pathology that needs to be addressed.
General information and concepts
What does the word dementia mean in medicine?
Dementia - irreversible process, acquired disruption of the brain, expressed in a decrease in the mental abilities of a person, the loss of their existing knowledge and skills.
In addition, patients have a decrease in cognitive activity and learning ability.
Brain - a special body responsible for performing various mental functions. If there are certain reasons, the structures of the body are damaged, therefore, their functionality is also lost, the person develops dementia in varying degrees of severity.
What is dementia syndrome?
This concept characterizes violation of mental and intellectual functions of a person, as a result of which the patient partially or completely loses the skills of self-service, ability to learn.
Pathology is also characterized by memory impairment, in which a person cannot recall the events (or their details) that happened to him some time ago. Besides, abstract thinking suffers.
In this case, the person is not able to imagine objects or things that do not have a material shell (they can not be seen or touched).
There is an irreversible personality change: the patient loses the emotions, feelings and character traits that were inherent in him earlier.
Depending on the extent of damage to brain structures, dementia can be mild, moderate or severe. In mild form, the patient is aware of his condition, self-care skills are not lost. For the average form is characterized by a partial violation of intellectual and domestic functions.
With severe lesions man completely loses skills and abilitiesthat he had previously. Thus, the patient is not able to independently perform even the most elementary actions (for example, to dress, to eat).
Differences from oligophrenia
Dementia can be distinguished from such a disease with similar manifestations as oligophrenia.
The main difference is the fact that oligophrenia - congenital abnormality, manifestations of which can be seen at a very early age.
If we are talking about dementia syndrome, the disease has an acquired character, there is mainly the older generation (in young and in childhood, cases of the disease are detected extremely rarely, and only because of traumatic or persistent infectious brain damage).
With this oligophrenia not prone to progressionHowever, dementia is considered a pathology that develops gradually, and over time the symptoms of the pathology only get worse.
With the development of dementia, the lesion of the brain has a clear localization, with oligophrenia, all parts of the organ are damaged.
In addition, in a patient with a congenital disorder, there is a general mental disorder, the second disease is characterized only by loss of cognitive abilities.
Dementia is commonly called acquired dementiatherefore, these 2 concepts are considered to be identical.
Pseudodementia - what is it?
Pseudodementia is a condition in which persistent but reversible violation of mental functions. The main cause of development is severe stress, emotional shock, in which the patient experiences bouts of hysteria.
Against the background of such a condition, the patient noted a significant decrease in intelligence, personality disorder, loss of self-care skills - all those symptoms that are characteristic of the true form of pathology.
When this difference from this form of the true disease is that brain damage in this case are functional rather than organicwhen the structure of the tissues of the organ at the cellular level is disturbed.
Etiology and risk factors
The main cause of the emergence and development of the pathological process is considered Alzheimer's disease.
It is this disease in most cases leads to the development of acquired dementia. To the number of others reasons for the development of pathology in men and women include:
- Pathologies of the cardiovascular system (in particular, increased blood pressure, atherosclerosis, multiple injuries of small and large blood vessels, changes in the composition and structure of the blood).
- Burdened heredity.
- Bad habits, such as addiction to alcohol and drugs.
- Parkinson's disease is a slowly developing pathology of a neurological nature, accompanied by a violation of the nervous system and the development of the trembling syndrome.
- Pick's disease, in which there is an organic lesion of the temporal and frontal areas of the brain, a violation of their functionality.
- Significant traumatic damage to the skull and brain tissue.
- Endocrine pathologies (for example, thyroid malfunction, diabetes mellitus).
- Diseases that have a long-term negative effect on the immune system (for example, systemic lupus erythematosus, HIV infection).
- Infectious pathologies (meningitis, encephalitis).
- Severe violations of the internal organs (in particular, liver, renal failure, serious heart disease).
There are secondary factors the presence of which increases the risk of developing the problem (although these causes do not contribute to the appearance of the disease in all cases):
- advanced age (over 65-70 years);
- systematic increase in pressure;
- changes in the structure of the blood, in particular, the high content of fatty lipid cells in its composition;
- abnormal overweight;
- lack of exercise, sedentary work;
- long absence of intellectual work;
- hormonal disorders, in particular, a decrease in the level of the female sex hormone estrogen in women (for example, during menopause or with long-term use of hormonal drugs).
Classification: types and forms of pathology
There are several classification criteria according to which it is customary to distinguish various types and forms of pathology.
So, according to the lesion, emit a lacunar and total form.
With lacunar acquired dementia there are strictly demarcated foci of brain damage, while the departments responsible for short-term memory often suffer.
With this form of pathology, the patient is aware of his problem and takes actions aimed at normalizing his life (for example, many patients constantly take notes on paper so as not to forget any important detail).
Total form considered more serious. With this disease, there is a complete destruction of the personality, in a person all the character traits inherent in him disappear, the moral values that were dear to him disappear.
The behavior changes completely, the appearance of aggression and inadequacy is possible. A person becomes unadapted for living in society. Against the background of these problems, a persistent and severe violation of intellectual activity is noted, the patient completely loses his everyday and mental skills.
Depending on the reasons, distinguish such varieties pathologies like:
- Alzheimer's or organic formin which there are structural changes in the tissues of the cerebral cortex at the cellular level. Often, such organic disorders occur under the influence of age-related changes in the body, or when exposed to other negative factors. At the same time, the patient has a persistent violation of the intellect, a sense of reality and his own place in it, the personality decays (signs such as grumbling, a tendency to disorder or vagrancy, gluttony, aggression and conflict occur).
- Vascular or atherosclerotic formdeveloping due to multiple damage to the blood vessels of the brain. Often, the development of a pathology of this form results from a previous stroke - a disease associated with a significant damage to the blood vessels that feed the cells and brain tissue. As a result of such changes, the process of blood circulation and nutrition of the cells of the organ is disrupted, as a result of which they gradually die off, the functionality of the brain decreases. This variety is characterized by a variety of symptoms in varying degrees of severity. The clinical picture depends on the area of the lesion and its extent. Most often, patients have a violation of motor activity, a change in gait, articulation, voice timbre.
- Presenilnaya form. The causes of the development of pathology have not been studied, it is believed that the main predisposing factor is genetic predisposition. With the development of the disease in brain cells, atrophic processes are observed, during which an excess amount of specific elements, Levi's bodies, accumulate in the tissues of the body. They accumulate in the subcortical parts of the body, significantly disrupting the functionality of this area. With the development of the patient’s pathology, along with intellectual and mental abnormalities, nonspecific symptoms arise, such as a sharp drop in blood pressure when the body position changes, a tendency to fainting, a disturbance of heart rate, malfunction of the digestive, urinary and other systems.
- Alcoholic form. With prolonged use of alcoholic beverages in the brain tissues irreversible changes occur, which lead to a persistent violation of the intellect and disintegration of the personality (this is typical for the terminal stage of development of alcoholism). In addition to the direct negative effect of alcohol on the brain, toxic damage to the body also leads to the development of disorders (for example, with significant damage to the liver due to long drinking bouts, when the body is not able to properly perform its functions and remove toxic substances from the body). The patient has such manifestations as social disorientation, loss of moral principles, aggressive or inappropriate behavior.
Moreover, these manifestations occur not only when intoxicated, but also in a sober state.
First signs of frustration
To suspect the development of a dangerous disease in adults you can still at the very beginning of its progression. For this you need to pay attention to the first alarm bells, such as:
- Violation memory, which initially looks like ordinary absent-mindedness, but over time, the disorder progresses.
- Increased irritability, grumbling, conflict. Perhaps the appearance of aggression as a response to any, even the most minor irritants.
- Behavior change, the appearance of such features as cruelty, tendency to carelessness, indifference to their own appearance and housing.
- Apathy, loss of interest in previously loved activities.
Clinical symptoms and manifestations
Over time, the picture of the course of the disease becomes more and more expanded. There are signs such as:
- Persistent violation of short-term and long-term memory.
- Inability to perform basic household activities that the patient previously performed daily.
- Problems in communicating with relatives, friends (a person often forgets words or says them incorrectly, which makes it impossible to build normal, correct sentences during a conversation).
- Problems with orientation in space, when a person is unable to find his way home or to those places where he had previously been quite often.
- Lack of responsibility, short-sightedness.
- Lack of abstract thinking, when a person cannot imagine an object that does not have a material design.
- Tendency to chaos, mess in the dwelling (all the objects in the apartment are scattered, are not in their places).
- Frequent mood swings.
- Personality disorder and behavior disorder.
- Apathy, indifference to everything, lack of initiative, or vice versa, too active, but disorderly behavior.
Stages of development of the pathological process
Acquired dementia is a condition that develops gradually, going through several stages of its development:
- Early dementia - the initial stage at which changes in personality and behavior are mild. There are symptoms such as forgetfulness, confusion, loss of orientation in time and space.
- Middle stage characterized by more significant memory disorders in which the patient forgets the events that happened to him recently, the names of people, their faces (even if these people are close relatives with whom the patient communicated quite closely).
There are problems in communication, difficulties with self-service, changes in behavior and mood, inadequate behavior is often manifested (for example, repeated useless actions).
- Last stage dementia before death (severe or late form) is characterized by a complete loss of independence when the patient is heavily dependent on relatives, needs constant attention and care. At this stage, such symptoms appear as a complete loss of orientation in time and space, aggression, the impossibility of performing elementary actions (the patient cannot put on his own clothes, defend himself, take food). Often there is a complete loss of memory, a person ceases to recognize relatives and people close to him.
Diagnostic methods
To identify the pathology, it is necessary to talk with the patient and his relatives.
During such a conversation, the doctor determines the presence of signs characteristic of this disorder, For the diagnosis, you must have 5 mandatory manifestations, such as:
- memory impairment;
- speech impairment, inability to perform simple everyday activities, disorders of perception, in which the patient does not recognize his usual things or close people;
- violation of social adaptation, destruction of family attachments, problems in communication;
- lack of hallucinations and delirium - symptoms characteristic of delirium;
- the presence of lesions in the brain tissue (this is determined using instrumental methods of examination, such as CT, MRI).
To make a diagnosis, it is necessary that all these symptoms manifest in a patient for a long time - at least 6 months.
Treatment regimen
Dementia patient requires constant competent treatment and care. Therapy is carried out in several directions. This is a lifestyle correction, special exercises, and sociotherapy.
Home treatment rules
The patient needs constant help from relatives and friends, and this help consists in:
- Lifestyle Corrections. The patient needs a cozy home environment, the presence of close people who create a friendly and relaxed atmosphere around the patient. This will eliminate the feeling of anxiety, helplessness.
- Physical activity. The patient needs movement. And it should be simple, but quite active, for example, walks (under supervision), performing simple household duties, simple work in the garden or at the dacha.
- Dietary correction. The patient's menu should include products that reduce cholesterol, as well as dairy dishes, foods rich in vitamins and minerals.
Preparations
An important point of treatment is the reception of drugs prescribed by the doctor.
Usually sick Reception of the following groups of medicines is necessary:
- antidepressants to eliminate depression and improve mood (Venlafaxine, fluoxetine);
- preparations for the normalization of memory and thinking (Aricept, Neyromidin);
- agents that normalize metabolic processes and restore the regulatory function of the brain (Donepezil, Rivastigmine);
- means to eliminate aggression, psychosis (Respiridon).
Useful exercises
With the development of acquired dementia, it is very important to give the patient an adequate mental load for his condition.
For this there are specially designed exercises, aimed at maintaining intelligence. It can be such techniques as:
- Drawing images with various fine details (for example, the watch face). Drawing shapes in a mirror image.
- Proverbs and sayingswhen the patient is called the beginning of the expression, after which he must continue it.
- Sequence coupling (например, можно предложить больному соединить в правильной последовательности дни недели или названия месяцев).
- Поиск зашифрованных в сетке слов. Для начала все эти слова должны принадлежать к одной группе (например, продукты питания, предметы одежды).
Особенности общения
Как общаться с больным? Человек, страдающий приобретенным слабоумием, нуждается в постоянном общении. Конечно, окружающим будет непросто построить нормальный диалог, но это просто необходимо.
Общение должно быть максимально простым и понятным для больного, при этом необходимо проявить терпение и доброжелательность, не показывать собственного раздражения.
Как справиться с агрессией?
Нередко на фоне деменции наблюдается агрессивное поведение и жестокость.
Что делать в этом случае? Самое главное правило, на агрессию нельзя отвечать агрессией, это только усугубит ситуацию.
Важно как можно скорее успокоить больного, предложив ему занятие или разговор, вызывающий приятные, позитивные эмоции.
При наличии показаний и назначений врача, необходимо следить, чтобы больной вовремя принимал успокоительные медикаментозные препараты, нормализующие его состояние.
Выживаемость
Какова продолжительность жизни больного? Деменция является опасным для здоровья и жизни состоянием.
Больные, страдающие данным расстройством, обычно живут не более 5 лет, хотя все зависит от причин развития патологии, ее стадии, методов коррекции и от ухода за больным.
Можно ли вылечить болезнь?
Данное заболевание считается необратимым, однако, при условии правильного ухода и грамотного лечения удается значительно улучшить качество жизни пациента.
Меры профилактики
В чем состоит профилактика деменции в молодом и среднем возрасте? Для того чтобы снизить риск развития патологии необходимо:
- Тщательно следить за собственным здоровьем, своевременно выявлять и устранять патологии других органов и систем.
- Защищать головной мозг от травм и повреждений.
- Обеспечивать себя физической и умственной нагрузкой.
- Вести здоровый образ жизни (отказ от вредных привычек, правильное питание, двигательная активность), укреплять иммунитет.
- Развивать устойчивость к стрессам и неприятным ситуациям.
- Полноценно отдыхать, высыпаться.
Деменция - патологический процесс, в ходе которого наблюдается стойкое нарушение работы головного мозга, что проявляется в выраженных нарушениях интеллекта, способности к обучению, самообслуживанию.
Больному требуется не только помощь профессионалов, но и постоянное внимание и уход со стороны близких людей.
Причины деменции, симптомы, лечение, профилактика, советы родственникам:
