What Is Dementia?

GLOBAL MEDICAL EDUCATION PRESENTS WHAT IS DEMENTIA? WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: Y Attention V Memory O Reasoning M Language O Perception Planning E Learning V Behavior Common behavioral disturbances in patients with dementia include: 5 M Agitation O Apathy V Mood Disturbances Y Psychotic Symptoms MILLION More than of patients with dementia have behavioral disturbances 70% Almost 5 million Americans have dementia. AEmEm DEMENTIA IS NOT A DISEASE but an umbrella term used to describe a constellation of signs and symptoms. It can be due to many different causes. Mild Cognitive Impairment, a forerunner of dementia occurs in 10%-20% of people over 65. 5%-15% of cases of MCI will convert to dementia annually. EVERY 68 SECONDS Alzheimer's disease is the The number of people with Alzheimer's disease SIXTH LEADING someone in DOUBLES with every five year interval beyond the age of 65. CAUSE America develops of death in the US. Alzheimer's. REST IN PEACE 10 EARLY WARNING SIGNS OF DEMENTIA: :22 1 Memory difficulties affecting daily life. 2 Difficulty planning or solving problems. 3 Confusion with places and time. 4 Difficulty with familiar tasks at home. 5 Misplacing things. 6 Difficulty recalling words or following a conversation. 7 Problems with vision or perception. 8 Problems with judgment. 9 Changes in personality. 10 Social and work withdrawal. DID YOU KNOW that Global Medical Education (GME) has more than 50 videos on dementia and other topics in geriatric psychiatry? HTTP://Www.GMEDED.COM/CATEGORIES/GERIATRIC-PSYCHIATRY TYPES OF DEMENTIA INCLUDE THE FOLLOWING, AND SOME PATIENTS CAN HAVE MORE THAN ONE TYPE. ALZHEIMER'S DISEASE VASCULAR DEMENTIA LEWY BODY DEMENTIA (50%-78% OF ALL CASES) (28% OF ALL CASES) (15%-20% OF ALL CASES) Difficulty remembering Vascular dementia is a People with dementia with names and recent events is decline in thinking skills Lewy bodies often have memory loss and thinking problems common in often an early clinical caused by conditions that symptom; apathy and depression are also often block or reduce blood flow to the brain, depriving brain cells of vital oxygen Alzheimer's, but are more early symptoms. Later likely than people with symptoms include impaired judgment, disorientation, confusion, behavior changes and difficulty speaking, and nutrients. This often Alzheimer's to have initial or results from a stroke early symptoms such as or mini strokes. sleep disturbances, well-formed visual swallowing and walking. hallucinations, and muscle rigidity or other parkinsonian movement PARKINSON'S DISEASE DEMENTIA features. (5% OF ALL CASES) FRONTOTEMPORAL DEMENTIA (5% OF ALL CASES) Problems with movement are a common symptom early in the disease. If dementia develops, symptoms are often similar to dementia with Lewy bodies. Typical symptoms include changes in personality and behavior and difficulty with language. Nerve cells in the front and side regions of the brain are especially affected. In 60% of people with early Alzheimer's disease the condition The NATIONAL is NOT RECOGNIZED BY THEIR FAMILY or not evaluated by a doctor. ALZHEIMER'S PROJECT ACT e (NAPA) was signed into law in 2011 by President Obama to create By the time family members notice signs of dementia it is usually in the moderate stage. a NATIONAL PLAN TO In 2012 more than 15 MILLION FAMILY MEMBERS and unpaid caregivers provided OVERCOME Alzheimer's disease. care for patients with dementia a contribution valued at $216 BILLION DOLLARS. A useful resource for An estimated 2.3 million caregivers of patients and caregivers is people with AD and other dementias the ALZHEIMER'S ASSOCIATION live at least 1 HOUR away from the care recipient. at www.alz.org or 800.272.3900 WHAT ARE THE MAIN CHANGES IN DSM 5 FOR THE DIAGNOSIS OF DEMENTIA? • Replace the term Dementia with the term Major Neurocognitive Disorders • Etiologies of Major Neurocognitive Disorders specified like Alzheimer's disease, Vascular disease, Lewy body disease, Frontotemporal lobar degeneration, Parkinson's disease etc. HOW IS A PERSON DIAGNOSED WITH DEMENTIA? The diagnosis of dementia is made by obtaining a thorough medical and psychiatric history, and a medical, neurologic and mental status examination. Biomarkers being studied for the early diagnosis of dementia and MCI include elevated levels of tau protein and decreased levels of beta amyloid in the cerebrospinal fluid, decreased glucose uptake on PET scans and brain atrophy on MRI scans. Did you know that nanomedicine is being used as a promising approach for the diagnosis and treatment of Alzheimer's disease? Neuropsychological testing may sometimes be necessary. The Mini Mental State Exam (MMSE) is one of the commonest screening instruments for dementia in clinical practice. Laboratory testing may include blood chemistry, Assessment of driving ability in patients thyroid function, folate with dementia is important. The MMSE and B12 levels, and a does not correlate with ability to drive. CT scan or a MRI scan. HOW CAN DEMENTIA BE TREATED? The FDA has not approved any new drugs for Alzheimer's disease in the last 10 years. LIFESTYLE CHANGES MEDICATION The use of antipsychotics Lifestyle modifications that Treatments for dementia in patients with include medications like may help delay or prevent dementia in some people include avoiding smoking or dementia should donepezil, rivastigmine, be used as a last galantamine and memantine (alone or in resort and not first excessive alcohol intake, line treatment. combination) which may aggressive treatment of hypertension, diabetes, high lipids and late life improve mental processes like memory and sometimes slow the progression of depression, physical exercise, mental and social Alzheimer's disease, activity, and cognitive medications for Parkinson's training. The evidence for disease like Antidepressants like the use of antioxidants, carbidopa-levodopa which SSRI's, antipsychotics or homocysteine, certain diets, may help dementia due to psychostimulants may and omega 3 fatty acids is Parkinson's disease or help treat the behavioral inconsistent. Lewy body dementia. disturbances of dementia. "WHAT IS GOOD FOR THE HEART IS GOOD FOR THE BRAIN" RISH FACTORS FOR DEMENTIA: ARM BRACELETS with name and telephone number M Advancing Age Hypertension and SHOES WITH GPS V Family History Diabetes Mellitus are a good idea for patients V Late Life Depression Head Trauma with dementia. V Strokes MYTHS ABOUT DEMENTIA- 1 Severe memory loss is a natural part of aging. 2 Alzheimer's disease is not fatal. Aluminum intake can cause Alzheimer's dementia. 4 Only old people can get dementia. Artificial sweeteners like aspartame can cause dementia. THIS INFOGRAPHIC WAS BROUGHT TO YOU BY GLOBAL MEDICAL EDUCATION For more information on dementia from the world's leading experts visit: www.gmeded.com SOURCES: http://www.alz.org/alzheimers_disease_facts_and figures.asp http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet http://www.mayoclinic.com/health/alzheimers-disease/DS00161 http://www.alzheimersanddermentia.com/article/S1552-5260(13)00076-9/abstract http://www.ncbi.nim.nih.gov/pubmed/24002185 http://www.ncbi.nim.nih.gov/pubmed/23859061 http://aspe.hhs.gov/daltop/napa/NatIPlan2013.shtml http://www.alz.org/dementia/vascular-dementia-symptoms.asp http://www.alz.org/dementia/types-of-dementia.asp CME