DEMENTIA

Reporters: Bucala, Jeffrey C. Silverio, Troy BSN410

DEMENTIA
Definition Syndrome which refers to progressive decline in intellectual functioning severe enough to interfere with persons normal daily activities and social relationships. Common age above 50 years old.

Diagnostic Approach 1. Complete history 2. Neurologic Exam MRI CT-Scan EEG Etiology Dementia results from impaired functioning of multiple brain systems in both cortical and subcortical areas that are associated with short-term memory and other higher cognitive functions.

Two Types of Dementia 1. Reversible 2. Irreversible Reversible Dementia D : Drugs, Delirium E : Emotion, Endocrine disorders M : Metabolic disturbances E : Eye and Ear impairments N : Nutritional disorders T : Tumor, Toxicity, Trauma to head I : Infection disorders A : Alcohol, Ateriosclerosis Irreversible Dementia 1. 2. 3. 4. 5. 6. 7. 8. Alzheimers disease Lewy Body dementia Picks disease (Frontotemporal Disease) Parkinsons disease Huntingtons disease (Chorea) Cruzefeldt-Jacob disease (Mad Cow Disease) Wernickes korsakoff syndrome Multi-infarct dementia (Vascular Dementia)

Clinical Presentation of Dementia 1. 2. 3. 4. 5. Cognitive disturbances Behavioral disturbances Memory impairments Language deficits Visuospatial impairments a) Visual recognition impairments -troubles recognize familiar faces b) Spatial deficits -lost of familiar surroundings 6. 7. Functional impairments Problems with ADLs

Complications 1. 2. 3. 4. Delusions Depression Dangerous Behavior Death

Management of Dementia 1. Identify and treat underlying etiology 2. Monitor carefully: vital signs, intake and output, oxygenation, and safety. 3. Monitor and assure safety of patient I. Suicidality & violence potential. II. Fall and wandering risk. III. Remove potentially dangerous. 4. Environmental Intervention I. Sensory impairment II. Frequency reorientation III. Orientation cues IV. Night lights V. Music therapy 5. Pharmacologic Management Benzodiazepines ( Diazepam )