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Friday, October 8, 2010

Mild Alzheimer's Disease

By : Lamiaa Moustafa Elbosaty

          The individual with mild Alzheimer's disease continues to look and act normally to others, and only close family or friends may note any change. There is moderate memory loss, more marked for recent events that interfere with every day activities. The individual has difficulty learning and retaining new information. In addition, there may be disorientation in familiar places, difficulty handling complex financial transactions (paying bills, balancing a check book), and poor problem solving (Reisberg, et al., 2003).

The individual is independent in completing usual activities of daily livings (ADLs) but may need prompting to complete tasks. The ability to participate in complex home repairs and hobbies is reduced. The individual may experience personality changes of withdrawal from usual social activities because of fear of others detecting changes, lack of confidence in function, or lack of interest in his/her usual activities (Linton & Lach, 2007).

·        Moderate Alzheimer's Disease:

In moderate Alzheimer's disease, memory loss is sever and only highly learned material or established memory is retained, while new material is lost rapidly. As the damage of Alzheimer's disease spreads in cerebral cortex, language, reasoning, sensory processing, and conscious thought are impaired. The individual may be confused about the identity and relationships of relatives. The individual becomes increasingly dependent on the others and assistance is needed to carry out ADLs (Monias & Meier, 2003).

The individual may get lost in familiar settings, language changes are revealed as incomplete sentences and poor comprehension of written and spoken language. At this stage of Alzheimer's disease, disruptive behavioral changes often emerge. Agitation, restlessness (including wandering), sleep disturbances, day-night disorientation, verbal or physical aggression, suspiciousness, and hallucinations are common behaviors manifested (ADRDA, 2004).

The individual has decreased tolerance for stress and can't reliably interpret the environment. Disinhibition, socially in appropriate behaviors, and saying or doing things not usually said or done in public occur at this stage. Also there are weight loss, and dehydration which require careful monitoring (Monias & Meier, 2003).

Tuesday, September 28, 2010

Types of Dementia -2

By : Lamiaa Moustafa Elbosaty

Dementia with Lewy Bodies: Is the third most frequent cause of dementia, unlike Alzheimer's disease, it is more likely to be seen in men than women (Knopman, et al., 2003). Like Alzheimer's disease pathology (neurofibrillary tangles and senile plaques) it is a common concomitant finding in about 66% of dementia with Lewy bodies cases. It is a heterogeneous disorder characterized pathologically by neuronal loss and the presence of Lewy bodies in the cerebral cortex. There is some neuropathological evidences which suggest that visual hallucinations are associated with the quantity of Lewy bodies in the temporal lobes (Morris, 2005).

v    Clinical presentation:

          The criteria for dementia with Lewy bodies are a progressive dementia accompanied by at least two of the following: Parkinsonian signs, a fluctuating course, and prominent visual hallucinations. Other clinical symptoms include frequent unexplained falls, delusions (misidentifications and paranoid delusions), and auditory or olfactory hallucinations, behavioral changes, depression, apathy, anxiety and irritability (Knopman et al., 2003). There are also fluctuations and delirium, presence of fluctuations of daytime drowsiness, daytime sleep of  2 hours or more, periods of disorganized speech, flow of ideas, and long period of starting into space (Ferman  et al., 2004).

Friday, September 24, 2010

DEMENTIA

By : Lamiaa Moustafa Elbosaty

A. Definitions:

Dementia is defined as a change in mental status that caused by physical changes in the brain, it is usually a chronic condition that progresses slowly and is not reversible. Dementia is frequently associated with the elderly, and is often incorrectly assumed to be a part of the aging process. Actually, many elderly people retain their intellectual functioning into their eighties and nineties. Important factors determining whether dementia will occur are genetic predisposition, family history, nutritional status and general level of health (Barry, 2002).

According to Judith et al. (2005), dementia is a progressive impairment of cognitive functions occurring in clear consciousness (that is, in the absence of delirium). Dementia consists of a variety of symptoms that suggest chronic and widespread dysfunction. Global impairment of intellect is the essential feature, manifested as difficulty with memory, attention, thinking, and comprehension. Other mental functions may often be affected, including mood, personality and social behavior. The symptoms result in significant impairment in social or occupational functional and they represent a significant decline from a previous level of functioning.

While the Alzheimer's Association (2006), defined dementia as a  progressive brain disorder that gradually destroys a person's memory and ability to learn, reason, make judgments, communicate and carryout daily activities. As dementia progresses, many also experience change in  personality and behavior, such as anxiety, agitation, and hallucinations.