Showing posts with label men. Show all posts
Showing posts with label men. Show all posts

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).

Monday, September 27, 2010

Types of Dementia

By : Lamiaa Moustafa Elbosaty


 Vascular Dementia: It is slightly more common in men than in women. The prevalence increases with age, approximately doubling every 5 years. There appear to be geographical differences, with high rates reported in china, Japan, and the Russian Federation (O'Brien & Elias, 2004). Risk factors for vascular dementia include hypertension, cardiac abnormalities, diabetes mellitus, smoking, lipid abnormalities, autoimmune and infectious vasculitis. The age of onset is usually between 55 and 70 years (Gorelick, 2004).  
v    Clinical presentation: 
The wide variation in symptomatology of vascular dementia depends on the areas of infarction. Patient may recover initially from the neurological and cognitive deficits associated with each infarct depending on the location and extent of damage (Esiri & Nagy, 2002). The presentation of vascular dementia is an abrupt onset of cognitive loss with onset of dementia within 3 months of asymptomatic cerebrovascular accident. The progression of dementia is stepwise, with paroxysmal deterioration of intellectual function (Román, 2002).
Emotional and personality changes may appear first, followed by impairments of memory and intellect that characteristically progress in steps. Depression is frequent and confusion is common, especially at night. Transient ischemic attacks or mild strokes may recur from time to time. Behavioral retardation and anxiety are more common than in Alzheimer's disease (Gold et al., 2002).
According to Román (2002), there is a history of frequent unexplained falls, urinary frequency, urgency or other urinary changes not explained by urological disease, emotional liability, and personality/mood changes. Cognitive changes of memory loss occur but are not always as prominent as with the presentation of Alzheimer's disease. Executive function as the ability to execute complex behavior, sequence information, and problem solve, changes are the more prominent cognitive changes of vascular dementia.
Other cognitive change of problems with concentration and comprehension and disturbances in abstract thinking, judgment, and impulse control (Gorelick, 2003).
The course of vascular dementia is usually a stepwise progression with periods of deterioration that are sometimes followed by partial recovery for a few months. About 50% of the patients die from ischemic heart disease and others die from cerebral infarction or renal complications. From the time of diagnosis, the life span varies widely; most studies showed somewhat shorter survival in than in Alzheimer's disease (Kuller et al., 2005).
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