types of dementia. Degenerative dementia, Alzheimer's disease as a cause of dementia, manifestations, stages

Dementia is a persistent disorder of higher nervous activity, accompanied by the loss of acquired knowledge and skills and a decrease in the ability to learn. Currently, there are more than 35 million patients with dementia in the world. It develops as a result of brain damage, against the background of which the marked breakdown of mental functions occurs, which generally makes it possible to distinguish this disease from mental retardation, congenital or acquired forms of dementia.

What kind of disease it is, why dementia occurs more often at an older age, and what symptoms and first signs are characteristic of it - let's look further.

Dementia - what is this disease?

Dementia is insanity, expressed in the breakdown of mental functions, which occurs due to brain damage. The disease must be differentiated from oligophrenia - congenital or acquired infantile dementia, which is an underdevelopment of the psyche.

For dementia Patients are unable to comprehend what is happening to them., the disease literally “erases” everything from their memory that accumulated in it during the previous years of life.

Dementia syndrome manifests itself in many ways. These are violations of speech, logic, memory, unreasonable depressive states. People with dementia are forced to leave their jobs because they need constant treatment and supervision. The disease changes the life of not only the patient, but also his loved ones.

Depending on the degree of the disease, its symptoms and the patient's reaction are expressed in different ways:

• With mild dementia, he is critical of his condition and is able to take care of himself.
• With a moderate degree of damage, there is a decrease in intelligence and difficulties in everyday behavior.
• Severe dementia - what is it? The syndrome means a complete disintegration of the personality, when an adult cannot even relieve himself and eat on his own.

Classification

Taking into account the predominant lesion of certain parts of the brain, four types of dementia are distinguished:

1. Cortical dementia. The cerebral cortex suffers predominantly. It is observed in alcoholism, Alzheimer's disease and Pick's disease (frontotemporal dementia).
2. subcortical dementia. Subcortical structures suffer. Accompanied by neurological disorders (trembling of the limbs, muscle stiffness, gait disorders, etc.). It occurs with Huntington's disease and hemorrhages in the white matter.
3. Cortical-subcortical dementia is a mixed type of lesion characteristic of a pathology caused by vascular disorders.
4. Multifocal dementia is a pathology characterized by multiple lesions in all parts of the central nervous system.

senile dementia

Senile (senile) dementia (dementia) is a severe dementia that manifests itself at the age of 65 years and older. The disease is most often caused by the rapid atrophy of the cells of the cerebral cortex. First of all, the patient slows down the reaction rate, mental activity and short-term memory worsens.

Mental changes that develop in senile dementia are associated with irreversible changes in the brain.

1. These changes occur at the cellular level, neurons die due to lack of nutrition. This condition is called primary dementia.
2. If there is a disease due to which the nervous system has suffered, the disease is called secondary. Such diseases include Alzheimer's disease, Huntington's disease, spastic pseudosclerosis (Crutzfeldt-Jakob disease), etc.

Senile dementia, being among the mental illnesses, is the disease most common among the elderly. Senile dementia is almost three times more common in women than in men. In most cases, the age of patients is 65-75 years, on average in women the disease develops at 75 years, in men - at 74 years.

Vascular dementia

Vascular dementia is understood as a violation of mental acts, which is caused by problems with blood circulation in the vessels of the brain. At the same time, such violations significantly affect the patient's lifestyle, his activity in society.

This form of the disease occurs, as a rule, after a stroke or heart attack. Vascular dementia - what is it? This is a whole complex of signs that are characterized by a deterioration in the behavioral and mental abilities of a person after damage to the vessels of the brain. With mixed vascular dementia, the prognosis is the most unfavorable, since it affects several pathological processes.

At the same time, as a rule, dementia that developed after vascular accidents, such as:

• Hemorrhagic stroke (rupture of the vessel).
• (blockage of the vessel with the cessation or deterioration of blood circulation in a certain area).

Most often, vascular dementia occurs in hypertension, less often in severe diabetes mellitus and some rheumatic diseases, even less often in embolism and thrombosis due to skeletal injuries, increased blood clotting and peripheral vein diseases.

Elderly patients should control their underlying diseases that can cause dementia. These include:

• hypertension or hypotension,
• atherosclerosis,
• ischemia,
• diabetes, etc.

Dementia contributes to a sedentary lifestyle, lack of oxygen, addictions.

Dementia of the Alzheimer's type

The most common type of dementia. It refers to organic dementia (a group of dementive syndromes that develop against the background of organic changes in the brain, such as cerebrovascular disease, traumatic brain injury, senile or syphilitic psychosis).

In addition, this disease is quite closely intertwined with types of dementia with Lewy bodies (a syndrome in which the death of brain cells occurs due to Lewy bodies formed in neurons), having many common symptoms with them.

Dementia in children

The development of dementia is associated with the influence on the child's body of various factors that can cause disturbances in the functioning of the brain. Sometimes the disease is present from the birth of the baby, but manifests itself as the child grows.

In children, there are:

• residual organic dementia,
• progressive.

These species are divided depending on the nature of pathogenetic mechanisms. With meningitis, a residual-organic form may appear, it also occurs with significant traumatic brain injuries, and poisoning of the central nervous system with medicines.

The progressive type is considered an independent disease, which may be part of the structure of hereditary degenerative defects and diseases of the central nervous system, as well as lesions of the cerebral vessels.

With dementia, a child can develop a depressive state. Most often, this is characteristic of the early stages of the disease. The progressive disease impairs the mental and physical abilities of children. If you do not work to slow down the disease, the child may lose a significant part of the skills, including everyday ones.

For any type of dementia, loved ones, relatives and households should treat the patient with understanding. After all, it is not his fault that he does sometimes inadequate things, this is what the disease does. We ourselves should think about preventive measures so that the disease does not hit us in the future.

The reasons

Already after 20 years, the human brain begins to lose nerve cells. Therefore, small problems with short-term memory for older people are quite normal. A person can forget where he put the keys to the car, the name of the person he was introduced to at a party a month ago.

These changes happen to everyone. Usually they do not lead to problems in everyday life. With dementia, the disorders are much more pronounced.

The most common causes of dementia are:

• Alzheimer's disease (up to 65% of all cases);
• vascular damage caused by atherosclerosis, impaired circulation and blood properties;
• alcohol abuse and drug addiction;
• Parkinson's disease;
• Pick's disease;
• traumatic brain injury;
• endocrine diseases (problems with the thyroid gland, Cushing's syndrome);
• autoimmune diseases (multiple sclerosis, lupus erythematosus);
• infections (AIDS, chronic, encephalitis, etc.);
• diabetes;
• severe diseases of internal organs;
• a consequence of complications of hemodialysis (blood purification),
• severe renal or hepatic failure.

In some cases, dementia develops as a result of several causes. A classic example of such a pathology is senile (senile) mixed dementia.

Risk factors include:

• age over 65 years;
• hypertension;
• increased levels of lipids in the blood;
• obesity of any degree;
• lack of physical activity;
• lack of intellectual activity for a long time (from 3 years);
• low estrogen levels (applies only to the female sex), etc.

First signs

The first signs of dementia are a narrowing of horizons and personal interests, a change in the nature of the patient. Patients develop aggression, anger, anxiety, apathy. The person becomes impulsive and irritable.

The first signs to look out for are:

• The first symptom of a disease of any typology is a memory disorder that progresses rapidly.
• The reactions of the individual to the surrounding reality become irritable, impulsive.
• Human behavior is filled with regression: rigidity (cruelty), stereotyping, slovenliness.
• Patients stop washing and dressing, professional memory is disturbed.

These symptoms rarely signal to others about an impending illness, they are attributed to the current circumstances or to a bad mood.

stages

In accordance with the possibilities of social adaptation of the patient, there are three degrees of dementia. In cases where the disease that caused dementia has a steadily progressive course, they often talk about the stage of dementia.

Light

The disease develops gradually, so patients and their relatives often do not notice its symptoms and do not go to the doctor in time.

The mild stage is characterized by significant disturbances in the intellectual sphere, however, the critical attitude of the patient to his own condition remains. The patient can live independently, as well as perform household activities.

Moderate

The moderate stage is marked by the presence of more severe intellectual impairment and a decrease in the critical perception of the disease. Patients have difficulty using household appliances (washing machine, stove, TV), as well as door locks, telephones, latches.

severe dementia

At this stage, the patient is almost completely dependent on loved ones and needs constant care.

Symptoms:

• complete loss of orientation in time and space;
• it is difficult for the patient to recognize relatives, friends;
• constant care is required, in the later stages the patient cannot eat and perform simple hygiene procedures;
• behavioral disorders increase, the patient may become aggressive.

Symptoms of dementia

Dementia is characterized by its manifestation simultaneously from many sides: changes occur in the speech, memory, thinking, attention of the patient. These, as well as other functions of the body, are disturbed relatively evenly. Even the initial stage of dementia is characterized by very significant disorders, which will certainly affect a person as an individual and a professional.

In a state of dementia, a person not only loses ability demonstrate previously acquired skills, but also loses the opportunity get new skills.

Symptoms:

1. Memory problems. It all starts with forgetfulness: a person does not remember where he put this or that object, what he just talked about, what happened five minutes ago (fixation amnesia). At the same time, the patient remembers in all details what happened many years ago, both in his life and in politics. And if he forgot something, he almost involuntarily begins to include fragments of fiction.
2. Thinking disorders. There is a slowdown in the pace of thinking, as well as a decrease in the ability to think logically and abstract. Patients lose the ability to generalize and solve problems. Their speech is detailed and stereotyped, its scarcity is noted, and with the progression of the disease, it is completely absent. Dementia is also characterized by the possible appearance of delusional ideas in patients, often with ridiculous and primitive content.
3. Speech . At first it becomes difficult to select the right words, then you may get stuck on the same words. In later cases, speech becomes broken, sentences do not end. With good hearing, he does not understand speech addressed to him.

Typical cognitive disorders include:

• memory impairment, forgetfulness (most often this is noticed by people close to the patient);
• difficulties in communication (for example, problems with the selection of words and definitions);
• obvious deterioration in the ability to solve logical problems;
• problems with making decisions and planning their actions (disorganization);
• coordination disorders (staggering gait, falls);
• disorders of motor functions (inaccuracy of movements);
• disorientation in space;
• disturbances of consciousness.

Psychological disorders:

• , depressed state;
• unmotivated feeling of anxiety or fear;
• personality changes;
• behavior unacceptable in society (permanent or episodic);
• pathological arousal;
• paranoid delusions (experiences);
• hallucinations (visual, auditory, etc.).

Psychoses—hallucinations, manic states, or—occur in approximately 10% of people with dementia, although in a significant percentage of patients, the onset of these symptoms is temporary.

Diagnostics

Brain scan in normal (left) and in dementia (right)

Manifestations of dementia are treated by a neurologist. Patients are also consulted by a cardiologist. If severe mental disorders occur, the help of a psychiatrist is required. Often such patients end up in psychiatric boarding schools.

The patient must undergo a comprehensive examination, which includes:

• a conversation with a psychologist and, if required, with a psychiatrist;
• dementia tests (brief mental status assessment scale, "FAB", "BPD" and others) electroencephalography
• instrumental diagnostics (blood tests for HIV, syphilis, thyroid hormone levels; electroencephalography, CT and MRI of the brain, and others).

When making a diagnosis, the doctor takes into account that patients with dementia very rarely can adequately assess their condition and are not inclined to note the degradation of their own mind. The only exceptions are patients with dementia in the early stages. Consequently, the patient's own assessment of his condition cannot become decisive for a specialist.

Treatment

How to treat dementia? Currently, most types of dementia are considered incurable. However, treatment methods have been developed to control a significant part of the manifestations of this disorder.

The disease completely changes the character of a person and his desires, therefore one of the main components of therapy is harmony in the family and in relation to loved ones. At any age, help and support, sympathy from loved ones is needed. If the situation around the patient is unfavorable, then it is very difficult to achieve any progress and improve the condition.

When prescribing drugs, you need to remember the rules that must be observed so as not to harm the patient's health:

• All medicines have their own side effects that must be taken into account.
• The patient will need help and supervision for regular and timely medication.
• The same drug can act differently at different stages, so therapy needs periodic adjustment.
• Many of the drugs can be dangerous if taken in large amounts.
• Individual drugs may not mix well with each other.

Patients with dementia are poorly trained, it is difficult to interest them in new things in order to somehow compensate for the lost skills. It is important in the treatment to understand that this is an irreversible disease, that is, incurable. Therefore, there is a question about the adaptation of the patient to life, as well as high-quality care for him. Many devote a certain period of time to caring for the sick, looking for nurses, quitting their jobs.

Prognosis for people with dementia

Dementia usually has a progressive course. However, the rate (speed) of progression varies widely and depends on a number of reasons. Dementia shortens life expectancy, but estimates of survival vary.

Measures that ensure safety and provide appropriate environmental conditions of existence are extremely important in treatment, as well as the help of a caregiver. Some medications may be helpful.

Prevention

In order to prevent the occurrence of this pathological condition, doctors recommend to engage in prevention. What will be required for this?

• Follow a healthy lifestyle.
• Give up bad habits: smoking and alcohol.
• Control blood cholesterol levels.
• Eat well.
• Control blood sugar levels.
• Timely treat emerging ailments.
• Make time for intellectual pursuits (reading, solving crossword puzzles, and so on).

This is all about dementia in the elderly: what is the disease, what are its main symptoms and signs in men and women, is there a treatment. Be healthy!

The term "dementia" in medicine is used to denote acquired dementia, characterized by a violation of the basic mental functions of a person: thinking, intelligence, attention, memory, and others. The disease usually progresses slowly, but in some cases it occurs very quickly. The rapid development of pathology is observed, as a rule, with craniocerebral injuries or intoxication, in which brain cells die in a short period of time.

With dementia, a person loses the ability to cognize the world, loses previously acquired skills, does not show emotions, forgets events that occurred recently, while the patient is not aware of what is happening to him. Violations are usually so pronounced that a person cannot carry out his professional activities and experiences serious difficulties in everyday life. Many people whose relatives are faced with this pathology are wondering how many years patients with dementia live. It is very difficult to give a definite answer, as it all depends on many factors. If a person receives the necessary care and supportive care, they can live for many years. You should also consider how quickly dementia develops, and what causes it was caused.

According to statistics, dementia is most often diagnosed in older people over the age of sixty. In patients over the age of eighty, the disease is diagnosed in approximately 80% of cases.

Reasons for the development of the disease

Dementia develops as a result of severe damage to the central nervous system of an organic nature, therefore, any pathological conditions leading to degenerative changes and death of the cellular structures of the cerebral cortex can be the starting point for its onset. Considering the most probable causes of this, it is first necessary to single out those specific types of acquired dementia in which the destruction of the cerebral cortex acts as an independent mechanism of pathology. In this case, we are talking about Alzheimer's disease, Pick's disease, etc. Such pathologies are most often diagnosed in patients over the age of sixty-five years.

In other cases, dementia occurs with a secondary lesion of the human brain. Often this pathology acts as a complication of trauma, infectious lesions, vascular diseases that occur in a chronic form, exposure to various toxic substances. Most often, secondary organic brain damage occurs with vascular pathologies, such as atherosclerosis, hypertension, etc.

It is possible that dementia can develop due to the abuse of alcohol and drugs, with tumors in the brain. Quite rarely, infections contribute to the development of the disease: meningitis, viral encephalitis, AIDS, neurosyphilis and others.

It is extremely difficult to say how many reasons there are that contribute to one degree or another to the development of acquired dementia. In some cases, dementia becomes a complication of hemodialysis, severe liver or kidney failure, certain endocrinological and autoimmune diseases. In most cases, the disease occurs as a result of exposure to several provoking factors at once. A typical example of such a disorder is the so-called senile (senile) dementia.

It is worth noting that the risk of developing acquired dementia increases with age. Based on medical statistics, among people under the age of sixty, the percentage of patients with dementia is extremely small, while among older people over seventy or eighty years old, this figure reaches 75-80%.

Classification

In modern clinical practice, dementia is divided into the following functional and anatomical forms:

Dementia can occur in lacunar or total form. In the first case, the patient has localized lesions of those structures that are responsible for the function of the intellect. In this case, serious violations of short-term memory are usually observed, and minor asthenic manifestations may also occur.

If there is a complete destruction of the core of the personality, we are talking about total dementia. In such patients, not only the deterioration of memory and intelligence occurs, but also serious disorders of the emotional-volitional sphere. If the disease develops over several years, then the patient may completely lose his previously characteristic interests, spiritual values. A person becomes completely socially maladapted.

Clinical picture

Depending on the stage of dementia, its symptoms can be quite variable. This disease is characterized by a violation of all cognitive functions of a person. Behavioral and personality disorders can form at any stage of the disease, as well as motor dysfunctions and other deficit syndromes.

The most rapid development is usually characterized by vascular dementia, while, for example, in Alzheimer's disease, the pathology progresses at a slow pace. As temporary clinical manifestations, many patients experience various psychoses characterized by manic, depressive, paranoid states.

Dementia at an early stage can be manifested by impaired memory function. The patient is not able to remember and understand new information, there may be speech disorders associated with difficulties in choosing words. Personality disorders and mood swings are also quite common early in the development of acquired dementia. Quite often, patients have progressive difficulties with the performance of their usual daily activities. It becomes difficult for them to find their way home, remember where they live, and so on. loss of independence often leads to outbreaks of aggression and depressive disorders.

Other symptoms that characterize incipient dementia include apraxia, agnosia, and aphasia. Often, close people of a sick person notice early signs of the disease, complaining about his strange behavior and emotional instability.

At an intermediate stage in the development of pathology, patients are almost completely deprived of the ability to learn. Their memory does not disappear completely, but is significantly reduced, especially for those events that occurred relatively long ago, for example, a couple of years ago. It becomes more and more difficult for patients to take care of themselves: dress, wash, etc. At the same time, personal changes also progress: irritability appears, sometimes accompanied by outbursts of aggression, or complete passivity occurs with a lack of emotional manifestations and signs of depression.

Dementia at this stage of its development often leads to the fact that the patient loses an adequate sense of space and time. A person finds it difficult to answer elementary questions, for example, how old is he, he can get lost in his own apartment, they confuse day with night. Such disorders can eventually transform into psychosis, accompanied by hallucinations, mania and depression.

In the severe stage of the disease, patients lose the ability to move independently. Often the disease at this stage is accompanied by urinary incontinence, a complete lack of memory. The patient can forget how to eat and drink independently. These patients are at a very high risk of developing pressure sores and pneumonia. Often, patients are placed in specialized medical facilities to ensure proper care.

Diagnostics

With cognitive impairment and suspected dementia, a comprehensive examination of the patient is necessary. As a rule, at the very beginning of the development of the disease, few people pay attention to minor changes, and therefore dementia is often diagnosed already at a fairly advanced stage. Relatives need to be careful and consult a doctor if a loved one for some reason began to confuse words, forget recent events, became uncommunicative and irritable.

To identify the disease, specialists use special psychometric tests. An examination by a neurologist and an ophthalmologist is mandatory. In order to exclude infectious and metabolic diseases, a number of laboratory tests are prescribed. This usually includes a blood test for sugar levels, a hormonal analysis of blood serum, and other studies.

During a neurological examination in patients with dementia, a slowdown in psychomotor functions is detected. The patient may expend a lot of effort, but not give correct answers. As one of the most informative tests for detecting acquired dementia, doctors often suggest that patients evaluate their short-term memory. If you put three or four objects in front of the patient, and then remove them and ask them to name after a few minutes, the person with dementia will not be able to do this.

In addition to identifying a memory disorder, when diagnosing acquired dementia, it is necessary to confirm that the patient has aphasia, agnosia, apraxia, and other characteristic signs of the disease. In addition to everything, an assessment of the mental status of the patient is carried out.

Electrocardiography, vascular dopplerography, magnetic resonance and computed tomography are mandatory. Vascular dementia and Alzheimer's disease are detected using the Khachinsky ischemic scale. The verdict on the disease and its stage is made on the basis of the total points scored by the patient.

Differential Diagnosis

In clinical practice, organic dementia during the examination of the patient must be differentiated from the so-called depressive pseudodementia. Very often, severe depression is accompanied by a pronounced disorder of the intellect, which can be mistaken for signs of dementia. Severe psychological trauma and stress can also cause pseudodementia as a kind of protective reaction.

In some cases, intellectual impairment occurs with metabolic disorders, for example, a lack of vitamin B12, folic acid, or other substances necessary for the human body. In such cases, all the symptoms of dementia disappear after a competent correction of violations.

It is important to emphasize that it can be very difficult to differentiate between pseudodementia and organic dementia, even for experienced professionals. Most often, the correct diagnosis is possible only with constant and long-term monitoring of the patient's condition. in addition, dementia must be differentiated from memory impairments, which are common in the elderly, cognitive disorders that occur against the background of depression.

Unfortunately, with organic dementia, treatment can almost always be only supportive. Therapy is prescribed to compensate for the deficit of cognitive functions and improve cerebral circulation. To do this, the doctor prescribes the appropriate medications, individually setting their dosage for each individual patient. Speaking about how long such treatment should last, it should be emphasized that maintenance therapy is necessary throughout life. As a symptomatic treatment, sedatives and antidepressants may be prescribed. It is worth noting that dementia that occurs against the background of depression does not disappear even when the latter is eliminated.

dementia(literally translated from Latin: dementia- "madness") - acquired dementia, a condition in which there are violations in cognitive(cognitive) sphere: forgetfulness, loss of knowledge and skills that a person possessed before, difficulty in acquiring new ones.

Dementia is an umbrella term. There is no such diagnosis. This is a disorder that can occur in various diseases.

Dementia facts and figures:

• According to 2015 statistics, there are 47.5 million people with dementia in the world. Experts believe that by 2050 this figure will increase to 135.5 million, that is, approximately 3 times.
• Every year, doctors diagnose 7.7 million new cases of dementia.
• Many patients are unaware of their diagnosis.
• Alzheimer's disease is the most common form of dementia. It occurs in 80% of patients.
• Dementia (acquired dementia) and oligophrenia (mental retardation in children) are two different conditions. Oligophrenia is an initial underdevelopment of mental functions. With dementia, they were previously normal, but over time began to disintegrate.
• People call dementia senile insanity.
• Dementia is a pathology, not a sign of the normal aging process.
• At the age of 65, the risk of getting dementia is 10%, it greatly increases after 85 years.
• The term "senile dementia" refers to senile dementia.

What are the causes of dementia? How do brain disorders develop?

These changes happen to everyone. Usually they do not lead to problems in everyday life. With dementia, the disorders are much more pronounced. Because of them, problems arise both for the patient himself and for the people who are close to him.

Dementia is caused by the death of brain cells. Its reasons may be different.

What diseases cause dementia?

Name	Mechanism of brain damage, description	Diagnostic methods
Neurodegenerative and other chronic diseases
Alzheimer's disease	The most common form of dementia. According to various sources, it occurs in 60-80% of patients. During Alzheimer's disease, abnormal proteins accumulate in brain cells: Beta-amyloid is formed during the breakdown of a larger protein that plays an important role in the growth and regeneration of neurons. In Alzheimer's disease, beta-amyloid accumulates in nerve cells in the form of plaques. Tau protein is part of the cell skeleton and provides transport of nutrients within the neuron. In Alzheimer's disease, its molecules stick together and are deposited inside cells. In Alzheimer's disease, neurons die, and the number of nerve connections in the brain decreases. The volume of the brain is reduced.	examination by a neurologist, observation in dynamics; positron emission tomography; single photon emission computed tomography.
Dementia with Lewy bodies	Neurodegenerative disease, the second most common form of dementia. According to some reports, it occurs in 30% of patients. In this disease, Lewy bodies accumulate in the neurons of the brain - plaques consisting of the protein alpha-synuclein. Brain atrophy occurs.	examination by a neurologist; CT scan; Magnetic resonance imaging; positron emission tomography.
Parkinson's disease	A chronic disease characterized by the death of neurons that produce dopamine, a substance necessary for the transmission of nerve impulses. In this case, Lewy bodies are formed in the nerve cells (see above). The main manifestation of Parkinson's disease is impaired movement, but with the spread of degenerative changes in the brain, symptoms of dementia may occur.	The main diagnostic method is an examination by a neurologist. Positron emission tomography (PET) is sometimes done to help detect low levels of dopamine in the brain. Other studies (blood tests, CT, MRI) are used to exclude other neurological diseases.
Huntington's disease (Huntington's chorea)	A hereditary disease in which a mutant mHTT protein is synthesized in the body. It is toxic to nerve cells. Huntington's chorea can develop at any age. It is detected in 2-year-old children, and in people older than 80 years. Most often, the first symptoms appear in 30-50 years. The disease is characterized by movement disorders and mental disorders.	examination by a neurologist; MRI and CT - revealed atrophy (reduction in size) of the brain; positron emission tomography (PET) and functional magnetic resonance imaging - changes in brain activity are detected; genetic research (blood is taken for analysis) - a mutation is detected, but there are not always symptoms of the disease.
Vascular dementia	The death of brain cells occurs as a result of impaired cerebral circulation. Violation of blood flow leads to the fact that neurons cease to receive the necessary amount of oxygen and die. This occurs in stroke and cerebrovascular disease.	examination by a neurologist; rheovasography; biochemical blood test (for cholesterol); angiography of cerebral vessels.
Alcoholic dementia	It occurs as a result of damage to the brain tissue and cerebral vessels by ethyl alcohol and its decay products. Often, alcoholic dementia develops after an attack of delirium tremens or acute alcoholic encephalopathy.	examination by a narcologist, psychiatrist, neurologist; CT, MRI.
Volumetric formations in the cranial cavity: brain tumors, abscesses (abscesses), hematomas.	Volumetric formations inside the skull compress the brain, disrupt blood circulation in the cerebral vessels. Because of this, the process of atrophy gradually begins.	examination by a neurologist; ECHO-encephalography.
Hydrocephalus (dropsy of the brain)	Dementia can develop with a special form of hydrocephalus - normotensive (without increased intracranial pressure). Another name for this disease is Hakim-Adams syndrome. Pathology occurs as a result of impaired outflow and absorption of cerebrospinal fluid.	examination by a neurologist; lumbar puncture.
Pick's disease	Chronic progressive disease characterized by atrophy of the cortex of the frontal and temporal lobes of the brain. The causes of the disease are not fully known. Risk factors: heredity (the presence of the disease in relatives); intoxication of the body with various substances; frequent operations under general anesthesia (the effect of the drug on the nervous system); head injury; past depressive psychosis.	examination by a psychiatrist;
amyotrophic lateral sclerosis	A chronic incurable disease during which the destruction of motor neurons of the brain and spinal cord occurs. The causes of amyotrophic lateral sclerosis are unknown. Sometimes it occurs as a result of a mutation in one of the genes. The main symptom of the disease is paralysis of various muscles, but dementia can also occur.	examination by a neurologist; electromyography (EMG); general blood analysis; blood chemistry; genetic research.
Spinocerebellar degeneration	A group of diseases in which degeneration processes develop in the cerebellum, brain stem, and spinal cord. The main manifestation is a violation of coordination of movements. In most cases, spinocerebellar degeneration is hereditary.	examination by a neurologist; CT and MRI - reveal a decrease in the size of the cerebellum; genetic research.
Hallervorden-Spatz disease	A rare (3 patients per million people) hereditary neurodegenerative disease in which iron is deposited in the brain. A child is born sick if both parents are sick.	genetic research.
Infectious diseases
HIV-associated dementia	Caused by the human immunodeficiency virus. Scientists do not yet know how the virus damages the brain.	Blood test for HIV.
Viral encephalitis	Encephalitis is an inflammation of the substance of the brain. Viral encephalitis can lead to the development of dementia. Symptoms: violation of hematopoiesis and the development of anemia; violation of the synthesis of myelin (the substance that makes up the sheaths of nerve fibers) and the development of neurological symptoms, including memory impairment.	examination by a neurologist, therapist; general blood analysis; determination of the level of vitamin B 12 in the blood.
folic acid deficiency	Deficiency of folic acid (vitamin B 9) in the body can occur as a result of its insufficient content in food or assimilation disorders in various diseases and pathological conditions (the most common cause is alcohol abuse). Hypovitaminosis B 9 is accompanied by various symptoms.	examination by a neurologist, therapist; general blood analysis; determination of the level of folic acid in the blood.
Pellagra (vitamin B3 deficiency)	Vitamin B 3 (vitamin PP, niacin) is necessary for the synthesis of ATP molecules (adenosine triphosphate) - the main energy carriers in the body. The brain is one of the most active "consumers" of ATP. Pellagra is often referred to as the "three D's disease" because its main manifestations are dermatitis (skin lesions), diarrhea, and dementia.	The diagnosis is established mainly on the basis of the patient's complaints and clinical examination data.
Other diseases and pathological conditions
Down syndrome	Chromosomal disease. People with Down syndrome usually develop Alzheimer's disease at a young age.	Diagnosis of Down syndrome before birth: Ultrasound of a pregnant woman; biopsy, examination of amniotic fluid, blood from the umbilical cord; cytogenetic study - determination of the set of chromosomes in the fetus.
Post-traumatic dementia	Occurs after traumatic brain injuries, especially if they have occurred repeatedly (for example, this is often found in some sports). There is evidence that a single traumatic brain injury increases the risk of developing Alzheimer's disease in the future.	examination by a neurologist or neurosurgeon; x-ray of the skull; MRI, CT; In children - ECHO-encephalography.
Interactions of certain drugs	Some drugs, when used simultaneously, can cause symptoms of dementia.
Depression	Dementia can occur in the presence of a depressive disorder and vice versa.
Mixed dementia	It occurs as a result of a combination of two or three different factors. For example, Alzheimer's disease can coexist with vascular dementia or Lewy body dementia.

Manifestations of dementia

• memory impairment. The patient does not remember what happened recently, immediately forgets the name of the person with whom he was just introduced, asks the same question several times, does not remember what he did or said a few minutes ago.
• Difficulty performing simple, familiar tasks. For example, a housewife who has been cooking all her life is no longer able to cook dinner, cannot remember what ingredients are needed, in what order they need to be put into the pan.
• Problems in communication. The patient forgets familiar words or uses them incorrectly, has difficulty finding the right words during a conversation.
• Disorientation in the terrain. A person with dementia may go to the store along the usual route and not find their way back home.
• shortsightedness. For example, if you leave the patient to sit with a small child, then he can forget about it and leave home.
• Abstract thinking disorder. This is most clearly manifested while working with numbers, for example, during various operations with money.
• Violation of the arrangement of things. The patient often puts things in their usual places - for example, he can leave the keys to the car in the refrigerator. Moreover, he constantly forgets about it.
• Sudden mood swings. Many people with dementia become emotionally unstable.
• Personality changes. The person becomes overly irritable, suspicious, or begins to be constantly afraid of something. He becomes extremely stubborn and almost unable to change his mind. Everything new, unfamiliar is perceived as a threat.
• Behavior changes. Many patients become selfish, rude, unceremonious. They always put their interests first. They can do weird things. Often they show an increased interest in young people of the opposite sex.
• Decreased Initiative. A person becomes inactive, does not show interest in new undertakings, proposals of other people. Sometimes the patient becomes completely indifferent to what is happening around.

Stages of dementia (WHO classification, source:

Diagnosis of dementia

It is important that during the conversation, the specialist doctor adhere to standardized methods, and not be guided only by his impressions of the patient's mental abilities - they are far from always objective.

Cognitive tests

The Hodkins technique was called the abbreviated mental test score (AMTS).

Test questions:

1. What is your age?
2. What time is it to the nearest hour?
3. Repeat the address I'll show you now.
4. What year is it now?
5. In which hospital and in which city are we now?
6. Can you now recognize the two people you saw earlier (e.g. doctor, nurse)?
7. State your date of birth.
8. In what year did the Great Patriotic War begin (you can ask about any other well-known date)?
9. What is the name of our current president (or other famous person)?
10. Count backwards from 20 to 1.

GPCOG test

This is a simpler test than the AMTS, with fewer questions. It allows you to conduct an express diagnosis of cognitive abilities and, if necessary, refer the patient for further examination.

One of the tasks that the test subject must complete in the process of passing the GPCOG test is to draw a dial on a circle, roughly respecting the distance between divisions, and then mark a certain time on it.

If the test is conducted online, the doctor simply notes on the web page which questions the patient answers correctly, and then the program itself automatically issues the result.

The second part of the GPCOG test is a conversation with a relative of the patient (can be done by phone).

The doctor asks 6 questions about how the patient's condition has changed over the past 5-10 years, which can be answered "yes", "no" or "don't know":

1. Are there more problems with remembering recent events, things that the patient uses?
2. Has it become more difficult to remember conversations that took place a few days ago?
3. Has it become more difficult to find the right words during communication?
4. Has it become more difficult to manage money, manage a personal or family budget?
5. Has it become more difficult to take medications on time and correctly?
6. Has it become more difficult for the patient to use public or private transport (this does not mean problems that arose due to other reasons, for example, due to injuries)?

The patient is examined by a neurologist, if necessary, by other specialists.

Laboratory and instrumental studies that are most often used when dementia is suspected are listed above, when considering the causes.

Dementia treatment

Therefore, in Alzheimer's disease and other degenerative diseases, a complete cure is impossible - at least there are no such drugs today. The main task of the doctor is to slow down the pathological processes in the brain, to prevent further growth of disorders in the cognitive sphere.

If the processes of degeneration in the brain do not occur, then the symptoms of dementia may be reversible. For example, the restoration of cognitive function is possible after traumatic brain injury, hypovitaminosis.

Symptoms of dementia rarely come on suddenly. In most cases, they increase gradually. Dementia is preceded by cognitive impairment for a long time, which cannot yet be called dementia - they are relatively mild and do not lead to problems in everyday life. But over time, they grow to the degree of dementia.

If these disorders are detected in the early stages and appropriate measures are taken, this will help delay the onset of dementia, reduce or prevent a decrease in working capacity, quality of life.

Dementia Care

Because of this, patients around the world are often discriminated against, especially in nursing homes, where they are cared for by strangers, who often lack knowledge and do not fully understand what dementia is. Sometimes even medical staff behaves rather rudely towards patients and their relatives. The situation will improve if society knows more about dementia, this knowledge will help to treat such patients with greater understanding.

Prevention of dementia

Key measures to prevent dementia:

• Quitting smoking and drinking alcohol.
• healthy eating. Useful vegetables, fruits, nuts, cereals, olive oil, lean meats (chicken breast, lean pork, beef), fish, seafood. Avoid excessive consumption of animal fats.
• Fighting overweight. Try to monitor your weight, keep it normal.
• moderate physical activity. Physical exercise has a positive effect on the state of the cardiovascular and nervous system.
• Try to be mentally active. For example, a hobby like playing chess can reduce the risk of dementia. It is also useful to solve crossword puzzles, solve different puzzles.
• Avoid head injury.
• Avoid Infections. In the spring, it is necessary to follow the recommendations for the prevention of tick-borne encephalitis, which are carried by ticks.
• If you are over 40 years old, take a blood test for sugar and cholesterol annually. This will help to detect diabetes mellitus, atherosclerosis in time, prevent vascular dementia and many other health problems.
• Avoid psycho-emotional overwork, stress. Try to get enough sleep and rest.
• Control your blood pressure. If it rises periodically, see a doctor.
• When the first symptoms of disorders of the nervous system appear, immediately contact a neurologist.

Dementia, or more simply, senile dementia, is a severe disorder of higher nervous activity, provoked by brain damage. This disease, which mainly affects the elderly, manifests itself as a decrease in mental abilities and a gradual degradation of the personality. It is impossible to cure dementia, but it is quite possible to slow down the progression of the disease, the main thing is to know the cause that caused the brain damage and the principles of treating the disease.

Causes and types of dementia

Tellingly, secondary dementia, with timely treatment, is completely reversible, while organic or primary dementia is an irreversible process in which you can only slow down its development and relieve unpleasant symptoms, thereby prolonging the life of the patient.

signs of dementia

A little later, absent-mindedness, a general decrease in understanding, an apathetic and depressive state are added to these signs. The patient can get lost in space and time, forgets what happened to him a few hours ago, but remembers the events of many years ago in detail. A characteristic sign of dementia is slovenliness and lack of a critical attitude towards one's appearance. Approximately 20% of such patients have psychosis, hallucinations and a manic state. Often it seems to them that close people are plotting around them and trying only their lives.

Dementia affects not only the psyche of the patient and his cognitive functions. In most cases, people with this disorder have speech problems that become slow, incoherent, and sometimes incoherent. Another sign of the disease are seizures, which occur at all stages of the disease.

Dementia treatment

Organic dementia at an early stage is treated with the following drugs:

In the later stages of the fight against dementia, the patient is prescribed acetylcholinesterase inhibitors, which means the drug Donepezil and others. These funds help to improve the social adaptation of patients, and thus reduce the burden on people caring for such patients. Source -

Dementia, or more simply, senile dementia, is a severe disorder of higher nervous activity, provoked by brain damage. This disease, which mainly affects the elderly, manifests itself as a decrease in mental abilities and a gradual degradation of the personality. It is impossible to cure dementia, but it is quite possible to slow down the progression of the disease, the main thing is to know the cause that caused the brain damage and the principles of treating the disease.

Causes and types of dementia

Depending on the cause that caused the disease, dementia is divided into primary and secondary. Primary, or organic, dementia occurs when there is mass death of neurons in the brain or when there is a malfunction of the blood vessels. Diseases such as Alzheimer's disease, Pick's disease or dementia with Lewy bodies lead to this. In 90% of cases, senile dementia is caused by these reasons. The remaining 10% are secondary dementia, which can be caused by an infection in the brain, malignancy, metabolic problems, thyroid disease, and brain injury.

Tellingly, secondary dementia, with timely treatment, is completely reversible, while organic or primary dementia is an irreversible process in which you can only slow down its development and relieve unpleasant symptoms, thereby prolonging the life of the patient.

signs of dementia

Organic dementia is characterized by manifestations of Alzheimer's disease. Initially, they are poorly noticeable, and therefore they can be identified only by closely observing the patient. At an early stage of dementia, a person's behavior changes - he becomes aggressive, irritable and impulsive, often suffers from forgetfulness, loses interest in the next occupation and is unable to perform work in accordance with the norms.

A little later, absent-mindedness, a general decrease in understanding, an apathetic and depressive state are added to these signs. The patient can get lost in space and time, forgets what happened to him a few hours ago, but remembers the events of many years ago in detail. A characteristic sign of dementia is slovenliness and lack of a critical attitude towards one's appearance. Approximately 20% of such patients have psychosis, hallucinations and a manic state. Often it seems to them that close people are plotting around them and trying only their lives.

Dementia affects not only the psyche of the patient and his cognitive functions. In most cases, people with this disorder have speech problems that become slow, incoherent, and sometimes incoherent. Another sign of the disease are seizures, which occur at all stages of the disease.

Dementia treatment

The fight against the disease in question is aimed at stabilizing the pathological process, as well as at reducing the severity of existing symptoms. Treatment is complex and must necessarily include the fight against diseases that exacerbate dementia (atherosclerosis, hypertension, obesity, diabetes).

Organic dementia at an early stage is treated with the following drugs:

• nootropics (Cerebrolysin, Piracetam);
• homeopathic remedies (Ginkgo biloba);
• dopamine receptor stimulants (Piribedil);
• means for improving blood circulation in the brain (Nicergoline);
• CNS mediators (Phosphatidylcholine);
• drugs that improve the utilization of glucose and oxygen by brain cells (Actovegin).

In the later stages of the fight against dementia, the patient is prescribed acetylcholinesterase inhibitors, which means the drug Donepezil and others. These funds help to improve the social adaptation of patients, and thus reduce the burden on people caring for such patients. Take care of yourself!