Dementia Paralytica

 Dementia Paralytica

Overview

Dementia is a term for several diseases that affect memory, thinking, and the ability to perform daily activities.

The illness gets worse over time. It minly affects older people but not all people will get it as they age.

Things that increase the risk of developing dementia include:

*age (more common in those 65 or older) 

*high blood pressure (hypertension)

*high blood sugar (diabetes)

*being overweight or obese

*smoking

*drinking too much alcohol

*being physically inactive

*being socially isolated

*depression.

Dementia is a syndrome that can be caused by a number of diseases which over time destroy nerve cells and damage the brain, typically leading to deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from the usual consequences of biological ageing. While consciousness is not affected, the impairment in cognitive function is commonly accompanied, and occasionally preceded, by changes in mood, emotional control, behaviour, or motivation.

Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their carers, families and society at large. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care.

Signs and symptoms

Changes in mood and behaviour sometimes happen even before memory problems occur. Symptoms get worse over time. Eventually, most people with dementia will need others to help with daily activities.

Early signs and symptoms are:

*forgetting things or recent events

*losing or misplacing things

*getting lost when walking or driving

*being confused, even in familiar places

*losing track of time

*difficulties solving problems or making decisions 

*problems following conversations or trouble finding words 

*difficulties performing familiar tasks

*misjudging distances to objects visually.

Common changes in mood and behaviour include:

*feeling anxious, sad, or angry about memory loss 

*personality changes

*inappropriate behaviour

*withdrawal from work or social activities

*being less interested in other people’s emotions.

Dementia affects each person in a different way, depending upon the underlying causes, other health conditions and the person’s cognitive functioning before becoming ill.

Most symptoms become worse over time, while others might disappear or only occur in the later stages of dementia. As the disease progresses, the need for help with personal care increases. People with dementia may not be able to recognize family members or friends, develop difficulties moving around, lose control over their bladder and bowls, have trouble eating and drinking and experience behaviour changes such as aggression that are distressing to the person with dementia as well as those around them.

CAUSES

Dementia is caused by many different diseases or injuries that directly and indirectly damage the brain. Alzheimer disease is the most common form and may contribute to 60–70% of cases. Other forms include vascular dementia, dementia with Lewy bodies (abnormal deposits of protein inside nerve cells), and a group of diseases that contribute to frontotemporal dementia (degeneration of the frontal lobe of the brain). Dementia may also develop after a stroke or in the context of certain infections such as HIV, as a result of harmful use of alcohol, repetitive physical injuries to the brain (known as chronic traumatic encephalopathy) or nutritional deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.

Diagnosis

To diagnose the cause of dementia, a health care professional must recognize the pattern of loss of skills and function. The care professional also determines what the person is still able to do. More recently, biomarkers have become available to make a more accurate diagnosis of Alzheimer's disease.

A health care professional reviews your medical history and symptoms and conducts a physical exam. Someone who is close to you may be asked about your symptoms as well.

No single test can diagnose dementia. You'll likely need a number of tests that can help pinpoint the problem.

Cognitive and neuropsychological tests

These tests evaluate your thinking ability. A number of tests measure thinking skills, such as memory, orientation, reasoning and judgment, language skills, and attention.

Neurological evaluation

Your memory, language skills, visual perception, attention, problem-solving skills, movement, senses, balance, reflexes and other areas are evaluated.

Brain scans

CT or MRI. These scans can check for evidence of stroke, bleeding, tumor or fluid buildup, known as hydrocephalus.

PET scans. These scans can show patterns of brain activity. They can determine whether amyloid or tau protein, hallmarks of Alzheimer's disease, have been deposited in the brain.

Laboratory tests

Simple blood tests can detect physical problems that can affect brain function, such as too little vitamin B-12 in the body or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, for inflammation or for markers of some degenerative diseases.

Psychiatric evaluation

A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms.

Treatment and care

There is no cure for dementia, but a lot can be done to support both people living with the illness and those who care for them.

People with dementia can take steps to maintain their quality of life and promote their well-being by: 

being physically active 

taking part in activities and social interactions that stimulate the brain and maintain daily function.

In addition, some medications can help manage dementia symptoms:

Cholinesterase inhibitors like donepezil are used to treat Alzheimer disease. 

NMDA receptor antagonists like memantine are used for severe Alzheimer disease and vascular dementia.

Medicines to control blood pressure and cholesterol can prevent additional damage to the brain due to vascular dementia.

Selective serotonin reuptake inhibitors (SSRIs) can help with severe symptoms of depression in people living with dementia if lifestyle and social changes don’t work, but  these should not be the first option.

If people living with dementia are at risk of hurting themselves or others, medicines like haloperidol and risperidone can help, but these should never be used as the first treatment

TYPE OF DOCTOR AND DEPARTMENT : Neuropsychologist SPECIALIST CAN DIAGNOSE THIS DISEASE.