Diagnosis of senile dementia. Types of dementia and causes. Dementia syndrome in old age.

Memory, intelligence and speech, provoked by changes in the molecular exchange between cells in the cerebral cortex caused by different reasons. And the more pronounced these changes, the more severe the senile dementia, which is called dementia in medicine. Old man at the same time, he loses not only the existing knowledge, experience, ability to learn, but also his own personality.

Is Alzheimer's disease contagious in humans?

Still no scientific evidence that Alzheimer's disease is contagious in humans. Therefore, special protection is not required in the daily handling of patients or in treatment. However, the question of possible contagiousness in fundamental research is not ignored. Experiments with genetically modified mice suggest that Alzheimer's disease can be transmitted in laboratory conditions. Research results of the laureate Nobel Prize Stanley Prusinera also raises the question of whether Alzheimer's disease can be initiated by synthetic amyloid beta.

About what causes dementia, how many years they live with this diagnosis, and how they look different types this pathology, we will discuss later in the article.

Classification of dementia

Noticing that an elderly person living nearby is changing habits, character and ability to communicate, relatives begin to worry, fearing himself. worst case development of events - total dementia, which, as a rule, turns out to be a harbinger of imminent death native person. Is it so? How fast does the brain age?

What types of dementia are there?

However, these results are not applicable to humans. Alzheimer's disease is the most common form of dementia, accounting for about two-thirds of all cases. On the other hand, neurological research and science has over 50 different forms of dementia, which often also appear as mixed forms.

Approximately 15% of all dementias vascular dementia caused by a disorder in the blood supply to the brain. Cause is either torn blood vessel or a blood clot. In both cases, the brain tissue is destroyed. Abnormal brain cell densities also lead to dementia. This form is known by the English term Levi-Body Dementia. Their symptoms are similar to those of Parkinson's disease and Alzheimer's disease. The cause of this type of dementia is not yet known. Estimates of how many people suffer from dementia with Lewy bodies vary widely.

To understand this, one should determine what kind of dementia one had to face. In medicine, there are different classifications of this pathology. And since she is not independent disease, then, depending on the main problem that caused it, the following types of dementia are divided:

Atrophic form of the disease (provoked by Alzheimer's or Pick's disease), which occurs against the background of the initial degenerative reactions occurring in the cells of the central nervous system.
Vascular, caused by atherosclerosis and hypertension. It occurs due to a violation of blood circulation in the brain.
Mixed type - the development of this pathology has mechanisms similar to atrophic appearance, and on the vascular.

Causes of dementia

The described problems can begin their destructive action as a result of natural process aging of the body, as well as due to diseases of internal organs, ailments of the thyroid gland, neurological and vascular pathologies(such as ischemia, arterial hypertension, atherosclerosis, etc.).

This is probably the third most common form. Frontotemporal dementia is somewhat less common than dementia with Lewy bodies. In the brain, among other things, the forehead and / or symptoms and concomitant symptoms. Anticipation and anxiety, compulsive impulsive behavior, impulsivity, decreased body care, slow loss speech.

Are memory problems a symptom of Alzheimer's disease?

As people age, they are more likely to complain of memory problems. However, slight forgetfulness and "slow" memory are related to normal process aging. Older people just need more time to learn new things or remember old ones. Everyone forgets to forget where he put his car keys. However, people with Alzheimer's can no longer remember what the key is. Therefore, Forgetfulness means that the person does not remember a specific detail of the event, whereas in the case of dementia, the complete event has disappeared from memory.

Alcohol intoxication or drugs can also push the body to pathological changes. destructive action renders and chronic poisoning poisonous chemical compounds in production.

Strokes, tumors, and head injuries can also rupture neural connections which will eventually lead to dementia.

Memory problems can be a sign of Alzheimer's disease, but it doesn't have to be. Therefore, it is generally important to be able to study this with a doctor. Only he can determine what is causing the forgetfulness. There are other conditions that can contribute to the development of memory problems and dementia, such as infections, drug abuse, metabolic and nutritional disorders, brain tumors, depression, or other progressive diseases such as Parkinson's disease.

What is the cause of death in Alzheimer's disease?

On last step Alzheimer's patients need care around the clock.

Can Alzheimer's cause violence and aggression?

Aggression and violence can lead to dementia. They arise for many reasons. The disease makes extreme demands on the patient. While physical violence is relatively rare, verbal aggression or arguments usually occur more frequently. People with dementia are temporarily overwhelmed, frustrated, or unable to recognize their deficiency as clearly as a nurse.

True, cases have been recorded when the causes of dementia lie not in the process of natural aging or the listed diseases, but in taking medicines. In such cases, the process is reversible if the number of such drugs is limited or discontinued.

Dementia due to Alzheimer's disease

Most often, the reasons causing development hidden in organic damage to those areas of the brain that are responsible for human thinking and memory. And the most common among them is Alzheimer's dementia, that is, dementia resulting from degenerative processes in neurons and the destruction of synaptic connections.

In addition, dementia is also caused long period mourning, which can also cause anger. Pharmacotherapy is primarily aimed at relieving the symptoms of Alzheimer's disease and treating possible comorbidities. mental behavior patients should be improved and their day-to-day management should be facilitated, and possible behavioral problems or depression should be mitigated. What is the effect of drugs? Because as patient needs change over the course of the disease, drug compatibility may change.

During this disease, amyloid (protein) plaques, as well as neurofibrillary tangles, are formed on the nerve cells of the patient's brain, which ultimately causes the death of these cells. Pathological areas atrophy as a result of these processes, and damage over time captures the entire brain, and this process, alas, is irreversible.

What medications are not available?

Non-drug therapies can help keep patients involved as long as possible. public life and positively affect the patient's condition. Treatment is used by trained therapists depending on the symptoms and extent of the disease. First contact person in case of memory problems is family doctor, which can then refer the patient to a neurologist, psychiatrist, or memo. Memory rooms, also known as memory clinics, are hospital-affiliated departments that specialize in brain disorders.

How does Alzheimer's dementia develop?

All stages of dementia in Alzheimer's disease are characterized primarily by an increase in short-term memory impairment, and as it progresses, a narrowing of the circle of interests, insufficient resourcefulness, inattention, passivity, slowness of thinking and motor reactions, and irritability.

How do Alzheimer's patients experience nutrition and sexuality, and what changes?

The desire for intimacy and tenderness also persists into old age. However, the topic of "sex in old age" is still considered taboo in society. Another component of the table is added when one of the partners suffers from Alzheimer's disease. IN many respects healthy partner must say goodbye to famous person through progressive changes caused by Alzheimer's disease. It also changes the overall proximity.

There is no guidance on how sexual behavior develops in Alzheimer's patients over time. It may happen that the pleasure completely subsides, re-awakens or there is a sexual de-inhibition. Ideas, inclinations, and desires that were repressed before illness may come to light and then perhaps survive. Changes can lead to a change in the rolling ratio in a pair. This may be the case, for example, when patients in a nursing home exchange endearments with prospective strangers.

Later, patients show a lack of understanding of the events taking place around them, they can repeat what was said for a long time, treat others inappropriately, and uncritically - to themselves. And over time, they may develop paranoid ideas and hallucinations.

Total dementia in this case is accompanied by muscle rigidity and impaired control of urination and bowel movements. Epileptic seizures may occur.

How is sexuality treated in a medical facility?

A diagnosis of Alzheimer's disease can also lead to a cut in the affected person's sexuality. Since Alzheimer's patients feel pleasure and in some cases there is sexual de-inhibition, sexuality doesn't stop at feeding either.

Complete social degradation

This represents serious problem for nursing institutions, which currently cost differently. In many homes, the issue of sexuality is still taboo. So far, there is no clear and comprehensive guidance. In general, when an Alzheimer's patient is given a sexual history, it can make care easier, as doctors and nurses can better adapt to the patient. However, this requires the necessary structures - primarily trained personnel.

How long people live with this type of dementia depends on many reasons, and on average it is about 6 years, but the process can take up to 20. lethal outcome, as a rule, lead to intercurrent (accidental) diseases that have arisen against the background of dementia.

Alzheimer's disease, according to statistics, is the cause of dementia in 70% of recorded cases. But, unfortunately, not only this pathology can push to the beginning of the development of dementia.

The husband describes his Alzheimer's wife as counting and rhyming. She is much clearer than usual. Her laugh shows that she likes it. However, he worries about his wife. Since people with Alzheimer's disease have short-term memory and memory for a more recent past, this woman probably refers to long-established, learned words and rhymes.

Many people with Alzheimer's disease always ask the same question: to establish or express a certain concern. Sentences, phrases, and even verses are often repeated. Sometimes the patient also tends to perform the same activity over and over again, like vacuuming shelves or cleaning shoes. This is usually not a cause for concern, but rather a sign that the patient has found a job that he enjoys or is doing well.

Vascular dementia: causes and symptoms

Against the backdrop of violations cerebral circulation developing vascular dementia. In older people, as already mentioned, it can be provoked by atherosclerosis, hypertension, cerebral vascular ischemia, arrhythmia, heart defects, heart valve pathologies, or increased content lipids in the blood. By the way, in the male part of the population, the predisposition to the vascular form of dementia is one and a half times higher than in women.

Bring it all medical records to your doctor's appointment, as well as a list of medications you are currently taking. If you don't know the names of the medicines, bring your medicine with you. A drug or even a combination of certain drugs can sometimes cause similar symptoms such as Alzheimer's disease. Because doctor visits are often limited, you should also make a list of symptoms and complaints. Therefore, do not forget anything that you want to contact the doctor.

What is the cost of care insurance?

Nursing insurance continued to have five nursing classes. The goal is to better take into account the different needs of people in need of care. The concept of long-term care has been expanded. Because the need for medical care, people with physical limitations, but also mentally or mentally handicapped patients, are no longer considered to be in need of care. People with Alzheimer's or other dementia benefit more from long-term care insurance. The need for assistance is no longer measured as before over the time required for assistance.

At the initial stage of the disease, symptoms are expressed by irritability, increased fatigue, sleep disturbances, lethargy and headaches. At the same time, distraction and depressive experiences become systematic.

In the future, the patient's memory is noticeably impaired. This is expressed in disorientation, as well as in forgetting names, dates, etc.

Last stage of dementia

What matters is how independent a person is. For classification, the degree of self-employment is decisive in six areas. Spiritual and communication skills: For example, local and temporal orientation, needs formulate behavior and psychological problems: For example, night riots, aggression, lack of drive. Self-reliance: Personal care, treatment of diseases and therapies: Medication, visits independent doctors. Design Everyday life and social contacts: daily organization, social contacts. Stairs, sitting down and getting up, moving in the house. . Anyone who wishes to receive benefits from long-term care insurance must apply.

By the way, how dementia develops, how many years patients with this diagnosis live, directly depends on whether they had a history of stroke. In this case, life expectancy is greatly reduced. Neurological symptoms of this pathology are: hemiparesis, rigidity, speech disorders, swallowing, walking and urination.

Even with a diagnosis of Alzheimer's disease, there is no automatic maintenance benefit. The application is submitted to the competent nursing fund, which is linked to the health insurance funds. During the home visit, the examiner assesses how independent the applicant can be in everyday life. As a preparation, it is advisable to keep a book of nurses, which indicates situations in which help is needed. Physician reports and other important documents, such as supervisory services should be available.

It is also recommended that a person be present during the assessment who supports the person in need of care, such as a caregiver or carer. The decision to classify into a nursing degree is made by the Nursing Foundation based on an expert opinion. A contradiction may be brought against this decision. If a nursing degree is granted, the nursing fund pays retroactively from the date of the original application. You can choose between cash payment and in-kind contribution.

Is it possible not to miss the onset of dementia? Signs of the disease

Unfortunately, initial stages it is almost impossible to catch the onset of dementia, since this is a long and slow process that can stretch for 10-15 years. A person's memory of what happened recently is gradually deteriorating, but memories of events that have occurred long ago are retained.

Dementia in the elderly is mainly manifested by a loss of learning ability and intelligence. Patients find it increasingly difficult to navigate in space and time. And it soon turns out that it is already quite difficult for them to pick up the right words, and their speech is noticeably impoverished. By the way, no less problems arise in the process of operating with numbers.

Interestingly, some people long time able to hide signs of dementia by avoiding complex activities (such as checking with a checkbook). What betrays them is a noticeably reduced interest in reading and any kind of activity. Those who cannot rebuild their lives find themselves in a difficult position, as their ability to perform daily duties decreases - a person now and then forgets about important matters or does them incorrectly.

How does dementia start?

Of course, the development of dementia and life expectancy with this disease depend on many reasons: the state of health, past illnesses, personal characteristics, the relationship of others and much more. But if we talk about the signs of the disease in general, then we can distinguish some common features changes taking place in a person

Most often, changes in the character of the patient become especially noticeable. Some of his personality traits are aggravated, for example, thrift develops into stinginess, and perseverance - into stubbornness.
It is more and more difficult for a person, or rather impossible, to change the established view of events. He develops conservatism.
Thought processes deteriorate.
Often, these signs are followed by violations of moral norms of behavior (patients with dementia lose their sense of shame, the concept of duty, their spiritual values and vital interests are leveled).

Over time, they begin notable changes in a state of memory, and disturbances in temporal and spatial orientation. True, the features of behavior, gestures and speech of a particular person remain unchanged for a long time.

Last stage of dementia

As you know, the most rapid extinction of the patient occurs at the last, severe stage of the disease. The development of dementia at this time is characterized by trembling of the fingers, impaired coordination and gait, and exhaustion. The patient's speech becomes abrupt, and information about himself becomes fragmentary.

An elderly person in this state can no longer live without outside help take care of yourself, eat and observe elementary rules hygiene. In most patients, there is a violation of the process of urination. It can be both stagnant processes and uncontrolled urine output.

The disease shortens the lives of those who have it, due to the fact that in the severe stage of dementia the patient is no longer able to report ailments to the doctor, in addition, older people most often do not develop fever or leukocytosis as a response to infection. The doctor in this situation has to rely only on his insight and experience, but, unfortunately, any infection that has joined can cause the death of such a patient.

Features of the course of senile dementia

Interestingly, the so-called senile or senile dementia in older people sometimes shows a clear dissociation between overt dementia and preserved behaviors. The patient remains unchanged the previous manner of holding, gestures, correct speech, lively intonations. All this often misleads the outsider. He thinks he's talking to absolutely a healthy person, and only by chance question asked discovers that an old man who speaks so interestingly, who gives a lot of examples from the past, is not able to say how old he is, whether he has a family, where he lives and with whom he is talking now.

Senile dementia in the elderly in most cases is not accompanied by psychotic conditions that are inherent in the vascular form of this disease. This is, of course, in to a large extent makes life easier for both the patient himself and his relatives, since such a patient does not cause serious trouble to his environment.

But often in this category of patients there are signs of psychosis, which are accompanied by insomnia or inversion (time shift) of sleep. In these patients, hallucinations may appear, suspiciousness is aggravated, mood swings occur from tenderness to aggression.

And provoke all these severe symptoms can be changes in blood sugar levels, pressure drops and other health problems. Therefore, it is very important to protect older people with dementia from all kinds of diseases, both chronic and acute forms.

Why does senile dementia occur?

For what reason senile dementia appears in the elderly, why in these cases the human brain begins to age faster than normal, is still not completely clear.

Some researchers believe that in old age there are violations of immune regulation, which causes autoimmune processes. And the resulting autoantibodies damage brain cells. Cerebrospinal fluid, which normally contains immunocompetent cells that play protective role, in old age greatly changes their ratio and properties, which leads to pathological changes in the central nervous system.

Dementia in the elderly is caused by genetic factor. It was found that the risk of the disease increases by 4.3 times in those families where there have already been cases of this pathology. Somatic diseases can reveal symptoms that were previously mild senile dementia, change its picture and accelerate the pace of the course, while the timely elimination of these ailments can in some cases lead to a slower development of dementia.

Life expectancy of patients with a diagnosis of dementia, at what age should it be expected

Researchers at the University of Cambridge identified patients with established diagnosis"senile dementia". How many years such patients live, according to scientists, largely depends on external factors, but on average it is 4.5-5 years.

By the way, statistics confirm that dementia occurs in about 2% of cases between the ages of 60 and 69, and up to 20% of older people are affected by it after 80 years. By the age of 90, the risk of getting sick increases to 45%.

Although it should be noted that the figures given are very approximate, since it is enough a large percentage older people do not come under the supervision of psychiatrists, because they do not have psychotic conditions, and it all comes down to problems with memory, intelligence and slight mood swings. Such patients are in families, it is quite convenient to take care of them, and they do not create big problems for loved ones.

Speaking about how long people with dementia live, it should be emphasized once again that there are just very few deaths from this diagnosis. These include only those who died from accidents related to the characteristics of this disease. Basically, death occurs from a stroke or heart attack, most often accompanying the vascular form of the disease.

What is the prognosis for dementia

Increasingly common in the elderly, the described pathology is mostly irreversible, and modern medicine, unfortunately, can only slow down the process or remove unpleasant symptoms associated with a diagnosis of dementia.

It is difficult to say exactly how many years they live with this disease, since, for example, with rapid progression vascular form possible in a few months. The reason for this is most often concomitant diseases in the form of sepsis (in bedridden patients) or pneumonia.

Acquired dementia, which most often affects the elderly, is called dementia (from Latin “madness”). This pathology is not congenital, but acquired. Before the disease, a person is able to think logically and serve himself, but partially loses these opportunities.

Dementia - what is it?

It is important to understand when dementia sets in, that it is a disease that is caused by damage to the brain. Dementia affects people of all ages, not just old people, and the number of cases is steadily increasing. Unlike other deviations, such as oligophrenia, this syndrome acquired and does not mean underdevelopment of the psyche. Dementia is severe disorder nervous activity, as a result of which the patient loses acquired skills and knowledge, and cannot comprehend new ones. Decay is observed mental functions healthy person.

Dementia in psychology

Often the syndrome develops as a result of other diseases (Parkinson, Pick, Alzheimer, etc.), injuries. The disorder originates in the cerebral cortex and may have various forms by severity and course: mild, moderate and severe. If available comorbidity and it progresses, dementia itself develops, the disease depersonalizes the patient. The patient loses most of his thinking, ceases to cognize the world, and interest in life is fading away. The syndrome manifests itself in many ways: memory, speech, logic are disturbed, depressive states appear.

Dementia - causes

This syndrome results from organic damage brain after an injury or some kind of disease (sometimes several at once). More than 200 can provoke his illness. pathological conditions. In specific forms of dementia, disturbances in the cerebral cortex are the leading mechanism of the disease. In other cases, damage to the central nervous system is a consequence of this syndrome.

The most common causes of dementia are:

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

Dementia - symptoms

There are three stages of the disease, so each of them has its own symptoms:

Main symptom this disease- Progressive memory loss. Obvious signs of dementia are sudden irritability, cruelty, slovenliness, regression in a person's behavior.
Secondary signs syndrome: amnestic memory disorders, when the patient ceases to recognize himself in the mirror, confuses the right and left hand and so on.
At the last stage, it begins to rise muscle tone, which can lead to a vegetative state and death.

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

For dementia mild degree he is critical of his condition and able to take care of himself.
At moderate degree defeat marked decrease in intelligence and difficulty 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.

How to avoid dementia?

Senile dementia is one of the leading causes of disability in the elderly. The development of the syndrome is not thought about in youth, while the first signs of degradation may appear as early as 55-60 years. When wondering how to prevent dementia long before its possible manifestation, you need to introduce a few rules and good habits into your life:

giving up alcohol and smoking;
proper nutrition (daily use required amount vitamins, the exclusion of fast food and fatty foods);
moderate physical exercise;
intellectual activity;
peace of mind (should avoid stress, do not succumb to irritation);
prevention of vitamin D deficiency - its lack in the body leads to the development of Alzheimer's disease and subsequent dementia.

Types of dementia

The manifestation of the syndrome depends on the affected parts of the brain, pathological processes, the presence of concomitant or primary diseases, the age of the patient. According to localization, dementia disease is divided into several types:

Cortical, which is formed when the cerebral cortex is damaged. It is divided into subtypes: frontal (suffer frontal lobes) and frontotemporal (lesion of the frontotemporal lobe).
subcortical or subcortical in which subcortical structures are affected.
Cortical-subcortical(there are both types of lesions described above).
Multifocal when there are numerous lesions in the brain.

senile dementia

Age-related dementia is a common pathology, striking people old age. Due to a lack of nutrition, the neurons in the brain die, and this leads to irreversible changes. On initial stage a person may not understand the development of the syndrome, then he was struck by dementia, that this is a disease that can lead to complete insanity. The first signs of the disease are a decline and fatigue. Other harbingers: slowdown intellectual activity, difficulties with elementary actions, mood changes.

Alcoholic dementia

The disease does not necessarily affect the elderly. With prolonged - from 15 years - alcohol abuse occurs alcoholic dementia, the symptoms of which are: social degradation, loss of moral values, decrease mental capacity, absent-mindedness, memory disorder, impaired activity of internal organs, atrophic changes brain. Usually the degradation of personality is last stage development of alcoholism. Up to 20% of all patients acquired this diagnosis as a result of alcohol abuse.

The danger of ethyl alcohol is that it disrupts the work of neurotransmitters responsible for emotions. suffer from alcohol abuse internal organs, vascular walls, brain. Dementia of this type appears after a long-term damage to neurons ethyl alcohol. And usually the development of the disease is observed in the third stage of addiction, when a person loses control over the quality and quantity of alcohol consumed.

organic dementia

One of the causes of acquired dementia is brain damage as a result of traumatic brain injuries, inflammation and bruises. Also, the impetus for development can be vascular diseases, AIDS, syphilis, etc. Organic dementia is a disease that can be total when all forms suffer cognitive activities(thinking, attention, memory, etc.), and partial (partial). In the second case, separate sides are affected cognitive process with relative safety critical thinking and social behavior.

Schizophrenic dementia

Different diseases associated with dementia show specific symptoms. In schizophrenia, the syndrome is characterized by an insignificant decrease in intelligence, but the appearance of apathy, inadequacy, the formation of psychosis and paranoia. The period of exacerbation begins against the background of the oppressed emotional state. This is followed by disorientation in space. Schizophrenic dementia is dementia in which memory remains unchanged for a long time, but purposefulness is absent. The patient's behavior is characterized as strange and helpless.

How to deal with people with dementia?

With this disease, the prognosis is doubtful. The main difficulty is frequent shifts personality and behaviour. And the main question that worries the relatives of patients: how to help a patient with dementia. Exist individual programs treatment and social rehabilitation measures. It is important to understand and distinguish that dementia is such a pattern of behavior, and not a pathology. It is important for those around you to tune in to positive interaction, because it depends on them how the patient will maintain contact with the outside world. It is recommended to follow simple advice regarding the patient:

formulate questions clearly, speak slowly and clearly;
give hints if a person can not cope, be able to wait;
capture the attention of the patient;
divide actions into a chain of simple steps;
communicate in a positive way.

How to treat dementia?

For effective treatment dementia syndrome should be diagnosed as early as possible, and treatment tactics depend on the diagnosis. There is no clear recommendation for the treatment of senile dementia, as each person is different. But proper care, taking strengthening drugs and drugs that normalize brain function can significantly reduce the level of degradation and even completely stop dementia. With proper therapy, deviations in cognitive functions are reversible.

It is possible to achieve a reduction in the manifestations of the disease even with the help of the normalization of nutrition and regimen (for example, in the case of alcoholic dementia).
Prevent death nerve cells and eliminate the symptoms of the disease and medication. Therapy includes drugs to improve nervous processes, normalization of blood circulation in the vessels and drugs that strengthen neural connections in the brain.
Patients need not only medication, but also psychological help. Psychosocial therapy has proven itself well, positively influencing the patient's mood and improving cognitive abilities impaired during the course of the disease. Have a beneficial effect on general condition patient contact with loved ones, animals, music therapy.