Dementia- A living bereavement  

Article   Asst. Prof. Dr. Suman Prasad Adhikari  on Sun, May 05 2019 02:32 PM 467 Views 0 Comments 2 persons recommended

Dementia is a condition characterized by progressive loss of cognitive functions without change in consciousness. 

The cognitive functions affected are: 

  1. Praxis- motor functions like ability to perform tasks
  2. Gnosis- ability to recognize things
  3. Memory
  4. Speech 

The resultant effects of changes in these functions are: 

  1. Apraxia- inability to perform activities of daily life that individual used to perform normally.Ex: inability to button and unbutton clothes, inability to brush teeth, comb hair and shave beard, inability to work in kitchen, garden. 
  2. Agnosia- inability to recognize things/ items used in daily life. 
  3. Amnesia- forgetfullness, initially  past memories are preserved but later individual has no memory of either past or present. He is unable to learn new things. 
  4. Aphasia- some people experience change in speech with inability to understand and respond to questions or inability  to name things/people and inability to put up words together. 

Besides cognitive other symptom domains of dementia are: 

  1. Executive- inability to plan, organise and maintain attention.
  2. Behavioral and psychosocial symptoms- hyperorality (mouthing everything), hyperphagia (increased food intake), apathy (dulled emotions), psychotic and affective symptoms. 
  3. Activity- agitation, aggressiveness, wandering

Prevalence

  • 5% in population more than 65 years
  • 20-40% in more than 85 years

Most common dementia is Alzheimers. 

Phases of Alzheimers dementia

  • 1st- failing/ poor memory, muddled tasks, spatial disorientation
  • 2nd- rapid progression of intellectual and personality deterioration
  • 3rd- profound apathetic dementia, bed ridden and double incontinence

Other types of dementia

  • Vascular dementia
  • Fronto- temporal dementia
  • Lewy body dementia
  • Huntington disease
  • HIV associated dementia
  • Head trauma associated dementia
  • Substance induced dementia

Treatment

  1. Behavior oriented therapy
  2. Cognition oriented therapy
  3. Emotion oriented therapy

 

 

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