Dementia: Symptoms and Treatment
Dementia determines the acquired form of dementia, within which patients experience loss of previously acquired practical skills and acquired knowledge (which can occur in varying degrees of intensity of manifestation), while simultaneously decreasing their cognitive activity. Dementia, the symptoms of which, in other words, manifest themselves in the form of the disintegration of mental functions, are most often diagnosed in old age, but the possibility of its development at a young age is also not ruled out.
Dementia develops as a result of brain damage, against which the marked disintegration of mental functions occurs, which, on the whole, makes it possible to distinguish this disease from mental retardation, congenital or acquired form of dementia. Mental retardation (it is also oligophrenia or lack of intelligence) implies a stopping of the development of the personality, which also occurs with the brain damage as a result of certain pathologies, but which manifests itself in the form of defeat of the mind, which corresponds to its name. At the same time, mental retardation differs from dementia in that the intellect of a person, an adult physically, does not reach the normal parameters corresponding to his age. In addition, mental retardation is not a progressive process, but is the result of a patient’s disease. Nevertheless, in both cases, and when considering dementia, and when considering mental retardation, there is a development of motor, speech and emotion disorder.
As we have already noted, dementia overwhelmingly affects people in old age, which determines its type, such as senile dementia (this pathology is usually defined as senile senility). Nevertheless, dementia appears in youth, which often occurs as a result of addictive behavior. Addiction implies, by itself, nothing more than addictions or pernicious habits — a pathological attraction in which there is a need for certain actions. Any type of pathological attraction contributes to an increase in the risk of developing a person’s mental illness, and often this attraction is directly related to existing social problems for him or personal problems.
Often, addiction is used to familiarize with such phenomena as drug addiction and drug dependence, but from a relatively recent time, another type of dependency is defined for it — non-chemical dependencies. Non-chemical dependencies, in turn, define a psychological dependence, which itself acts as an ambiguous term in psychology. The fact is that in the psychological literature, this kind of dependence is considered in a single form — in the form of dependence on narcotic substances (or intoxicating substances).
However, if we look at a deeper level of this type of dependence, this phenomenon also occurs in the ordinary mental activity that a person (hobby, hobby) encounters, which, therefore, determines as an intoxicating substance the subject of this activity, resulting in He, in turn, is seen as a substitute source, causing certain missing emotions. This includes alcoholism, Internet addiction, fanaticism, psychogenic overeating, gambling, etc. At the same time, addiction is also seen as a way of adaptation, through which a person adapts to conditions that are difficult for himself. Under the elementary agents of addiction are considered narcotic substances, alcohol, cigarettes, creating an imaginary and short-term atmosphere of «pleasant» conditions. A similar effect is achieved when performing relaxation exercises, at rest, and also with actions and things, in which short-term joy arises. In either of these options, after completion, the person has to return to reality and the conditions from which such ways have been «gone», as a result of which addictive behavior is viewed as a rather complex problem of internal conflict based on the need to avoid specific conditions, against which And there is a risk of developing mental illnesses.
Returning to dementia, it is possible to highlight the actual data provided by the WHO, on the basis of which it is known that the world incidence rates amount to about 35.5 million people with this diagnosis. Moreover, it is expected that by 2030 this figure will reach the figure of 65.7 million, and by 2050 will amount to 115.4 million.
With dementia, patients are not capable of realizing what is happening to them, the disease literally «erases» all that of their memory that has accumulated in it during previous years of life. Some patients survive the course of such a process at an accelerated pace, which means that they develop rapidly dementia, while others can stay long at the stage of the disease in the context of cognitive-mnestic disorders (intellectual and mnestic disorders) — that is, with mental performance disorders, a decrease Perception, speech and memory. In any case, dementia not only determines for the patient the result in the form of problems of an intellectual scale, but also the problems in which they lose many human personality traits. The severe stage of dementia determines for patients dependence on others, maladaptation, they lose the opportunity to perform simple actions related to hygiene and eating.
Causes of dementia
The main causes of dementia are the presence of Alzheimer’s disease in patients, which is defined as dementia of the Alzheimer’s type, as well as with actual vascular lesions to which the brain is exposed — is determined The disease in this case as vascular dementia. Less commonly, as a cause of dementia, there are any neoplasms developing directly in the brain, including craniocerebral trauma ( non-progressive dementia ). , Diseases of the nervous system, etc.
The etiologic significance in the consideration of the causes leading to dementia is given to arterial hypertension, systemic circulation disorders, major arterial vascular lesions against atherosclerosis, arrhythmias, hereditary angiopathies, repeated disorders, topical for cerebral circulation (vascular dementia) .
As the etiopathogenetic variants that lead to the development of vascular dementia, a microangiopathic variant is distinguished, a macroangiopathic variant and a mixed variant. This is accompanied by multi-infarct changes occurring in the brain substance and numerous lacunar lesions. In the macroangiopathic variant of dementia development, pathologies such as thrombosis, atherosclerosis and embolism are distinguished, against which background occlusion develops in the large artery of the brain (the process in which the lumen narrows and the vessel is blocked). As a result of this course, a stroke develops with symptoms corresponding to the basin that has been affected. As a result, later, vascular dementia develops.
As for the next, microangiopathic variant of development, angiopathy and hypertension are considered as risk factors here. The features of the lesion in these pathologies lead in one case to demyelination of the white subcortical substance with the simultaneous development of leukoencephalopathy, in another case they provoke the development of lacunar lesion against which Binswanger’s disease develops, and because of which dementia develops in turn.
About 20% of cases of dementia develop against a background of alcoholism, the appearance of tumors and the previously mentioned craniocerebral trauma. 1% of the incidence is attributed to dementia in the background of Parkinson’s disease, infectious diseases, degenerative diseases of the central nervous system, infectious and metabolic pathologies, etc. So, a significant risk is determined for dementia development against the background of actual diabetes mellitus, HIV, infectious brain diseases (meningitis, syphilis) , Thyroid dysfunction, internal diseases (renal or hepatic insufficiency).
Dementia in the elderly by the nature of the process is irreversible, even if the possible factors that triggered it (for example, taking drugs and canceling them) are eliminated.
Actually, on the basis of a number of listed features, the types of dementia are determined, namely, senile dementia and vascular dementia . Depending on the extent of the actual social adaptation for the patient, as well as the need for supervision and obtaining third-party care, in conjunction with his ability to self-identify the appropriate forms of dementia. So, in the general variant of the current, dementia can be mild, moderate or severe.
Mild dementia implies a state in which a sick person is experiencing a degradation in terms of his professional skills, and his social activity is also decreasing. Social activity in particular means a reduction in the time that is spent for everyday communication, thus extending to the nearest environment (colleagues, friends, relatives). In addition, in a state of mild dementia, patients are also weakened by interest in the conditions of the external world, as a result of which the rejection of the usual ways of spending free time and hobbies is actual. Mild dementia is accompanied by the preservation of existing self-service skills, in addition, patients are adequately oriented within the limits of their home.
Moderate dementia leads to a situation in which patients can no longer remain alone with themselves during a long period of time, which is caused by the loss of skills to use equipment and devices, Their surrounding (remote control, telephone, stove, etc.), do not exclude the difficulty even with the use of door locks. It requires constant monitoring and assistance from others. As part of this form of the disease, patients retain the skills to self-service and perform activities related to personal hygiene. All this, accordingly, increases the life and the environment of patients.
As for the form of the disease, severe dementia, , here it is already talking about the absolute disadaptation of patients to what surrounds them, with the simultaneous need to ensure ongoing care and Control, which are necessary even for the performance of simple actions (eating, dressing, hygiene measures, etc.).
Depending on the localization of the brain lesion, these types of dementia are distinguished:
- cortical dementia — the lesion primarily affects the cerebral cortex (which occurs against a background of lobar (frontotemporal) degeneration, alcoholic encephalopathy, Alzheimer’s disease);
- subcortical dementia — in this case, subcortical structures are predominantly affected (multi-infarct dementia with white matter damage, supranuclear progressive paralysis, Parkinson’s disease),
- cortical-subcortical dementia (vascular dementia, cortical and basal degeneration),
- multifocal dementia — many focal lesions develop.
In the classification of the disease we are considering, we also take into account the dementia syndromes that determine the corresponding variant of its course. In particular, it can be lacunar dementia , which implies a primary memory loss, manifested in the form of a progressive and fixative form of amnesia. Compensation for such a defect in patients is possible due to important notes on paper, etc. The emotional-personal sphere in this case is affected only slightly, because the nucleus of the individual is not subject to defeat. Meanwhile, the appearance in patients of emotional lability (instability and changeability of moods), tearfulness and sentimentality is not ruled out. As an example of this type of disorder is Alzheimer’s.
Alzheimer’s type dementia , whose symptoms appear after the age of 65, within the initial (initial) stage, proceeds in conjunction with cognitive-mnestic disorders in the event of an increase in disorders in the form Orientation in place and in time, delusional disorders, the appearance of neuropsychological disorders, sub-depressive reactions to their own insolvency. At the initial stage, patients are able to critically assess their condition and take measures to correct it. Moderate dementia in this condition is characterized by the progression of the above symptoms with a particularly severe violation of the inherent functions of the intellect (difficulties in conducting analytical and synthetic activities, a lower level of judgment), loss of opportunities for performing professional duties, and the need for care and support. All this is accompanied by the preservation of the basic personality traits, a sense of inferiority with an adequate response to the existing disease. With the severe stage of this form of dementia, the memory decay occurs in full, support and care are necessary in everything and constantly.
The following syndrome is considered total dementia . It implies the appearance of gross forms of violations of the cognitive sphere (violation of abstract thinking, memory, perception and attention), as well as personality (here already distinguish morality disorders, in which such forms as shyness, correctness, politeness, sense of duty disappear And so forth). In the case of total dementia, in contrast to lacunar dementia, the destruction of the personality nucleus becomes actual. As reasons for this condition, the vascular and atrophic forms of lesions of the frontal lobes of the brain are considered. An example of this condition is Pick’s disease .
This pathology is diagnosed less often than Alzheimer’s, mainly among women. Among the main characteristics, there are actual changes in the emotional-personal sphere and the cognitive sphere. In the first case, the condition implies gross forms of personality disorder, complete absence of criticism, aspontaneity, passivity and impulsiveness of behavior; Actual hypersexuality, foul language and rudeness; The assessment of the situation is disturbed, there are disorders of drives and will. In the second, with cognitive disorders, there are gross forms of disturbance of thinking, automated skills are retained for a long time; Memory disorders are noted much later than personal changes, they are not as pronounced as in the case of Alzheimer’s.
Both lacunar and total dementia are generally atrophic dementias, and there is also a variant of the mixed form of the disease (mixed dementia) . Which implies a combination of primary degenerative disorders, which primarily manifests itself in the form of Alzheimer’s disease, and vascular type of brain lesions.
In this section, we will consider in a generalized form those signs (symptoms) that characterize dementia. As the most characteristic of them are considered violations related to cognitive functions, and such violations are most pronounced in their own manifestations. Emotional disorders in combination with behavioral disorders become no less important clinical manifestations. The development of the disease occurs in a gradual manner (often), its detection often occurs in the context of exacerbation of the patient’s condition, arising from changes in the environment surrounding it, as well as exacerbating the actual for him physical illness. In some cases, dementia may manifest itself in the form of aggressive behavior of a sick person or sexual disinhibition. In the case of personality changes or changes in the patient’s behavior, the question is raised about the relevance of dementia for him, which is especially important in the case of his age of more than 40 years and in the absence of a mental illness.
So, let’s dwell on the signs (symptoms) of the disease of interest to us.
- Violations of cognitive functions. In this case, memory, attention, and higher functions are considered.
- Memory disorders. Memory disorders in dementia consist in the loss of both short-term memory and long-term memory, besides, confabulation is not excluded. Confabulations, in particular, mean false memories. The facts from them, occurring earlier in reality or facts that previously occurred, but which have undergone a certain modification, are transferred to the patient at another time (often in the near future), if possible combined with events that are completely fictitious. The mild form of dementia is accompanied by moderate memory impairment, mainly related to events occurring in the recent past (forgetting conversations, phone numbers, events occurring within a certain day). Cases of a more severe course of dementia are accompanied by the retention in memory of only previously learned material with the rapid forgetting of newly arrived information. The last stages of the disease can be accompanied by forgetting the names of relatives, a kind of activity and name, manifested in the form of personal disorientation.
- Attention breakdown. In the case of a disease of interest to us, this disorder implies the loss of the ability to respond to several relevant stimuli at once, as well as the loss of the ability to switch attention from one topic to another.
- Disorders associated with higher functions. In this case, the manifestations of the disease are reduced to aphasia, apraxia and agnosia.
- Aphasia implies a speech disorder in which the ability to use phrases and words as means to express one’s own thoughts is lost, which is due to actual brain damage in certain areas of its cortex.
- Apraxia indicates a violation of the patient’s ability to perform targeted actions. In this case, the skills acquired earlier have been lost, and the skills that have been formed over the years (speech, everyday, motor, professional).
- Agnosia defines a violation of various types of perception in the patient (tactile, auditory, visual) with simultaneous preservation of consciousness and sensitivity.
- Impaired orientation. This type of violation occurs in time, and mainly — within the initial stage of the disease. In addition, the disruption of orientation in the temporal space precedes the disruption of orientation in the scale of orientation in place, and also within the framework of one’s own personality (here the symptom is different for dementia from delirium, the characteristics of which determine the preservation of orientation within the framework of self-examination). The progressive form of the disease with far-demented dementia and pronounced manifestations of disorientation in the scale of the surrounding space determines for the patient the likelihood that he can freely get lost even in an environment for a friend.
- Behavioral disorders, personality changes. The onset of these manifestations is a gradual one. The main features characteristic of individuals are gradually amplified, transforming to the inherent states of this disease as a whole. So, energetic and cheerful people become restless and fussy, and people are thrifty and neat, respectively, greedy. Similarly, the transformations inherent in other features are also considered. In addition, there is an increase in the egoism of patients, the disappearance of responsiveness and sensitivity to the environment, they become suspicious, conflictful and sensitive. Sexual disinhibition is also determined, sometimes the patients begin to wander and collect various trash. It also happens that patients, on the contrary, become extremely passive, they lose interest in communication. The untidiness is a symptom of dementia, arising in accordance with the progression of the general picture of the course of this disease, it combines with the unwillingness of self-service (hygiene, etc.), with unscrupulousness and, in general, the lack of reaction to the presence of people near to oneself.
- Thinking disorders. There is a slowing of the pace of thinking, as well as a decrease in the ability to logical thinking and abstraction. Patients lose the ability to generalize and solve problems. Their speech is circumstantial 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 an absurd and primitive content. So, for example, a woman with dementia, in the breakdown of thinking before the appearance of delusional ideas, can claim that she has stolen a mink fur coat, and this action can go beyond her surroundings (that is, her family or friends). The crux of the delirium in this idea is that she never had a mink fur coat at all. Dementia in men in this disorder often develops according to a delirium scenario based on jealousy and infidelity of the spouse.
- Decrease the critical attitude. This refers to the attitude of the patients both to themselves and to the world surrounding them. Stressful situations often lead to the emergence of acute forms of anxiety-depressive disorders (defined as a «catastrophic reaction») within which there is a subjective awareness of the inferiority in the intellectual plan. Partially preserved criticism in patients determines the possibility for them to maintain their own intellectual defect, which can look like a sharp change in the topic of conversation, the translation of a conversation into a playful form or distraction in other ways from it.
- Emotional disorders. In this case, you can determine the variety of such disorders and their overall variability. Often, these depressive conditions in patients in combination with irritability and anxiety, anger, aggression, tearfulness, or, conversely, complete absence of emotion in relation to everything that surrounds them. Rare cases determine the possibility of developing manic states in combination with a monotonous form of carelessness, with gaiety.
- Perceptual disorders. In this case, the states of the appearance of illusions and hallucinations in patients are considered. For example, with dementia the patient is sure that he hears in the next room the cries of the children killed in her.
Senile dementia: symptoms
In this case, a similar definition of the state of senile dementia is the senile dementia, senile senility or senile dementia that we indicated earlier, the symptoms of which appear against the background of age-related changes taking place in the structure of the brain. Such changes occur within the neurons, they arise as a result of insufficient blood supply to the brain, the effect it has on acute infections, chronic diseases and other pathologies that we examined in the relevant section of our article. Also, we repeat that senile dementia is a violation of irreversible and striking each of the spheres of cognitive psyche (attention, memory, speech, thinking). With the progression of the disease, all skills and abilities are lost; It is extremely difficult to find new knowledge for senile dementia, if not impossible.
Senile dementia, being among the mental diseases, is the most common disease among the elderly. Senile dementia in women occurs almost three times more often than in men. In most cases, the age of patients is 65-75 years, on average in women the disease develops at 75 years, for men at 74. Senile dementia manifests itself in several varieties of forms, manifesting itself in a simple form, in the form of presbyophoria and in the form of psychotic. The specific form is determined by the actual rate of atrophic processes in the brain, somatic diseases that have joined the dementia, as well as from factors of constitutional-genetic scale.
A simple form is characterized by low visibility, leaking in the form of disorders, inherent in aging. With an acute onset, there is reason to believe that previous mental disorders have been strengthened due to this or that somatic disease. There is a decrease in mental activity in patients, which manifests itself in the slowing down of the rate of mental activity, in its quantitative and qualitative deterioration (implying a violation of the ability to focus attention and its switching, its volume is narrowing, the ability to generalize and analyze, to abstract and in general The imagination is disturbed, and the capacity for ingenuity and resourcefulness in dealing with issues arising in everyday life is lost).
An increasingly sick person adheres to conservatism in terms of his own judgments, worldviews and actions. What happens in the present tense is seen as something insignificant and not worthy of attention, and is often rejected altogether. Returning to the past, the patient, in a predominant way, perceives it as a positive and worthy sample in certain life situations. A characteristic feature is the propensity for edification, bordering on obstinacy, intractability and increased irritability, arising from contradictions or disagreements on the part of the opponent. The interests that existed before are largely narrowed, especially if they are in one way or another connected with general issues. Increasingly, patients emphasize their own attention to their physical condition, in particular, it concerns physiological dispensations (ie, bowel evacuation, urination).
In patients, also affective resonance decreases, which manifests itself in the growth of complete indifference to what does not directly affect them. In addition, attachment is also weakened (this concerns even relatives), as a whole, understanding of the essence of relations between people is lost. Many lose their shyness and sense of tact, the range of shades of mood is subject to narrowing too. Some patients may show carelessness and general complacency, while adhering to monotonous jokes and a general tendency to jokers, while in others, discontent, pickiness, capriciousness and pettiness prevail. In any case, the past character traits inherent in patients become scarce, and the awareness of the personality changes that have arisen either disappears early or does not occur at all.
The presence before the disease of expressed forms of psychopathic traits (in particular those of them that are stenotic, this refers to authority, greed, categorical, etc.) leads to their exacerbation in manifestation at the initial stage of the disease, often to the caricature form (as determined As senile psychopathy). Patients become mean, begin to accumulate trash, from their side more and more often reproaches various accusations against the nearest environment, in particular it concerns irrationality, in their opinion, expenses. Also censure on their part is subject to the mores that have developed in public life, in particular this applies to marital relations, intimate life, etc. Initial psychological changes combined with personal changes that occur with them are accompanied by a deterioration of memory, in particular, this relates to current events. Surrounding patients, they are usually seen later than the changes that have occurred in their nature. The reason for this is to revive the memories of the past, which is perceived by the environment as a good memory. Its disintegration in fact corresponds to those laws that are relevant for the progressive form of amnesia.
Thus, first, the memory associated with differentiated and abstract topics (terminology, dates, names, names, etc.) gets hit, then the fixation form of amnesia, manifested in the form of inability to memorize current events, is added here. Also, amnestic disorientation develops with respect to time (ie, patients are unable to specify a specific number and month, day of the week), and chronological disorientation develops (impossibility to identify important dates and events with reference to a specific date, regardless of whether such dates Personal life or social life). To top it off, spatial disorientation develops (manifested, for example, in situations when patients can not return back at home from the house, etc.).
The development of total dementia leads to a violation of self-recognition (for example, when considering yourself in reflection). Forgetting the events of the present is replaced by the revival of memories relating to the past, often it can concern youth or even childhood. Often, such a substitution of time leads to the fact that patients begin to «live in the past,» considering themselves as young or children, depending on the time on which such memories come. Tales of the past in this case are reproduced as events relating to the present time, and it is not excluded that these memories are in general fiction.
The initial periods of the course of the disease can determine the mobility of patients, the accuracy and speed of performance of certain actions, motivated by an occasional need or, conversely, the habitual implementation. Physical marasmus is already noted in the framework of a far-reaching disease (complete disintegration of behavior patterns, mental functions, speech skills often with relative retention of skills of somatic functions).
With a pronounced form of dementia, the states of apraxia, aphasia and agnosia considered earlier are noted. Sometimes these disorders manifest themselves in a sharp form, which can resemble the picture of the course of Alzheimer’s disease. There are a few and single epileptic seizures, similar to fainting. There are sleep disorders, in which patients fall asleep and rise indefinitely, and the duration of their sleep is on the order of 2-4 hours, reaching an upper limit of about 20 hours. In parallel with this, periods of prolonged wakefulness can develop (regardless of time of day).
The final stage of the disease determines for patients the achievement of a state of cachexia, in which there comes an extreme form of exhaustion, in which there is a sharp weight loss and weakness, a decreased activity in part of the physiological processes with accompanying changes in the psyche. In this case, it is characteristic to accept the embryo posture when the patients are in a drowsy state, there is no reaction to surrounding events, sometimes muttering is possible.
Vascular dementia: symptoms
Vascular dementia develops against the background of previously indicated disorders that are relevant for cerebral circulation. In addition, as a result of studying the brain structures in patients after their death, it was revealed that vascular dementia often develops with a transferred infarction. If you determine more precisely, it’s not so much the transfer of this state, but the fact that because of it a cyst is formed, which determines the subsequent likelihood of developing dementia. This probability is in turn determined not by the size of the affected cerebral artery, but by the total volume of the cerebral arteries necroticized.
Vascular dementia is accompanied by a decrease in indicators that are relevant for cerebral circulation in combination with metabolism, otherwise the symptomatology corresponds to the general course of dementia. When a disease is combined with a lesion in the form of laminar necrosis, in which glial tissue proliferation occurs and neuronal death occurs, it is possible to develop serious complications (vascular blockage (embolism), cardiac arrest).
As for the priority category of people who develop a vascular form of dementia, in this case, the data indicate that mostly here are people aged 60 to 75 years, and half as often as men.
Dementia in children: symptoms
In this case, the disease, as a rule, acts as a symptom of certain diseases in children, which may include oligophrenia, schizophrenia and other types of mental disorders. This disease develops in children with a characteristic decrease in mental abilities, it manifests itself in the violation of memory, and in severe variants of the flow there are difficulties even with remembering one’s own name. The first symptoms of dementia in children are diagnosed early, in the form of loss of certain information from memory. Further, the course of the disease determines the appearance of disorientation in them within the framework of time and space. Dementia in young children manifests itself in the form of loss of skills previously acquired by them and in the form of speech impairment (until its complete loss). The final stage, similar to the general course, is accompanied by the fact that patients stop watching themselves, they also lack control over the processes of defecation and urination.
Within the children’s age, dementia is inextricably linked with oligophrenia. Oligophrenia, or, as we previously defined it, mental retardation, is characterized by the urgency of two features relating to the intellectual defect. One of them is that mental underdevelopment is total, that is, the child’s thinking and his mental activity are subject to defeat. The second peculiarity is that with the general psychological underdevelopment, the «youngest» functions of thinking (the young ones — when they are examined on a phylogenetic and ontogenetic scale) are most affected, for them insufficient development is determined, which makes it possible to associate the disease with oligophrenia.
An intellectual deficit of a persistent type that develops in children aged 2-3 years, when traumas and infections are transferred, is defined as organic dementia, the symptoms of which are manifested due to the disintegration of relatively developed intellectual functions. To such symptoms, due to which there is a possibility of differentiation of the disease from oligophrenia, are:
- lack of thought activity in its purposeful form, lack of criticism
- A severe type of memory impairment and attention
- emotional disorders in a more pronounced form that do not correlate (that is, unrelated) to the degree of intellectual capacity that is relevant to the patient
- Frequent development of violations relating to instincts (perverse or increased forms of attraction, the performance of actions under the influence of increased impulsiveness, and the weakening of existing instincts (instinct of self-preservation, lack of fear, etc.)
- often the behavior of a sick child does not adequately correspond to a specific situation, which also occurs in the case of an acute form of intellectual insufficiency for him;
- in many cases, the differentiation of emotions is subject to weakening, there is no attachment to close people, the child is completely indifferent.
Diagnosis and treatment of dementia
Diagnosis of patients is based on a comparison of the actual for them symptomatology, as well as recognition of atrophic processes in the brain, which is achieved through computed tomography (CT).
Regarding the issue of treating dementia, now there is no effective method of treatment, especially if the cases of senile dementia are considered, which, as we noted, is irreversible. Meanwhile, the proper care and the use of therapies aimed at suppressing symptoms, in some cases, can seriously alleviate the condition of the patient. It also considers the need to treat concomitant diseases (with vascular dementia in particular), such as atherosclerosis, hypertension, etc.
Treatment of dementia is recommended under the conditions of a home environment, placement in a hospital or psychiatric ward is relevant for a severe degree of the disease. It is also recommended to make the regime of the day so that it includes the maximum of active activity in the periodic fulfillment of household duties (with the allowable form of the load). The appointment of psychotropic drugs is made only in the case of hallucinations and insomnia, within the early stages it is advisable to use nootropic drugs, then — nootropic drugs in combination with tranquilizers.
The prevention of dementia (in the vascular or senile form of its course), as well as the effective treatment of this disease, is currently excluded due to the practical lack of appropriate measures. When there is a symptom that indicates dementia, it is necessary to visit such specialists as a psychiatrist and a neurologist.