Dementia
Introduction
Why do people suddenly lose their memory, especially
after an accident, or why do we find old people battling with the problem of
memory loss? Can we scientifically identify the cause of memory loss, or could
the cause be spiritually, or can find a psychological explanation for it? The above questions arise because we see
cases of people who display acts that connote partial or total memory loss (Dementia).
In DSM-5, dementia is represented as neurocognitive disorders.[1]
This paper is an attempt to discuss the nature of dementia,
its features, types, etiology, treatment, prognosis, and related issues.
Case studies
The case is told of a woman in her
early 50s who was admitted to a hospital because of her increasingly odd
behaviuor; she had been showing memory problems and strong feelings of
jealousy, disorientation at home and the tendency of hiding objects. During a
doctor's examination, it was discovered that she was unable to remember her
husband's name, the year, or how long she had been at the hospital. Also, she
could read but did not understand what she read, and she stressed the words in
an unusual way. It was also seen that she sometimes became agitated and seemed
to have hallucinations and irrational fears. The woman’s, name was Auguste Deter.,
she was the first person reported to have the disease now known as Alzheimer's
disease (The most common type of Dementia). Auguste Deter died in 1906, and
then various doctors examined her brain and found that it was reduced in size,
and also found inside the nerve cells some unusual features; including strange
clumps of protein called plaques and tangled fibres.[2]
Also, I know of one person who is
experiencing memory loss at the moment. He is a Dominican priest. He was
knocked down by a motor cycle, which affected his brain and legs. I happen to
be among those who take care of him, and I observe that occasionally,
especially in the morning and evening, he loses count of where he is, and where
he has been. Most times, he tells us, the brothers who care for him that he
wants to go back to his house that the house is just outside the window, and so
on. He reakky remembers what he said a previous day, and sometimes forgets that
he has taken his meals.
Features
Dementia (memory loss) is a
collective term used to describe the problems that people with various
underlying brain disorders or damage can have with their memory, language and
thinking. While the likelihood of having dementia increases with age, it is not
a normal part of aging. It is represented as Neurocognitive Disorders in DSM-5.[3]
Signs and symptoms
The following are common signs and
symptoms of dementia: recent memory loss, difficulty completing familiar tasks,
problems communicating, disorientation with time and place, poor judgment, problems
with abstract thinking, misplacing things - including putting them in the wrong
places and forgetting about doing this, mood changes - unlike those we all
have, swinging quickly through a set of moods, personality changes -becoming
irritable, suspicious or fearful, loss of initiative - showing less interest in
starting something or going somewhere, etc.[4]
Types of Dementia
There
are various types of dementia. DSM-5 captures the following: (1) Alzheimer’s disease: This is the most
common type of dementia in people over age 65. Its cause is related to amyloid
plaques and neurofibrillary tangles It affects almost all brain functions,
including memory, movement, language, judgment, behavior, and abstract
thinking.[5] (2).Vascular dementia: This is the second
most common cause of dementia, caused by brain damage from cerebrovascular or
cardiovascular problems (strokes) or other problems that inhibit vascular
function; symptoms similar to Alzheimer’s disease ,but personality and emotions
effected only late in the disease.[6] (3).
Lewy body::This is common and
progressive where cells in the brain's cortex die and others contain abnormal
structures; symptoms include hallucinations, shuffling gait, and flexed posture
with symptoms that may vary so often.[7] (4).
Frontotemporal dementia: This is
linked to degeneration of nerve cells in the frontal and temporal brain lobes
and some evidence for a genetic factor (many have a family history of the
disease). Symptoms in patients (usually ages 40 – 65) have judgment and social
behaviuor problems such as stealing, neglecting responsibilities, increased
appetite, compulsive behavior and eventual motor skill problems and memory
loss. [8] (5).
HIV-associated dementia: This is due
to infection of the brain with HIV; symptoms include impaired memory, apathy,
social withdrawal, and concentration problems.[9] (6).
Huntington’s disease: This is a
heredity disorder caused by a faulty gene.
Symptoms begin in 30-40 year old people with personality changes such as
anxiety, depression, involuntary jerky, and arrhythmic movements of the body.[10] (7).Creutzfeldt-Jakob disease:: This is a
rare disease that seems related to a gene mutation that causes rapid degenerative and fatal brain disease in people
usually over 60 years old; personality changes and reduced coordination
develop, rapidly followed by impaired judgements and vision/[11]
General Causes
All dementias are said to be caused
by brain cell death and also by neurodegenerative disease, however, progressive
brain cell death that happens over a course of time is behind most dementias. Other causes include damage to brain cells, a
head injury, a stroke or a brain tumor, head injury. This interferes with the
ability of brain cells to communicate with each other. It is thus obvious that
when brain cells cannot communicate normally, thinking, behavior and feelings
can be affected.
Diagnosis of dementia
Many different kinds of tests are used to determine if
someone has dementia. Diagnosis is based on a careful medical history, a
physical examination, laboratory tests, and the characteristic changes in
thinking, day-to-day function and behavior associated with each type. It is difficult to identify the particular
type of dementia one has because the symptoms and brain changes of different
dementias can overlap.[12]
Treatment and care
Most treatments for dementia will neither reverse or
stop the disease; however, there are treatments and medications that may reduce
the symptoms and slow the disease progression; they are tight glucose control
by persons with diabetes, intellectual stimulating activities, lowering
cholesterol and homocysteine levels, regular exercise, education, controlling
inflammation of body tissues,.[13] Treatment
of dementia depends on its cause. In the case of most progressive dementias,
including Alzheimer's disease, there is no cure and no treatment that slows or
stops its progression. But there are drug treatments that may temporarily
improve symptoms. The same medications used to treat Alzheimer's are among the
drugs sometimes prescribed to help with symptoms of other types of dementias.
Non-drug therapies can also alleviate some symptoms of dementia.[14]
Conclusion
We have, in this paper, shown the features,
types, etiology, symptoms, diagnosis, treatment and etiology of dementia. With
proper medical care, patients of dementia can be helped to face up to the many
challenges that the disorder brings. Early treatment and management is
encouraged.
BIBLIOGRAPHY
American
Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Washington
DC, American Psychiatric Publishing, 2013
“Dementia”
http://www.medicinenet.com/dementia/article.htm. Accessed on 10/06/2015
“Dementia”
http://www.uptodate.com/contents/dementia-including-alzheimer-disease-beyond-the-basics?view=print.
Accessed on 10/06/2015
“Alois
Alzheimer first case: August Deter” http://www.dementiatoday.com/alois-alzhemers-first-case-auguste-deter.
Accessed on 12/06/2015
[1] Cf. American Psychiatric Association, Diagnostic
and Statistical Manual of Mental Disorders,
5th edition, ( Washington DC: American Psychiatric Publishing, 2013) p.591
[2] Cf. “Alois Alzheimer
first case: August Deter” http://www.dementiatoday.com/alois-alzhemers-first-case-auguste-deter. Accessed on 12/06/2015
[3] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, (Washington DC: American Psychiatric Publishing, 2013), p.591
[4] Cf. “Dementia” http://www.medicinenet.com/dementia/article.htm.
Accessed on 10/06/2015
[5] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 611-614
[6] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 621-624
[7] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 618-621
[8] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 613-618
[9] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 632-634`
[10] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 639-641
[11] Cf. American
Psychiatric Association, Diagnostic and
Statistical Manual of Mental Disorders,
5th edition, pp. 635-636
[12] Cf. “Dementia” http://www.uptodate.com/contents/dementia-including-alzheimer-disease-beyond-the-basics?view=print. Accessed on 10/06/2015
[14] Cf.“Dementia” http://www.uptodate.com/contents/dementia-including-alzheimer-disease-beyond-the-basics?view=print.
Accessed on 10/06/2015
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