Dementia is a disease manifested by cognitive impairment (loss of intellectual capacity) characterized by significant impairment of memory, attention, cognition and language.
Why does cognitive impairment occur?
What are the symptoms of senile dementia?
What is dementia?
Dementia is a disease manifested by cognitive impairment (loss of intellectual capacity) characterized by significant impairment of memory, attention, cognition and language.
Why does cognitive impairment occur?
Depending on the causes of its onset, dementia can be classified into two main categories:
- Dementia caused by brain atrophy seen in Alzheimer’s disease and dementia with Lewy bodies
- Senile dementia due to strokes causing focal atrophy of brain regions involved in logical thinking
- Both forms of the disease are caused by neuronal degeneration due to various pathological processes, the end result of which is cognitive deterioration, the appearance of behavioral and relational disorders and motor dysfunctions with impaired quality of life
The factors contributing to cognitive decline in senile dementia are represented by: chronic alcohol consumption, inappropriate diet with increased cholesterol intake, cerebral arterial malformations, cranio-cerebral trauma, cerebral aneurysms, hypertension, diabetes mellitus or hypercholesterolemia, vitamin B12 deficiency and thyroid dysfunction.
What are the symptoms of senile dementia?
The early physical symptoms of senile dementia are represented by:
- Change in posture with the adoption of an unconventional position by bringing the shoulders and cephalic extremity forward
- Difficulty in maintaining balance
- Muscle weakness
- Fragility of the bone system
- Joint stiffness
Cognitively, patients with senile dementia show memory loss, infantile behavior, temporal-spatial confusion (temporal-spatial disorientation is caused by problems with recent memory), decision-making difficulty, personality changes and sleep disturbances. Psychomotor agitation, irritability or depressed mood, visual hallucinations, loss of appetite and swallowing difficulties occur in advanced forms of dementia and require constant supervision of the patient by caregivers or specialized medical professionals. Frequently senile dementia is characterized by loss of memory of facts with preservation of affective memory.
Diagnosis of senile dementia
The diagnosis of senile dementia is established with the help of anamnesis data provided by caregivers, physical examination including neurological, neuropsychological and cognitive testing and paraclinical investigations represented by:
- Positron emission tomography to determine the extent of pathological processes in the brain and identify the cause of dementia (stroke, brain lesions specific for Parkinson’s disease or other neurological diseases)
- Single photon emission computed tomography
- Diffusion nuclear magnetic resonance
- Examination of cerebrospinal fluid collected by lumbar puncture for identification of specific oligoclonal protein bands
- Laboratory tests for investigation of thyroid and liver function, determination of vitamin B12 levels and serological testing to determine HIV infection
Treatment of senile dementia
The treatment of senile dementia is used to improve the quality of life of the patient and uses antipsychotic and antidepressant medication to relieve symptoms.
Psychological therapy helps to manage symptoms while cognitive stimulation involves engaging the patient in activities designed to improve memory and speech as well as problem-solving skills. Behavioral intervention involves a non-pharmacological therapeutic approach to patients with dementia and aims to identify the causes of the patient’s behavioral changes.
The aetiological treatment of senile dementia involves the use of:
- Vitamins in case of B12 deficiency
- Hormone replacement for thyroid dysfunction
- Parkinson’s disease-specific treatments with levodopa and COMT Catechol-O-methyltransferase inhibitors
- Specific prophylactic treatment for stroke prevention
Learn More:
- Senile Dementia – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1821975/
- EARLY SENILE DEMENTIA IN MONGOLOID IDIOCY – https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.105.2.102
- Language function in senile dementia – https://www.sciencedirect.com/science/article/abs/pii/0093934X82900864
