The occurrence of vascular dementia and its treatment in older people

Many people attribute forgetfulness or loss of interest in a loved one's life to natural aging. No one rushes to seek medical help until the patient himself makes the life of his loved ones unbearable.

Strange behavior in old age is already the development of dementia. In common parlance, the disease is called marasmus or senile dementia. Only timely treatment will reduce the occurrence of unpleasant consequences.

General information

Dementia is a clinical syndrome characterized by loss of memory , as well as other thinking functions.
This phenomenon occurs in the case of chronic degenerative brain lesions of a progressive nature. However, dementia is characterized not only by changes in thought processes, but also by the manifestation of behavioral disturbances, as well as changes in a person’s personality. It is important to understand that dementia differs from mental retardation or congenital dementia , first of all, in that it occurs as a result of illness or brain damage. As a rule, dementia is a condition characteristic of older people. Due to natural aging, malfunctions in the functioning of various systems begin to occur in the body. The neuropsychic sphere is characterized by cognitive , behavioral , and emotional disorders. Cognitive disorders include dementia. However, if we consider this condition, guided by its external manifestations, then patients with dementia also have emotional disturbances (state of depression , apathy ), behavioral disorders (waking up too often at night, lost hygienic skills). In general, a person with dementia gradually deteriorates as a person.

Dementia is a severe and, as a rule, irreversible disorder that very noticeably affects a person’s normal life activities, destroying his social activity. Due to the fact that dementia is characteristic of elderly patients, it is also called senile dementia or senile marasmus . According to specialist research, approximately 5% of people over 65 years of age suffer from certain manifestations of this condition. The condition of dementia in elderly patients is considered to be not a consequence of aging, which cannot be avoided, but an age-related disease, a certain part of which (about 15%) can be treated.

Treatment

Dementia is a disease in elderly or young people that is considered incurable, with the exception of rare cases when dementia develops against the background of reversible processes (tumors, traumatic brain injuries, hematomas, certain infections, lack of a certain vitamin or mineral).

However, doctors recommend seeking medical help as soon as the first symptoms are noticed. Early treatment helps slow progression and ease the course of the disease.

First of all, the root cause that caused the brain disorder is identified, then drug treatment is prescribed that stops the development of the disease, suppresses the symptoms, the stage of dementia and the required level of observation and care for the patient are determined.

Drug treatment

Vascular dementia Alzheimer's disease, dementia with Lewy bodies and other common types of disease require the prescription of neuroprotectors to improve brain activity and blood circulation. Also, the treatment of dementia is almost impossible without NMDA receptor antagonists and cholinesterase inhibitors.

Patients with depression, depression, and apathy are prescribed antidepressants, sedatives, and tranquilizers may be prescribed for severe and aggressive patients.
Also, patients with dementia often suffer from sleep disturbances, so doctors prescribe sleeping pills. If the cause is vascular disease, the patient is prescribed medications to regulate blood pressure. Table of commonly used drugs

Group of drugs	Commonly Prescribed Drugs
Nootropics	Piracetam, Cerebrolysin, Semax, Noocetam, Encephabol, Pyritinol
Neuroleptics	Haloperidol, Carbidine, Chlorpromazine, Ziprasidone
Cholinesterase inhibitors	Rivastigmine, Galantamine, Donepezil
NMDA receptor antagonists	Akatinol memantine, Ketamine, Phencyclidine

Patient care

Patients who are in the second stage of the disease must be under the constant supervision of relatives or health workers, as they gradually lose all everyday skills and can harm themselves or others. Basic care includes full control of the patient's activities, regular light physical and mental exercise, meal preparation and control over food intake. The last point is mandatory, since dementia with Lewy bodies, Alzheimer's and other similar lesions are characterized by severe forgetfulness, which is why a person may refuse food or, on the contrary, overeat.

Reference. For patients whose relatives do not have the opportunity to constantly be nearby, there are special institutions where 24-hour supervision of patients by specialists is provided.

Patients in the third stage require constant care. In most cases, such people have to be fed and changed. They often lose the ability to move, do not control their sphincters, and cannot express or even feel hunger or thirst.

Symptoms of dementia

Dementia is characterized by its manifestation from many sides simultaneously: changes occur in speech , memory , thinking , and attention of the patient. These, as well as other body functions, are disrupted relatively evenly. Even the initial stage of dementia is characterized by very significant impairments, which certainly affects the person as an individual and as a professional. In a state of dementia, a person not only loses the ability to demonstrate previously acquired skills, but also loses the opportunity to acquire new skills. Another important sign of dementia is the relatively stable manifestation of these disorders. All violations manifest themselves regardless of the state of a person’s consciousness.

The very first manifestations of this condition may not be particularly noticeable: even experienced doctors are not always able to determine the onset of the development of the disease. As a rule, first of all, various manifestations of changes in a person’s behavior begin to alarm his family and friends. At the initial stage, these may be certain difficulties with resourcefulness, signs of irritability and forgetfulness, indifference to things previously interesting to a person, and the inability to work at full capacity. Over time, the changes become even more noticeable. The patient exhibits absent-mindedness, becomes inattentive, and cannot think and understand as easily as before. Memory disorders are also noted: it is most difficult for the patient to remember current events. Changes in mood are very pronounced, and most often the person becomes apathetic and sometimes cries. While in society, a person may exhibit deviations from general norms of behavior. Patients with dementia are no strangers to paranoid or delusional ideas; in some cases, they may also suffer from hallucinations . With all the changes described, the person himself cannot adequately assess the changes that have occurred to him; he does not notice that he behaves differently than before. However, in some cases, at the very first manifestations of dementia, a person notices changes in his own abilities and general condition, and this greatly worries him.

If the described changes progress, patients eventually lose almost all mental abilities. In most cases, speech disorders - it is very difficult for a person to select words in a conversation, he begins to make mistakes when pronouncing them, and does not understand the speech with which others address him. , dysfunction of the pelvic organs is added to these symptoms , and the patient’s reactivity decreases. If at the first stage of the disease the patient may have an increased appetite, then later his need for food decreases significantly, and eventually a state of cachexia . Voluntary movements are poorly coordinated. If the patient has a concomitant illness, which is accompanied by febrility, or metabolic provoke the occurrence of confusion. stupor or coma may occur . The described degradation process can last from several months to several years.

Such disturbances in human behavior are a consequence of damage to the nervous system. All other disorders that occur arise as a reaction to the onset of dementia. Thus, in order to hide memory impairments, the patient may be too pedantic. His dissatisfaction in response to the need for restrictions in life is expressed by irritability and bad mood.

As a result of degenerative diseases, a person may be in a state of complete decortication - not understanding what is happening around him, not speaking, not showing interest in food, although he still swallows food put in his mouth. A person in this state will have tense muscles of the limbs and face, increased tendon reflexes, grasping and sucking reflexes.

Typical symptoms

There are a number of signs that help distinguish mental retardation from true dementia.

The first symptoms of vascular dementia in older people are mild, but their identification is a reason to consult a doctor.

Main features:

• Memory impairment. The patient does not remember his personal biography and past life. There is difficulty remembering events and dates. This disorder is explained by damage to cells in a certain area of ​​the brain that controls the storage of information. This problem is considered the first sign of approaching dementia.
• Impaired perception of space . The feeling of oneself in the surrounding space is lost. A person cannot compare personal feelings with the external picture. The patient does not recognize himself as a person. Inadequacy is explained by incorrect perception of nerve impulses by the brain.
• Change in speech. Slow and incoherent speech appears, and dementia disrupts brain activity. The patient cannot construct a long sentence. The conversation comes down to a few words combined into a short sentence. Such phrases indicate the development of dementia. Problems appeared in the cerebral cortex.
• Deterioration of thinking. With senile vascular dementia, it is impossible to solve a basic everyday problem. The patient loses a sense of responsibility for his actions, as he does them unconsciously. It is difficult for him to find a way to solve the simplest problem.
• Long-term concentration. Reaction inhibition appears. A person needs time to comprehend an object and remember its purpose. The patient's attention stops on one object. This does not mean thinking, since it is possible to diversify the picture of vision.
• Personal changes. This happens gradually. Selfishness appears and the feeling of compassion disappears. This self-centeredness alienates older people with vascular dementia from other members of society. The patient becomes whiny, complains about everything and criticizes others. At a severe stage of the disease, interest in life disappears.
• Decreased physical activity. The patient forgets how to dress. It is difficult for him to perform any movement on command. Muscle tone is increased, which leads to stiffness of movements, and the facial muscles do not reproduce emotions at all.
• Social degradation. A person is completely deprived of conscious actions that allow him to be identified as a person. The patient withdraws and begins to ignore all the rules of the world around him. He considers his actions to be the most faithful and fair.

All these symptoms can appear separately.
Their intensity is affected by the progression of the disease. If you notice even one symptom, you need to urgently consult a specialist. You can learn about the types of vascular dementia (acute, cortical, mixed and others), the disease code according to ICD-10 from this article.

Forms of dementia

It is customary to distinguish the state of dementia according to the severity of the disease. The main criterion for such a distinction is the degree to which a person is dependent on the care of others.

In a state of mild dementia, cognitive impairment is manifested by a deterioration in a person’s professional abilities and a decrease in his social activity. As a result, the patient's interest in the outside world as a whole weakens. However, in this state, a person takes care of himself independently and maintains a clear orientation in his own home.

With moderate dementia, the next stage of cognitive impairment appears. The patient already needs periodic care, because he cannot cope with most household appliances, and it is difficult for him to open the lock with a key. Those around him are forced to constantly prompt him to take certain actions, but the patient can still take care of himself independently and retains the ability to perform personal hygiene.

With severe dementia, a person is completely maladapted to the environment and directly depends on the help of other people, and needs it when performing the simplest actions (eating, dressing, hygiene).

Causes of this syndrome

The main reason for the development of senile insanity is organic damage to brain cells. Factors that provoke this condition are:

1. Alzheimer's disease.
2. Atherosclerosis.
3. Arterial hypertension.
4. Injuries.
5. Stroke.
6. Chemical poisoning.
7. Brain tumor.
8. Infectious diseases (meningitis, encephalitis, syphilis, polio).
9. Endocrine pathologies.
10. Hereditary predisposition.

Patients at risk for dementia are those with the following problems:

• hypertension;
• high cholesterol;
• obesity;
• hormonal disorders;
• lack of physical and intellectual activity;
• the presence of close relatives suffering from mental disorders.

Find out more about dementia:

• symptoms and treatment of the condition in older people;
• signs of dementia in men and women, children and adolescents;
• acquired and congenital dementia, as well as connections with other diseases;
• features of early dementia;
• receiving disability and needing nursing care;
• Read about tips for communicating with someone with dementia.

Causes of dementia

The reasons for the development of senile dementia are varied. Thus, pathological disorders that negatively affect cells sometimes occur directly in the brain. As a rule, neurons die due to the presence of deposits that are detrimental to their functioning, or due to their poor nutrition due to poor blood circulation. In this case, the disease is organic in nature (primary dementia). This condition occurs in approximately 90% of cases.

Due to deterioration in the functioning of the brain, a number of other diseases may appear - malignant tumors , infections , deterioration of metabolism . The course of such diseases negatively affects the functioning of the nervous system and, as a result, secondary dementia manifests itself. This condition occurs in approximately 10% of cases.

Dementia treatment

Doctors are forced to admit for now that there are no reliable means that can stop the development of the neurodegenerative process, especially at a later age. Vascular dementia in non-advanced stages gives a greater chance, in which gradual normalization of blood circulation in the affected areas of the brain can partially restore cognitive and mnemonic functions. Atrophic disorders in Alzheimer's disease, alas, are irreversible and medications can only delay the inevitable development of the pathology.

Against this background, early prevention of atrophic lesions of the cortex and subcortex of the brain is becoming increasingly important, especially in the face of risk factors. These factors include:

1. Genetic predisposition to cerebral pathologies (diagnosis of dementia, Parkinson’s disease in one of the relatives).
2. Regular addictive behavior, primarily alcoholism. It has been proven that ethyl alcohol, and even more so its metabolite, acetaldehyde, can cause permanent changes both in the walls of blood vessels and in the structure of the brain parenchyma. Drug use can also contribute to the development of dementia, but drug addicts rarely live to see it, dying from more dangerous pathologies and complications of addiction.
3. Chronic endocrine diseases, primarily diabetes.
4. Hormonal disorders, including in women during menopause and postmenopause. According to statistics, women suffer from senile dementia approximately twice as often as men (although many researchers attribute this to the fact that women, in principle, live longer).
5. Features of life at a young and mature age.

The risks of developing cerebral pathologies increase in people who experience constant stress at work, troubles in family life, or who have experienced divorce. Wars, famines, injuries and infectious diseases can also contribute to degeneration of the cerebral cortex.

At the same time, there are factors that have a positive effect on brain function. It has been statistically proven that people who speak two languages ​​develop Alzheimer's disease almost 10 times less often than those who speak only their native language. Ambidexters are practically protected from dementia - people who operate with both their left and right hands with equal success. Intense mental activity, preferably associated with solving non-standard problems that simultaneously require logical thinking, sensory organs, and fine motor skills, is very useful for the prevention of disorders of higher nervous activity. The simplest example is the “colorful text” exercise.

Exercise “colorful text”

The task is to read the words in the square to yourself and at the same time say out loud the color in which the word is written. At first, this is incredibly difficult, since different parts of the cerebral cortex are responsible for the perception of text and color. But over time, a synaptic connection will be established between these areas, and the exercise will be performed more and more successfully.

Neurologists and psychiatrists also strongly recommend using your non-dominant hand as often as possible - trying to write with it, brush your teeth, insert a key into a keyhole, etc. Thus, synaptic connections between the hemispheres of the brain will be trained.

Much depends on proper nutrition, although there is no ultimate truth here either. For example, it has been proven that the risk of neuropathy decreases with the consumption of the phospholipid phosphatidylserine, which plays an extremely important, not yet fully understood role in metabolic processes in the brain. But its main source is meat, mainly beef. After an outbreak of prion encephalopathy among cows (mad cow disease), beef consumption was sharply limited in many countries around the world. Luckily, phosphatidylserine is found in dairy products, beans, and soy.

Diagnosis of dementia

To make a correct diagnosis, it is important, first of all, to correctly determine the nature of dementia. This directly affects the prescription of the treatment method for the disease. The most common causes of primary dementia are changes of a neurodegenerative nature (for example, Alzheimer's disease ) and vascular nature (for example, hemorrhagic stroke , cerebral infarction ).

The occurrence of secondary dementia is mainly provoked by cardiovascular diseases , excessive drinking metabolic disorders . In this case, dementia may disappear after the cause of it is cured.

When making a diagnosis, the doctor first of all conducts a detailed conversation with the patient to find out whether the patient really has reduced intellectual indicators and personality changes. In the process of clinical and psychological assessment of the patient’s condition, the doctor conducts a study aimed at determining the state of gnostic function , memory , intelligence , objective actions , speech , attention . It is important to take into account during the research the stories of the patient’s loved ones who have constant contact with him. Such information contributes to an objective assessment.

In order to fully ascertain the presence of symptoms of dementia, a long-term examination is required. There are also specially developed scales for assessing dementia.

It is important to distinguish dementia from a number of mental disorders. So, if among the patient’s symptoms there is fatigue , nervousness, and sleep disturbances, then, assuming the absence of changes in mental activity, the doctor can assume the presence of a mental illness. In this case, it is important to take into account that mental disorders in middle-aged and elderly people are the consequences of either organic brain damage or depressive psychosis.

When making a diagnosis, the doctor takes into account that patients with dementia are very rarely able to adequately assess their condition and are not inclined to note the degradation of their own mind. The only exceptions are patients with dementia in the early stages. Consequently, the patient’s own assessment of his condition cannot become decisive for the specialist.

After diagnosing a patient with dementia, the doctor prescribes a number of other examinations to identify signs of diseases of a neurological or therapeutic nature, which makes it possible to correctly classify dementia. The study includes computed tomography, EEG, MRI, lumbar puncture . Toxic metabolic products are also studied. In some cases, it is necessary to monitor the patient for a certain period of time to make a diagnosis.

Diagnostics

There are clear criteria for diagnosing this disease. Timely diagnosis will help stop the development of pathology.

The diagnostic steps are as follows:

• At the first appointment, the doctor studies the medical history and talks with the patient and his relatives. It is necessary to clarify the symptoms and the time of their onset.
• A physical examination is then carried out to look for memory impairment and problems with coordination or spatial orientation.
• A laboratory test is required, including a urine test and blood biochemistry. This will reveal the presence of diabetes mellitus, dysfunction of the thyroid gland, lack of vitamins and possible metal intoxication.
• The patient undergoes a neuropsychological test that evaluates thinking and memory. The study takes no more than 5 minutes. Psychiatrists suggest memorizing a group of words or drawing a clock with the exact time.
• Naturally, an MRI of the brain and an electroencephalogram are prescribed. They are aimed at detecting or excluding hemorrhages and neoplasms.

The final diagnosis of dementia is made only after six months of typical symptoms. In another case, this is only a presumptive diagnosis.

Prevention of dementia

To prevent the onset of dementia, measures are taken to reduce the risk of this disease to some extent. your cholesterol and homocysteine ​​levels – they should not be high. of hypertension should not be allowed . An important factor in the prevention of dementia is an active social life, regular intellectual activity, and an active lifestyle. Measures to prevent vascular dementia include quitting smoking, excessive consumption of alcohol, salt and fatty foods. It is important to control blood sugar and avoid head injuries.

Dementia - what is this disease?

Dementia is insanity, expressed in the breakdown of mental functions, which occurs due to brain damage. The disease must be differentiated from oligophrenia - congenital or acquired infantile dementia, which is a mental underdevelopment.

With dementia, patients are not capable of realizing what is happening to them; the disease literally “erases” everything from their memory that accumulated in it during the previous years of life.

Dementia syndrome manifests itself in many ways. These are disorders of speech, logic, memory, and causeless depressive states. People suffering from dementia are forced to leave work because they require constant treatment and supervision. The disease changes the life of not only the patient, but also his loved ones.

Depending on the degree of the disease, its symptoms and the patient’s reaction are expressed differently:

• With mild dementia, he is critical of his condition and is able to take care of himself.
• With a moderate degree of damage, there is a decrease in intelligence and difficulties in everyday behavior.
• Severe dementia – what is it? The syndrome means a complete breakdown of personality, when an adult cannot even relieve himself or eat on his own.

List of sources

• Damulin I.V. Alzheimer's disease and vascular dementia / Ed. Yah-no N.N. M., 2002.
• Damulin I.V., Parfenov V.A., Skoromets A.A. and others. Circulatory disorders in the brain and spinal cord. Diseases of the nervous system: A guide for doctors. T.1. Ed. N.N. Yakhno. 4th ed., revised. and additional M.: OJSC "Publishing House Medicine", 2005;
• Levin O.S. Modern approaches to the diagnosis and treatment of dementia // Handbook of a polyclinic doctor. — 2007. — No. 1
• Damulin I.V. Cognitive disorders: modern aspects of diagnosis and treatment. - M., 2005.

Treatment of the disease

Dementia is treated by a psychiatrist and neurologist. Treatment tactics are selected depending on the cause and stage of the disease. To treat the disease, drug therapy and sessions with a psychologist are used.

Drug therapy

Groups of drugs for therapy are selected according to the type of disease.

Alzheimer's type dementia is treated with the following:

1. Improves cerebral circulation (Eufillin, Reserpil).
2. Antioxidants (Mexidol).
3. Improves memory (Memontin).

Medicines for the treatment of cerebrovascular dementia:

1. Lowering blood pressure (Capoten, Captopril).
2. Anti-sclerotic (beds).
3. Blood thinners (Aspirin cardio).
4. Corticosteroids (Kenacort).

Alcohol-induced dementia is treated with medications such as:

1. Adsorbents.
2. Sedatives.
3. Antioxidants.
4. Improves cerebral circulation.

The duration of the course varies from 15 days to a month. If necessary, treatment is repeated after a month's break.

Psychotherapy

Patients work with psychologists both individually and in groups.

They perform tasks to improve attention, memory, and thinking (solve simple problems, learn poetry, read books).

Psychological training has a good effect. They are aimed at improving the social adaptation of patients.

Physical exercise and walks in the fresh air are of great importance. The patient cannot be isolated from society or locked at home.

Communication with people prevents the development of the disease and allows you to maintain everyday skills.

Mechanism of disease

The pathogenesis of senile dementia is caused by a malfunction of the hypothalamic-pituitary system. In this case, a hormonal imbalance occurs in the body, the connection between the cortex and the subcortical structure is disrupted. The disruption of the activity of the centers leads to the gradual death of neurons.

As a result, diffuse atrophy of areas of the cerebral cortex occurs, its mass decreases, and the convolutions are smoothed out.

The decline in brain function is caused by the gradual death of neurons and the formation of necrotic foci. Neurons are responsible for mental processes, social adaptation and intelligence.

Vascular dementia is the result of circulatory disorders. How dementia will progress and how much it will affect the patient’s life expectancy directly depends on whether there has been a history of stroke (acute cerebrovascular accident) and ischemic vascular damage.

Signs of dementia in vascular dementia take a very long time to develop. The reason for this is the process of death of brain cells as a result of oxygen starvation. This type of disease is characterized by long-term memory retention.

In men, the predisposition to vascular dementia is one and a half times higher than in women.

There is post-traumatic dementia, the impetus for the development of which is infections and brain injuries. The clinic begins with manifestations of forgetfulness and leads to a complete loss of self-control. Dementia of any of these types is an irreversible process.

Classification

Taking into account the predominant damage to certain areas of the brain, four types of dementia are distinguished:

1. Cortical dementia. The cerebral cortex is predominantly affected. It is observed in alcoholism, Alzheimer's disease and Pick's disease (frontotemporal dementia).
2. Subcortical dementia. Subcortical structures suffer. Accompanied by neurological disorders (trembling limbs, muscle stiffness, gait disorders, etc.). Occurs in Parkinson's disease, Huntington's disease and white matter hemorrhages.
3. Cortical-subcortical dementia is a mixed type of lesion, characteristic of pathology caused by vascular disorders.
4. Multifocal dementia is a pathology characterized by multiple lesions in all parts of the central nervous system.

Senile dementia

Senile dementia (dementia) is severe dementia that manifests itself at the age of 65 years and older. The disease is most often caused by rapid atrophy of cells in the cerebral cortex. First of all, the patient’s reaction speed and mental activity slow down and short-term memory deteriorates.

Mental changes that develop during senile dementia are associated with irreversible changes in the brain.

1. These changes occur at the cellular level; neurons die due to lack of nutrition. This condition is called primary dementia.
2. If there is a disease due to which the nervous system is damaged, the disease is called secondary. Such diseases include Alzheimer's disease, Huntington's disease, spastic pseudosclerosis (Creutzfeldt-Jakob disease), etc.

Senile dementia, being among the mental illnesses, is the most common disease among older people. Senile dementia occurs almost three times more often in women than in men. In most cases, the age of patients is 65-75 years, on average, in women the disease develops at 75 years, in men - at 74 years.

Vascular dementia

Vascular dementia is understood as a disorder of mental acts, which is caused by problems with blood circulation in the vessels of the brain. Moreover, such disorders significantly affect the patient’s lifestyle and activity in society.

This form of the disease usually occurs after a stroke or heart attack. Vascular dementia - what is it? This is a whole complex of symptoms that are characterized by a deterioration in a person’s behavioral and mental abilities after damage to the blood vessels of the brain. With mixed vascular dementia, the prognosis is the most unfavorable, since it affects several pathological processes.

In this case, as a rule, dementia that develops after vascular accidents, such as:

• Hemorrhagic stroke (vascular rupture).
• Ischemic stroke (blockage of a vessel with cessation or deterioration of blood circulation in a certain area).

Most often, vascular dementia occurs with atherosclerosis and hypertension, less often with severe diabetes mellitus and some rheumatic diseases, and even less often with embolism and thrombosis due to skeletal injuries, increased blood clotting and peripheral venous diseases.

Elderly patients should monitor their underlying medical conditions that may cause dementia. These include:

• hypertension or hypotension,
• atherosclerosis,
• ischemia,
• arrhythmias,
• diabetes mellitus, etc.

Dementia is promoted by a sedentary lifestyle, lack of oxygen, and addictions.

Alzheimer's type dementia

The most common type of dementia. It refers to organic dementia (a group of dementive syndromes that develop against the background of organic changes in the brain, such as cerebrovascular diseases, traumatic brain injuries, senile or syphilitic psychoses).

In addition, this disease is quite closely intertwined with types of dementia with Lewy bodies (a syndrome in which the death of brain cells occurs due to Lewy bodies formed in neurons), having many common symptoms with them.

Dementia in children

The development of dementia is associated with the influence of various factors on the child’s body that can cause disturbances in the functioning of the brain. Sometimes the disease is present from birth, but manifests itself as the child grows.

In children there are:

• residual organic dementia,
• progressive.

These types are divided depending on the nature of the pathogenetic mechanisms. With meningitis, a residual organic form may appear; it also occurs with significant traumatic brain injuries and poisoning of the central nervous system with medications.

The progressive type is considered an independent disease, which may be part of the structure of hereditary degenerative defects and diseases of the central nervous system, as well as cerebral vascular lesions.

With dementia, a child may develop depression. Most often, this is characteristic of the early stages of the disease. The progressive disease impairs children's mental and physical abilities. If you do not work to slow down the disease, the child may lose a significant part of his skills, including household ones.

With any type of dementia, loved ones, relatives and household members should treat the patient with understanding. After all, it’s not his fault that he sometimes does inappropriate things, it’s the illness that does it. We ourselves should think about preventive measures so that the disease does not affect us in the future.

How to treat

Treatment for dementia in the elderly should begin as soon as the first symptoms appear. It should consist of spirit aspects:

1. Medication. Medicines prescribed by a doctor will stop the development of certain symptoms and slow down destructive processes in the brain.
2. Psychological. The patient should live in a family where love and mutual understanding reign. You can’t scold him for his mistakes and illogical actions. Only support and respect can reduce the level of aggression.

Physical side of life

Often, senile dementia also changes the ability of a person to move. With the onset of brain changes, movements become not as coordinated as before, endurance decreases, and the person becomes weaker (in rare cases, attacks of increased strength are possible).

The physical side suffers especially in Parkinson's disease, a frequent companion of senile dementia. In this case, the following symptoms appear:

• tremor (shaking) of parts of the body - first of one of the arms, then gradually moving to all limbs, including involuntary movements of the head;
• muscle rigidity (stiffness) – disappearance of facial expressions, preservation of the given body position;
• problems with movement - gait becomes unnatural, movement is difficult, assistance is often required.

List of diseases that may be accompanied by dementia

Stage of minor cognitive impairment (MCI)

The first stage of dementia, when changes in brain function have already appeared but do not manifest clinical symptoms, is considered the stage of preclinical symptoms of MCI (Mild Cognitive Impairment).

The first manifestations of the pathology are nonspecific. The risk of MCI is indicated by the appearance of lack of initiative, narrowing of interests, and minor changes in behavior.

The nature of the first symptoms depends on the type of dementia. If the cerebral cortex is affected, as in Alzheimer's disease or frontal lobe dementia, then the first signs of cognitive disorder are manifested by mild forgetfulness and difficulty choosing words in a conversation.

In Parkinson's disease, the brain's motor neurons, which are responsible for motor activity, are destroyed. The first symptoms of dementia in Parkinson's disease appear at the MCI stage with changes in gait, trembling of fingers, and poor facial expressions.

Damage to the frontotemporal lobes of the brain causes frontotemporal degeneration, which is characterized at an early stage by deviations in the emotional sphere and inadequate assessment of the actions and intentions of others.

The initial signs of vascular dementia may include memory impairment and loss of orientation in a familiar room. For dementia with Lewy bodies, in which connections between neurons are destroyed, the appearance of slight stiffness of movements and a decrease in the speed of thinking are typical at the MCI stage.

How to help a patient

MCI - stage features and solutions
At the stage of mild cognitive impairment, a person is able to adequately assess his condition. He understands that the emerging memory problems are abnormal and is actively involved in the treatment process.

Potential interventions for the cognitive impairment stage of MCI include:

• performing physical exercises;
• walks;
• healthy sleep;
• diet;
• expanding your social circle (attending group classes, communicating with relatives and friends);
• stimulation of mental activity (solving logical problems, crosswords, playing chess).

A Mediterranean diet is beneficial for proper brain function. The diet should include whole grains, fish, nuts, fruits, fish, olive oil, avocado, seafood.

Lentils, berries, especially blueberries, cabbage (broccoli, cauliflower, Brussels sprouts), and low-fat dairy products are good for brain health. The diet is limited to red meat, fatty, salty, smoked foods.

Moderate physical activity helps maintain mental alertness into old age. Just 30 minutes a day of dancing, Nordic walking or swimming is enough to maintain active longevity.

To preserve brain function, you should protect your hearing. Disruption of the auditory analyzer changes the performance of the brain as a whole. And, of course, you need to completely give up bad habits.

An indicator of destructive changes in the brain is a deterioration in the sense of smell. Statistics show that the risk of developing dementia in old age increases 3 years after the loss of smell.

Who is at risk for dementia

Experts recommend that those who are at risk or live with relatives belonging to it be required to study the symptoms and signs of dementia. Most often these are people:

• Over the age of 60-65 years;
• After a traumatic brain injury;
• With cardiovascular diseases (hypertension, heart attack, stroke);
• Obese;
• With endocrine pathology.

Also at risk are those who lead a sedentary lifestyle, avoid mental and physical stress, have bad habits or uncontrollably take psychotropic substances. Close relatives of those who suffered from this disease should pay attention to the possibility of developing dementia, since scientists have proven a hereditary factor.

Classification of types of disease in the weaker sex

Senile dementia is divided into three types:

• Atrophic. It is characterized by primary degeneration in the brain.
• Vascular. It is also called secondary, as it develops against the background of existing deviations.
• Mixed. It is based on the two previous points.
• Multifocal. The entire nervous system is affected.

Experts also distinguish cortical and subcortical localizations.

Provoking factors for early signs of dementia in women under 50 years of age

The causes are point mutations in the DNMT3A and TET2 genes, which are responsible for vascular growth throughout the life cycle.

American and Australian scientists have proven that an unhealthy lifestyle also leads to dementia.

For prevention it is necessary:

• Do not abuse tobacco and alcohol products.
• Eat nutritiously and nutritiously. Include fish, vegetables and fruits in your diet.
• Engage in active sports.
• Strengthen neural connections by keeping the brain in good shape by reading and learning foreign languages.
• Work on a computer, master gadgets (brain “training”).
• Don't ignore depressive disorders.
• Treat yourself for hypertension and diabetes.
• Do not ignore hearing loss or deterioration and seek advice from an otolaryngologist.

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for an elderly person with dementia

Features of manifestations of age-related dementia in women

Its representatives are by nature more emotional than men, and therefore are subject to frequent mood swings. You should pay attention if you or a loved one exhibits:

• Irritability.
• Sudden aggression.
• Tearfulness or unreasonable laughter.
• Long-term severe depression.
• Excessive suspicion.
• Unreasonable stubbornness.
• Reluctance to communicate.
• Accusations against relatives, neighbors or complete strangers.

Senile dementia that is treatable

Unfortunately, many people believe that this disease cannot be cured with special medications. In their opinion, medications are not able to overcome age-related changes. Their opinion is wrong, because senile dementia is treatable. Moreover, it must be carried out without fail. How to save a loved one from dementia? The result of treatment in many cases depends on the type of senile dementia. First you need to establish the cause of this disease. Even if it arose as a result of an incurable disease, there is still a way out. To do this, you need to purchase special medications. Their activities are aimed at slowing down the development of negative manifestations of dementia. The patient's relatives should contact a psychiatrist. The responsibilities of this specialist include talking with the patient. After the conversation, he determines the presence of atrophic processes in the brain. In addition, the doctor may refer the patient for examinations in the form of a brain CT scan or electroencephalography. You need to know that only a specialist can make a diagnosis! It is necessary to consult a doctor immediately after the first signs of senile dementia appear. You cannot delay this, because at the final stage it is impossible to carry out effective treatment. Only symptomatic treatment improves the patient's fate.

In order for the result to pleasantly surprise relatives, they need to create a comfortable environment at home. A person with senile dementia should be involved in household chores. This is what can stop the development of dementia. When a patient experiences hallucinations or insomnia, a specialist prescribes special psychotropic drugs. In the early stages, the patient should use nootropics, and in the later stages, tranquilizers.

Features of therapy

Senile insanity provokes organic damage to brain neurons. In this case, the pathological processes are irreversible, so it is impossible to cure the disease. However, modern treatment methods make it possible to slow down further death of nerve cells and improve the patient’s quality of life.

Drug treatment involves taking the following medications:

• Nootropics (Lucetam, Piracetam, Pramistar, Phenotropil, Pantogam, Cerebrolysin). Medicines are widely prescribed in the early stages of the disease to restore memory and improve brain activity;
• Antidepressants (Lerivon, Amitriptyline, Coaxil). The drugs help eliminate anxiety, depression, and relieve emotional stress;
• Tranquilizers in small dosages (Phenazepam). Treatment must be carried out with caution, because discontinuation of the drug can provoke the development of severe anxiety and depression;
• Sleeping pills and sedatives (tincture of motherwort, valerian, Novopassit, mint, lemon balm). Herbal preparations effectively reduce emotional stress, normalize sleep, and rarely provoke the development of adverse reactions.

Important! The dosage and regimen of taking the listed medications is determined solely by the doctor. Self-medication can only worsen the course of the disease.

Experts recommend carrying out therapeutic activities in a familiar environment for the patient in order to reduce the patient’s nervous tension. However, treatment requires constant care and supervision of an elderly person, which is not always possible to organize at home. In such cases, the optimal solution would be to place the patient in special boarding houses for elderly people with dementia.

See also:

• Vascular dementia: causes, stages, symptoms, treatment
• Memory loss in older people: short-term, progressive, after stroke
• Discirculatory encephalopathy in the elderly

Important! In addition to drug therapy, patients with senile insanity need regular physical activity, communication with relatives, and walks in the fresh air.

Special attention should be paid to the nutrition of an elderly patient. You will need to exclude heavy foods from your diet (fatty, fried, spicy foods, processed foods). Nutritionists recommend adhering to the rules of a balanced diet, eating small portions every 3-4 hours.

Important! If symptoms of cachexia are present, the patient should be fed liquid or pureed foods.

In the initial stages of senile insanity, psychotherapy is widely used to restore or form new behavioral reactions. However, at the third stage, this treatment is not effective.

Dementia in older people and its forms can be divided into three main stages:

1. Early.
2. Moderate.
3. Late.

It should be taken into account that the progression of dementia in pensioners occurs in stages and may not make itself felt for some time . Moreover, treatment of this disease, as a rule, is most effective in the early stages of development. Therefore, it is so important to systematically undergo examination and diagnostic procedures in specialized institutions.

Moderate stage

Everything we listed above is an early stage of the disease. But depending on the lesion, a person may experience:

• Severe mental disorders.
• Hallucative reasoning (when a conversation is conducted with fictional characters).
• Inability to remember past events.
• Complete collapse of personality.
• Impaired speech and ability to recognize things.
• Insanity, in which mental and physical work declines.

In addition, you can easily check for shifts by type of activity. If there is a driver in front of you, then pay attention to the following:

• how he navigates familiar terrain;
• does he drive according to the signs?
• how it reacts to force majeure circumstances;
• which turn signal turns on when changing traffic;
• what is his behavior during traffic jams, will he calmly wait for passage or will he overtake on the side of the road;
• whether control mechanisms are confused.

If the disease was not detected at an early stage, and therefore it was not possible to stop its further development and alleviate the course, rapid progression of dementia occurs. Symptoms get worse depending on the type of dementia. The patient loses professional and some household skills, does not want to engage in personal hygiene, and denies the presence of the disease.

A triad of neuropsychological syndromes may occur:

1. Apraxia is a disorder of motor activity; the patient is unable to perform complex actions.
2. Agnosia is the loss of certain perceptions, for example, the inability to identify sounds, colors and objects, or the faces of familiar people.
3. Aphasia is a speech disorder that occurs in dementia associated with Alzheimer's or Pick's disease.

Partial or complete loss of short-term memory occurs, problems with orientation in time and space develop, and the inability to determine the left and right sides the first time. Handwriting changes, the desire to communicate with family disappears.

Dementia at the last stage is very difficult. The patient completely loses his personality, as well as:

• does not recognize loved ones and himself;
• does not understand where he is, what year it is, what time of day it is;
• stops moving fully and is often bedridden;
• loses control of the sphincters;
• loses all skills, ceases to cope with food intake, and in the last days before death he may lose chewing and swallowing reflexes.

Sometimes the “mirror symptom” occurs when the patient looks in the mirror for a long time and talks to it.

Also, at the last stage, the process of dementia can be complicated by psychoses: hallucinations, delusions, persecutory delusions, severe phobias.
Comparison of disease symptoms

Function type	Early stage	Moderate stage	Severe stage
Memory	Development of easy forgetfulness	Partial loss of short-term memory	Loss of short-term memory, and in severe cases, complete amnesia
Emotions	Exacerbation of personal traits, slight changes in character	Apathy, depression, isolation from society	Aggression, anger or complete depression develops, the patient loses his personality, ceases to resemble his former self
Thinking and speech	Thinking becomes slightly dull and speech slows down	A person tells the same information several times, the “gramophone” symptom develops, speech is fast, some words are forgotten	Incoherent speech, without essence and logic, thoughts are confused
Movements	Rarely impaired, except in cases where alcoholic dementia occurs, the stages of development of which are characterized by motor disorders	Hand tremors, loss of coordination (sometimes may not occur)	Development of apraxia, problems with coordination, and in some cases, inability to move

The gradual development of the disease leads to death, which occurs due to the cessation of brain activity, extinction of vital functions, and less often due to pneumonia, strokes, heart attacks, and intestinal dysfunction. In the severe stage, before death, three more periods are distinguished: terminal, preagony and agony.

The terminal period is characterized by complete apathy, the person is not active, does not respond to sounds, and functions fade away. The development of predagonia can be suspected if the patient’s blood pressure and heart rate have decreased, and breathing has slowed down.

Dementia develops suddenly and sometimes ends in agony with a sharp but short-term improvement in the patient's condition. The person comes to his senses, memory, breathing, and blood pressure temporarily improve. After agony, clinical and later biological death always occurs.

Early stage dementia

Patients are practically no different from healthy people at this stage of development of the disease . Only minor manifestations may be noticed, which are usually associated with the natural aging process. An elderly person does not have significant negative changes in spatio-temporal orientation, he can take care of himself and demonstrates adequacy in behavior.

Symptoms of the onset of the disease:

• Slightly reduced performance.
• Some loss of interest in your hobbies and social circle.
• Strict adherence to traditions progresses, excessive importance is attached to the past and everything new is denied.
• Deviations in memory functioning.
• Decreased alertness or excessive concentration.
• Attacks of irritability, aggressiveness, touchiness and self-isolation appear.
• Physical activity decreases somewhat.

Emotional manifestations of dementia

The first signs of mental aging do not escape the attention of the bearer of these signs. At first, emotional changes are not associated with organics, but rather with the awareness of the inevitability of pathological phenomena. Therefore, a change in the psyche is often preceded by a decadent mood.

Important! Even before a deep organic change in the emotional state, depression can develop - the result of awareness of the inevitability of the disease.

Dementia due to Alzheimer's disease

As the disease progresses, depression goes away, emotions become not as complex as before, and they are caused by superficial phenomena. At this time the following appear:

• instability of mood - easy change from laughter to tears, fun to gloominess, calmness to irritability and vice versa;
• simplification of emotions - flat humor, superficial sadness, lack of feelings where before there would have been plenty of them - indifference;
• reduction of moral and ethical requirements - demonstration of a clear interest in non-social aspects of life - sex, for example, as well as a lack of desire to follow norms of behavior;
• exacerbation of character traits to the point of absurdity - sociability turns into talkativeness, modesty into avoiding any contact, frugality into hoarding and collecting unnecessary things, thriftiness into stinginess, caring for loved ones into authoritarianism and mentoring, criticality into grumpiness, shamelessness and aggression.

Dementia caused by repeated mini-strokes

Important! Emotionally, a person gradually ceases to be a member of the team, does not notice the affection and love of loved ones, which makes communication with him difficult.

Diagnosing dementia

A qualified doctor must study the patient’s condition, his clinical picture along with the medical history, and interview relatives. To accurately diagnose dementia, a questionnaire is used using a specific neuropsychological scale.

The following number of factors need to be taken into account:

• Symptoms appear for at least six months.
• Problems with emotions: unstable behavior, attacks of apathy and irritability.
• Impaired cognitive functions.
• Medical meanings of deviations and how they affect a person’s quality of life.

To obtain the most complete picture of the disease, additional brain examinations, blood samples for hormonal studies, and MRI may be prescribed.

Recommendations for relatives

Elderly patients with senile dementia require constant support. To do this you will need:

• Create a cozy and favorable atmosphere at home;
• Talk to the patient only in a calm tone;
• Address a person by name;
• When speaking, you should use simple phrases and words;
• Help with daily activities: dressing, eating, bathing, showering;
• When communicating, you should remember the old days;
• It is necessary to repeat the phrase if the patient does not understand its meaning.

First signs

The first signs of dementia are a narrowing of horizons and personal interests, a change in the patient’s character. Patients develop aggression, anger, anxiety, and apathy. The person becomes impulsive and irritable.

The first signs you need to pay attention to:

• The first symptom of any type of disease is memory disorder, which progresses rapidly.
• The individual's reactions to the surrounding reality become irritable and impulsive.
• Human behavior is filled with regression: rigidity (cruelty), stereotyping, sloppiness.
• Patients stop washing and dressing, and professional memory is impaired.

These symptoms rarely signal to others about an impending illness; they are attributed to current circumstances or a bad mood.

First signs of illness

Dementia can occur in different ways, depending on the cause of its occurrence, the location of the pathological process, and the stage of severity. The main signs of dementia appear already at the first stage, but in almost 90% of cases they go unnoticed by others. At the onset of the disease, the patient himself notices a number of changes, but does not attach due importance to them, considering them signs of fatigue, depression, or natural causes associated with the aging process. Subsequently, due to changes in mental activity and perception, the patient ceases to recognize and recognize his illness.

Regardless of the type of dementia, in general, the following symptoms and signs of dementia can be identified:

1. Memory problems. They begin with ordinary forgetfulness, the inability to remember minor information: the name of a new acquaintance, the location of the keys, a recent conversation. Further, professional memory suffers, gradually the first symptoms and signs of senile dementia are aggravated by memory failures, while the person tries to reconstruct the course of events, remember what happened, filling in the gaps with fictitious stories and facts. This point distinguishes dementia from ordinary forgetfulness. In a severe stage of the disease, memory is completely lost, a person does not recognize relatives (children, parents), and sometimes - his own reflection in the mirror.
2. Impaired thinking and concentration are also signs of incipient dementia. The patient's thoughts are disordered, it is difficult to concentrate on one thing, thinking is slow, clouded, the logic of judgment gradually disappears. In the later stages of the disease, a person thinks fragmentarily, false ideas arise (phobias, persecution mania, poisoning, etc.).
3. Speech disorders. Just like thinking, the patient’s speech suffers: in the early stages it is characterized by many errors, and sometimes the logical chain of the story is lost due to forgetfulness. At a later stage, speech is incoherent, even to the point of producing meaningless sounds.
4. Emotional disorders. They begin at the first stage and are characterized by frequent mood swings, tearfulness, moodiness, apathy, and asociality, which is why the disease is sometimes confused with depression. At later stages, panic, unreasonable anxiety, and aggression appear.
5. Sleep disorders. This symptom is characterized by a gradual loss of biorhythms (daytime sleep, night wakefulness).
6. Loss of sense of time and place. The patient forgets the day of the week, the year, cannot distinguish the time of day, and gets lost in a previously familiar area.

As already mentioned, signs of dementia in old people depend on the type of disease and the location of the pathological process. Thus, with dementia of the Alzheimer's type, memory suffers the most, false memories appear, speech disorders occur, and the ability to orientate in space is lost.

Vascular dementia, which accounts for 10-20% of all cases of the disease, occurs due to brain atrophy due to impaired blood supply. Signs of vascular dementia: a sharp decrease in mental activity, intelligence, fatigue, emotional disorders, impaired thinking and speech. Memory problems may not occur.

Also, the clinical manifestations of vascular dementia depend on the location of the lesion in the brain (hippocampus - impaired attention, memory; striatum - motor dysfunction; thalamus - meaningless speech).

Important! In 10% of cases, dementia is aggravated by various psychoses.

Differences between signs of dementia and other diseases

Dementia in old age is often mistaken for the processes of withering that occur in the body after 70-80 years. In this case, the combination of symptoms and their progression should alert relatives who observe suspicious symptoms.

The difference between dementia and natural decline of the body

Defeats	Senile dementia	Natural processes
Memory	First of all, the loss of short-term memory, while events of the distant past are remembered in detail. Also important signs and manifestations of dementia are fantasies and fictions that replace new memories. Another difference is the loss of professional skills	Loss of up to 20% of short-term memory, combined with forgetting past events. At the same time, acquired skills are not lost.
Emotions	Unreasonable changes in character that progress	Depression, apathy, irritability, and tearfulness may occur. However, such manifestations are not constant and have reasons (loneliness, resentment, etc.)
Intelligence	Gradual decline. The main distinguishing symptom is the inability to perceive, remember new information, and acquire new skills.	Decrease, against the backdrop of maintaining previously acquired skills. But the readiness and ability to learn and remember new information remains

Since dementia sometimes occurs in young people and children, the disease is mistakenly associated with mental retardation. To distinguish between these diagnoses, it is worth highlighting the main signs of mental retardation and dementia. The first disease is congenital and manifests itself at the age of 2-3 years. Children born with mental retardation lag behind their peers in mental and physical development. Dementia at this age most often occurs as a result of injuries, children are physically healthy, in addition to decreased mental activity, other characteristic symptoms appear, and the disease progresses.

The first signs of dementia in women

Women are much more likely to suffer from dementia than men. This is because about 50-60% of all cases of dementia are associated with Alzheimer's disease, which mainly affects women. In addition, the long life expectancy of female representatives also affects (the disease in most cases occurs after 60-70 years).

At the same time, the symptoms and first signs of senile dementia are easier to identify in women than in men. This is explained by the presence of a greater number of symptoms: patients are much more likely to experience emotional disorders, memory loss with the replacement of information with false memories.

The patient's mood can change very often and dramatically. The most typical manifestations are aggression, irritability, capriciousness, vulnerability, tearfulness, and greed. Closedness is noted, the woman stops communicating with friends and sometimes even relatives. There is no improvement in the emotional background; without treatment, the disease constantly progresses.

Signs of dementia in men

Most often, the first signs of dementia in men are disturbances in speech, thinking, and memory. Due to the localization of the lesion, nonspecific symptoms may develop: tremor, disturbances in purposeful movements. Emotional lability (frequent mood swings) is detected much less frequently than in women. Relatives may suspect the presence of the disease by an increasing decline in cognitive functions, and sometimes by unreasonable aggression or jealousy.

According to studies conducted in the USA, although the disease begins earlier in men (from 60 years of age), the first symptoms and signs of dementia appear later in men than in women. For this reason, the disease can rarely be detected at an early stage, and in some cases it remains undetected until the last stage.

Signs of the disease in young people

At a young age, dementia manifests itself in the same way as at an old age, but its prognosis is slightly more favorable. This is explained by the fact that young people more often seek help from specialists when the first signs of illness appear, as well as in connection with other causes of dementia. For example, in case of injuries, brain tumors, lack of vital vitamins and minerals, or hormonal imbalances, the progression of the disease can be completely stopped.

Symptoms and signs of dementia in young people are increasing forgetfulness, problems with thinking and speaking, concentrating, and the inability to focus and do normal work. All this leads to depression, loss of interest in life, withdrawal from society, and aggression.

Reference! Dementia in young people is registered relatively rarely; in different countries this figure reaches 1-10% of the total number of cases.

Signs of dementia

The disease develops gradually or spasmodically, depending on the accompanying pathology. With Alzheimer's disease, there is a slow loss of abilities and functions; with strokes, including micro-strokes, the changes are abrupt. In any case, they affect all aspects of a person’s personality: emotional, mental, communicative, physical activity.

The decisive moment of change is called memory impairment. Amnesia, at first subtle, then manifesting itself more clearly, affects all aspects of the patient’s life and turns him from an emotionally rich, living person into a flattened copy of him.

Memory Features

With the development of senile dementia, memory is primarily impaired. At first it is a slight forgetfulness, an inability to remember what you just thought about, an inability to find a word. They laugh at this, talk about approaching old age, but do not think about the fact that this could be a signal of the onset of a complex disease. Gradually, further memory deterioration is noticed:

1. A person forgets recent events, previously assigned tasks, and misses meetings that he himself had scheduled. At the same time, he remembers the events of the past well, which creates the illusion that everything is in order with his memory, and there is only a slight deviation, characteristic of all elderly people.
2. Thoughts are lost, what was important and what was just worrying the person is forgotten.
3. Spatial orientation deteriorates. The patient ceases to recognize places, even those where he has lived all his life.
4. Temporal orientation is lost. Dates are forgotten, people confuse the past with the present.
5. Memory for faces is impaired. A person loses the ability to recognize acquaintances, friends, close relatives. At some point in time, it ceases to recognize its reflection.

Any of these manifestations, having once arisen, does not disappear, but gradually becomes deeper and spreads to ever larger areas of a person’s life. The use of medications aimed at improving memory delays the deterioration of the condition for several years.

Mental activity

Mental activity changes slowly and gradually. Cognitive impairment usually results in dementia being referred to as senile dementia. Attention deteriorates - a person ignores and does not notice an important part of the information.

The knowledge and skills acquired earlier gradually disappear and are lost. First - abstract, rarely used. Then those that a person did and used automatically, for example, reading, counting, turning on and off household appliances. A person loses the ability to drive a car and does not recognize road signs. Speech changes - sentences mostly become simple, monosyllabic. Complex, rarely used words are forgotten and gradually lose their meaning for the patient.

As a result, the ability and ability to learn something new is lost. At first, a person cannot figure it out, deeply study some unfamiliar object, establish cause-and-effect relationships, or make complex calculations. Then the ability to recognize everyday things is lost.

How to create safe living conditions

1. Beginner. Signs of dementia are barely perceptible, these are: - instant forgetfulness (failure is observed immediately upon receipt of new information); – deterioration in temporal and spatial orientation; – insomnia, emotional decline (expressions of joy and sadness are reduced, the person has an apathetic appearance). 2. Early.

It occurs with difficulties in choosing words when speaking and writing, forgetting the names and locations of things. Lack of understanding of other people’s thoughts when communicating (requests, reasoning), the emotional state of the interlocutor. The ability to self-care is partially reduced (they cannot do laundry, cook food, clean the room, etc.).

Atypical changes in character are observed; tearfulness, aggression, withdrawal into oneself or, conversely, hysterical attacks, a desire to gather more “spectators” around oneself may appear. 2. Intermediate. During this period, sick people lose spatial orientation, sometimes do not respond to calls to them, lose the ability to perform household services, often forget the names of loved ones and cannot remember events from the past.

It is possible that such a course of the disease will require constant monitoring of the lives of patients, since they can unknowingly cause harm to themselves and others (leave the water in the tap, gas open, go outside and get lost, etc.). 3. Late. The last stage of dementia before death occurs with immobilization of patients, urinary and fecal incontinence, loss of memory and the ability to adequately perceive reality.

In the later stages, it is necessary to completely eliminate the possibility that the patient will harm herself or others. Do not allow it near a gas or electric stove, hot water, other household appliances, forks, knives. In addition, you need to remove all ropes, needles, belts, threads that could become dangerous.

It is important to prevent the patient from taking medications on her own, to exclude the consumption of alcoholic beverages. Additionally, it is important to prevent the possibility of opening windows and balcony doors, and not to allow the patient to go for a walk on her own.

With a sluggish course of the disease, the patient can live up to 20 years, but full control and care is necessary. With rapid progression of the condition, life expectancy is reduced to 10 years. With the development of Parkinson's disease, Pick's disease, Huntington's disease, vascular dementia or frontotemporal degeneration, the patient lives from 6 to 8 years with proper care.

The prognosis is always unfavorable because the disease cannot be treated. Senile dementia is a common and dangerous disease. Symptoms and signs appear more often in women than in men. Patients need constant supervision by a doctor and relatives.

Causes

After the age of 20, the human brain begins to lose nerve cells. Therefore, minor problems with short-term memory are quite normal for older people. A person may forget where he put his car keys, or the name of the person he was introduced to at a party a month ago.

These age-related changes happen to everyone. They usually do not cause problems in everyday life. In dementia, the disorders are much more pronounced.

The most common causes of dementia:

• Alzheimer's disease (up to 65% of all cases);
• vascular damage caused by atherosclerosis, arterial hypertension, impaired circulation and properties of blood;
• alcohol abuse and drug addiction;
• Parkinson's disease;
• Pick's disease;
• traumatic brain injuries;
• endocrine diseases (thyroid problems, Cushing's syndrome);
• autoimmune diseases (multiple sclerosis, lupus erythematosus);
• infections (AIDS, chronic meningitis, encephalitis, etc.);
• diabetes;
• severe diseases of internal organs;
• a consequence of complications of hemodialysis (blood purification),
• severe renal or liver failure.

In some cases, dementia develops from multiple causes. A classic example of such a pathology is senile (senile) mixed dementia.

Risk factors include:

• age over 65 years;
• hypertension;
• elevated blood lipid levels;
• obesity of any degree;
• lack of physical activity;
• lack of intellectual activity for a long time (from 3 years);
• low estrogen levels (applies only to females), etc.

Treatment with folk remedies

Dementia is a very complex disease and must be treated using an integrated approach. Basically, only medications are used. However, at the initial stage it is possible to improve the condition using folk methods.

Blueberry juice will help restore memory - it is recommended to drink a glass of it a day.

You can reduce anxiety and relieve a depressed state by drinking 20 drops of tincture of zamanika root 3 times a day.

Insomnia is treated with a decoction of peppermint leaves. Brew a tablespoon of the plant in a glass of boiling water, cook for 10 minutes and cool. Take 100 ml twice a day.

A decoction of fennel seeds with valerian root will reduce nervous excitability. To prepare it, brew 2 tablespoons of a mixture of valerian and fennel in 2 cups of boiling water, boil for 10 minutes, leave for an hour, strain, take 200 ml twice a day.

Prognosis for people with dementia

Dementia usually has a progressive course. However, the rate (speed) of progression varies widely and depends on a number of reasons. Dementia shortens life expectancy, but survival estimates vary.

Activities that ensure safety and provide appropriate living conditions are extremely important in treatment, as is the assistance of a caregiver. Some medications may be helpful.

Reasons for the development of pathology

There are a number of factors that can influence the development of senile insanity, but the main one is hereditary predisposition. People whose grandparents suffered from dementia are at high risk of losing some or all of their ability to think properly as they age.

In the mechanism of development of the disease, the leading role, following heredity, is given to disorders in the immune system. Atrophy of areas of the cerebral cortex occurs as a result of the destruction of brain cells. This process is triggered by the synthesis of autoantibodies that affect the cells of the organ.

Any disturbances in blood circulation and nutrition of the brain lead to the death of neurons and destruction of intercellular connections, which ultimately contributes to the development of senile dementia.

Factors that play a negative role in the development of the disease:

• diseases accompanied by chronic arterial hypertension;
• oncological processes (brain tumor);
• cerebral atherosclerosis;
• severe metabolic disorders (diabetes mellitus);
• sedentary lifestyle;
• decreased intellectual activity;
• history of traumatic brain injury;
• toxic brain damage due to alcohol abuse, smoking and drug use;
• neuroinfections suffered during life (bacterial or viral meningitis, meningoencephalitis);
• depression;
• long-term exposure to unfavorable external factors on the body (living in areas of heavy pollution with toxic emissions characterized by a high content of aluminum, selenium, nitrogen oxide, silicon and other substances);
• chronic poisoning with pesticides and similar toxic chemicals (by occupation);
• living in an area of ​​powerful electromagnetic fields;
• lack of vitamin D in the body.

The development of brain disorders can be caused by medications. In this case, the process is reversible, and when the medications are discontinued, brain activity is restored.

Signs of the disease in the second and third stages

In addition to the symptoms described above, in the second and third stages of the disease, household skills gradually disappear. A sick person cannot prepare food, forgets to close the refrigerator, and leaves the house leaving the door open. The skill and desire to take care of oneself is lost: washing, changing clothes.

In case of damage to the diencephalon and midbrain, hallucinations, confusion, and loss of the sense of time may appear.
Also, signs of the last stage of dementia may include various motor disorders: inability to maintain balance, tremors of the limbs, loss of praxis (the ability to perform purposeful motor acts). Three stages of dementia and the main distinguishing features

First stage	Second stage	Third stage
Loss of professional skills	Loss of simple skills, inability to use most household appliances, neglect of personal hygiene	Loss of all skills, inability to repeat simple actions, sometimes even move and eat
Minor emotional changes (these signs of dementia are especially common in older women)	Emotional changes: apathy, depression	Complete destruction of the personal core
Forgetfulness is noted	Short-term memory suffers	Loss of memory, disorientation in space, time and even self-identity

Such serious disorders as complete loss of personality, the inability to remember one’s own name, face, orient oneself in space and time, as well as the loss of the ability to independently take food and water can be interpreted as signs of death with dementia, which will soon occur.

Important! Starting from the moderate stage of dementia, the patient may refuse to eat or, conversely, eat more than necessary. This is due to the loss of short-term memory and the inability to correctly sense hunger or satiety.

What is dementia

Now in the world there are almost 50 million people suffering from dementia syndrome. In psychology, dementia is a chronic or progressive disease in which cognitive function deteriorates to a greater extent than is acceptable for normal aging. Degradation affects memory, thinking, understanding of speech, and spatial orientation. In this case, consciousness is practically not affected, but the disturbances are accompanied by a distortion of behavior, so one gets the impression that consciousness is also degrading.

Stages of senile dementia

Senile dementia can be divided into the following stages:

• First (initial). This period is accompanied by a deterioration in mental abilities. At this stage, the patient is self-critical, but he is still able to take care of himself.
• Second. This stage is characterized by impaired intellectual abilities. The patient stops using ordinary things for their intended purpose. It is difficult for him to understand the operation of the telephone, kitchen stove, washing machine, TV, etc. The patient experiences constant depression during this period. Hygienic skills are preserved at the second stage. The patient is still able to take care of himself.
• Third. This is the final stage, which is the most dangerous and terrible for both the patient and his relatives. The person becomes insane. His close people still fail to explain that he needs to take care of himself and perform his usual actions. The patient can leave gas or water on, relieve himself anywhere, and eat without using cutlery.

The last stages are considered the most dangerous for humans. He is predominantly in a supine position. He has a metabolic disorder. Any somatic disease can cause death.

Prevention of dementia

Having established the stage of the disease, you should prepare for further events. A person with dementia receives a disability and guardianship is issued over him. The guardian is called upon to encourage the patient’s physical and cognitive activity, monitor compliance with the regime, hygiene, and doctor’s orders. The burden on loved ones is enormous; they themselves need moral support.

How to proceed? It is necessary to create a calm, supportive environment for the elderly. Even everyday details matter: soft lighting, comfortable household items, muffled sounds. Communicating with a patient is not easy - it is important to speak clearly, understandably, and, if necessary, explain again, without getting irritated. It is necessary to surround the patient with love and care. He needs control and full care. Often, to ensure this, it is advisable to seek help from a professional nurse, or find an elderly person a boarding house for a comfortable stay.