Dementia

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Written by Tang Bo
Neurology
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What is dementia called?

The commonly mentioned senile dementia, also known as Alzheimer's disease, is the most common type of dementia. Its incidence generally increases in people over the age of 65 and continues to increase with age. It is a degenerative disease, with risk factors including age and gender, usually higher in women than in men. It is also related to educational level, whether there has been trauma, genetics, thyroid function, exposure to toxic substances, as well as vascular factors. Diabetes and depression are also risk factors for senile dementia.

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Written by Zhang Hui
Neurology
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precursors of senile dementia

The diagnosis of senile dementia must first meet the diagnostic criteria for dementia, primarily characterized by impairment in multiple cognitive areas such as memory, language skills, executive function, and computational ability, and these impairments affect daily life; this is called senile dementia. Before dementia occurs, there are some precursory signs, mainly slight declines in memory. For example, patients might occasionally forget to bring keys when going out, or forget to turn off the stove while cooking. These mild memory impairments are some of the precursors to senile dementia. Additionally, there is a decline in learning ability, including the symptoms of learning new knowledge and mastering new skills; these declines are also precursors to senile dementia. Therefore, the precursors of senile dementia can primarily be summarized as a slight decline in memory function and some slight decline in learning ability.

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Written by Tang Bo
Neurology
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Mild manifestations of senile dementia

Mild dementia, especially in its early stages, often goes unnoticed by family members. The initial symptoms generally include being particularly forgetful. This particularly affects short-term memory; for example, a person might repeat what was just said or be repeatedly clumsy in daily tasks, sometimes losing keys or forgetting to turn off the stove while cooking. This might seem like a lack of concentration, but in reality, it is due to forgetfulness. Emotionally, individuals who were once lively might become indifferent or detached, sometimes showing signs of excitement or agitation. Behaviorally, there can be changes, such as previously generous individuals becoming stingy. Interests and hobbies that were once loved may no longer hold appeal, and individuals may become lethargic and less concerned with cleanliness and personal appearance.

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Written by Zhang Hui
Neurology
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symptoms of dementia in the elderly

The symptoms of dementia mainly include: First, impaired memory function, where the patient’s memory loss is very noticeable. Initially, they may not remember recent events, and as the disease progresses, they may not remember past events, such as forgetting how many children they have or their children’s names. Second, it mainly involves symptoms of impairment in other cognitive areas, such as visual spatial dysfunction, manifesting as not being able to find the bathroom at home, getting lost after going out, and not being able to find the way back home. Additionally, the patient's ability to understand, calculate, and judge will also be significantly impaired, and they cannot master previously learned knowledge and skills. Third, in the late stages, some psychiatric symptoms appear, including visual and auditory hallucinations, and agitated behaviors such as hitting and cursing. Additionally, the patient may also experience some physical weakness, muscle atrophy, and incontinence.

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Written by Zhang Hui
Neurology
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What can be done about senile dementia?

Once a patient is diagnosed with dementia, it is crucial to promptly visit a hospital for treatment. The doctor will conduct some auxiliary examinations based on the patient's medical history to rule out other diseases. If the diagnosis confirms dementia, firstly, family members must pay attention to care. The living abilities of patients with dementia decline significantly, and they may experience wandering, thus enhancing caregiving to prevent any accidents in the elderly; Secondly, it is essential to encourage the patient to engage in physical activities. Exercise can slow down the progression of aging and delay the further deterioration of dementia; Thirdly, it is vital to enhance communication for the patient, encouraging them to converse more with others, as interaction can slow down the progression of dementia; Fourthly, some specific medications should be administered for treatment. These drugs mainly include acetylcholinesterase inhibitors and NMDA receptor antagonists, which current research confirms can alleviate certain symptoms of dementia.

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Written by Zhang Hui
Neurology
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Late-stage symptoms of dementia

In the later stages of dementia, symptoms become very severe. Patients experience significant impairment in memory function, forgetting not only recent events but also events from the past. Additionally, patients show obvious impairments in visuospatial abilities, having trouble locating the bathroom in their own home, and often getting lost when they go out. There is also a noticeable change in behavior, with patients exhibiting aggression, cursing, and inappropriate actions like urinating or defecating in random places. Some patients may experience recurrent visual and auditory hallucinations. As the disease progresses, elderly patients may eventually become bedridden for life, not interacting with anyone, remaining silent, and refusing to eat. They ultimately may die from complications such as lung infections, urinary tract infections, malnutrition, and bedsores. Therefore, the symptoms of dementia in its later stages are quite severe, with cognitive impairments, abnormal mental and behavioral symptoms, and various infections all posing serious threats to the health of the elderly.