Methods for Examining Dementia in the Elderly

Written by Tang Li Li
Neurology
Updated on September 29, 2024
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The examination of dementia mainly includes the following aspects.

First, it is to determine whether the patient has cognitive impairment, because in the early stages of dementia this impairment is often mild, primarily in recent memory, with other aspects not yet obvious. Early screening can use some cognitive evaluation scales, such as the Mini-Mental State Examination or the Montreal Cognitive Assessment, chosen according to the patient's cultural level.

Second, imaging examination, commonly using brain MRI, can reveal significant signs of dementia such as deepened brain sulci, narrowed gyri, and widened lateral fissures, indicating brain atrophy.

Third, genetic testing for the APOE gene, which may be related to dementia. Possession of this gene may increase the likelihood of developing dementia in the future, serving as an auxiliary diagnostic measure.

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Written by Zhang Hui
Neurology
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Is senile dementia hereditary?

The disease referred to as dementia mainly refers to Alzheimer's disease. Only a very small number of cases are hereditary, where patients have a certain family history caused by genetic mutations, thus having some hereditary traits. However, the vast majority of Alzheimer's cases are sporadic, unrelated to genetic mutations, and these sporadic cases are not hereditary, so there is no need to worry about transmitting it to offspring. Nevertheless, it is important to note that, with the progression of population aging, the incidence of this disease remains relatively high, especially for those over the age of 65, who need to pay close attention to this disease. If a patient exhibits a decline in memory function, do not assume it is just forgetfulness; it is crucial to visit a hospital for diagnosis and timely treatment.

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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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incidence of senile dementia

Dementia in the elderly has a very noticeable high incidence trend worldwide and in China, with many people over the age of 65 suffering from this disease. Statistics show that in Western countries, the incidence of dementia in the elderly might be around 3%-8%. In China, the incidence among the elderly over 65 may also be around 5%. Therefore, the number of elderly people suffering from this disease is very large, and thus it is essential to pay attention to this disease. This disease is mainly caused by the death of nerve cells due to many reasons. Currently, there is no effective cure for this disease, but there are some drugs that can alleviate the symptoms. These drugs mainly include cholinesterase inhibitors, which can increase the content of acetylcholine in the brain, improving the level of cognitive function in patients. Additionally, symptomatic treatment should be noted to prevent lung infections, malnutrition, and other complications in the elderly.

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Written by Zhang Hui
Neurology
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Symptoms of dementia in the elderly

Dementia in the elderly is medically known as Alzheimer's disease, which is categorized into mild, moderate, and severe stages. The clinical manifestations vary with the severity of the disease. Mild dementia primarily presents as memory impairment, starting with a decline in short-term memory, where patients often forget daily activities. For instance, they might forget the way home when they go out, forget to add salt when cooking, or forget to turn off the stove. Patients may also exhibit personality disorders, such as neglecting personal hygiene or not wanting to bathe. As the disease progresses to moderate dementia, besides worsening memory impairment, the patient's ability to work, learn new knowledge, and communicate with others significantly diminishes. There is a notable decline in previously acquired knowledge and skills, such as judgment and calculation abilities. They may also experience aphasia, apraxia, agnosia, and some patients may exhibit significant behavioral and psychological abnormalities. With further progression to severe dementia, patients may become emotionally detached, exhibit unpredictable crying or laughing, fail to recognize family members, lose verbal abilities, and even become unable to perform simple tasks such as dressing or eating. They may spend their days in bed, not speaking, and gradually lose contact with the outside world, ultimately leading to death.

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Written by Zhang Hui
Neurology
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Causes of Alzheimer's Disease in the Elderly

The causes of dementia in the elderly are not currently completely clear. Dementia in the elderly is mainly divided into familial and sporadic types. Familial dementia shows autosomal dominant inheritance, which is caused by a gene mutation on chromosome 21 leading to the accumulation of some toxins, resulting in the death of neurons and causing dementia fundamentally due to genetic mutations. However, most cases of dementia are sporadic and do not have a clear family history. The mechanisms and reasons for disease onset are not particularly clear. Some believe that abnormalities in cerebral vascular function may lead to neuronal cell functional disorders, resulting in decreased ability to clear certain cell toxins, thus leading to neuronal apoptosis and death, and consequently impaired cognitive functions. In addition, factors such as oxidative stress, inflammatory mechanisms, excessive fatigue, and emergency stress may also cause cell death. Overall, the causes of dementia in the elderly are not particularly clear.