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.

Other Voices

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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.

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Written by Zhang Hui
Neurology
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Determination of Senile Dementia

The assessment of dementia primarily encompasses three aspects: The first aspect mainly involves relevant neurological scales, which can scientifically and effectively measure the cognitive functions of elderly patients. These scales include the MSE (Mini-Mental State Examination) and the MoCA (Montreal Cognitive Assessment). The second aspect of the assessment involves some imaging tests, mainly cranial MRI scans. Cranial MRI can determine if there is brain atrophy in the elderly and examine for any related lesions in the temporal lobes and hippocampi. The third major aspect involves the analysis of cerebrospinal fluid, assessing the levels of amyloid proteins, which also play an important role in the assessment of dementia. In summary, the assessment of dementia primarily involves evaluations using neurological scales, cranial MRI, and cerebrospinal fluid analysis.

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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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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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Late-stage symptoms of senile dementia

Elderly dementia generally refers to Alzheimer's disease. This disease begins slowly and progressively worsens, with symptoms becoming increasingly severe. In the later stages of dementia, symptoms are numerous, mainly reflected in the following aspects: First, patients may exhibit significant personality changes. For example, a person who was originally gentle may become irritable and prone to aggressive behaviors such as hitting or yelling at others, and may even experience incontinence. Second, a patient's overall cognitive functions completely collapse, with a comprehensive decline in memory, as well as significant impairments in computational abilities, judgment, and comprehension. There are also problems with time orientation, with patients unable to distinguish between day and night. Additionally, patients may experience severe malnutrition, develop bedsores, and suffer from serious complications such as pulmonary infections and urinary tract infections.