Late-stage symptoms of dementia

Written by Zhang Hui
Neurology
Updated on September 01, 2024
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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.

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Written by Zhang Hui
Neurology
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Is senile dementia hereditary?

Dementia primarily refers to Alzheimer's disease, which mainly has two types: The first type is sporadic Alzheimer's disease, which does not have a clear familial history. It is caused by the degeneration and death of neurons due to various reasons, leading to certain clinical symptoms. This type of sporadic dementia does not have a genetic predisposition. The other type of dementia has a clear family history, where patients typically exhibit mutations in the APP gene, leading to increased secretion, which in turn causes the death of neurons and results in the symptoms of dementia. This familial type of dementia has a genetic predisposition. Dementia is a common condition in neurology and is the most common neurodegenerative disease. Currently, there are no effective treatments available. Family members must pay attention to caregiving, and patients can take cholinesterase inhibitors, which can improve symptoms to a certain extent.

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Written by Zhang Hui
Neurology
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early signs of dementia

Dementia in the elderly, mainly referring to Alzheimer's disease, is primarily characterized by a significant decline in the patient's memory and learning abilities. Of course, there are some prodromal symptoms before the onset of dementia. For example, patients might show no clinical signs of cognitive impairment or only display very slight memory decline. Patients might exhibit mild impairment in memory, a decrease in the ability to learn and retain new information, and mild impairments in other cognitive areas such as attention, executive function, language skills, and visuospatial abilities. However, these impairments are very slight and can go unnoticed by family members. Moreover, these mild impairments do not affect the patient's basic daily life abilities and do not reach the level of dementia. Patients can live independently and manage their routine daily tasks, which are mainly some of the early signs of dementia.

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Written by Zhang Hui
Neurology
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Alzheimer's disease is also called dementia.

Alzheimer's disease, also known as dementia in the elderly, was first identified abroad and thus named after the discoverer, Alzheimer. It is one of the most common neurodegenerative diseases in neurology, with a very high incidence among people over 65 in China and worldwide. The disease mainly affects patients' cognitive functions. Initially, patients do not meet the criteria for dementia and primarily exhibit a decline in memory. As the disease progresses, the decline in memory worsens, and patients begin to forget both recent and past events. Additionally, they may experience impairments in visuospatial abilities, judgment, comprehension, and learning capabilities. In the later stages, psychiatric symptoms and personality changes may appear, such as visual hallucinations, shouting, and gesturing wildly, among various other clinical manifestations.

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Written by Zhang Hui
Neurology
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Causes of Dementia

At present, the specific causes and mechanisms of Alzheimer's disease are not very clear, but they are mainly divided into two categories. The first category is hereditary, where some Alzheimer's disease cases have a clear family history and involve some genetic mutations. These genetic mutations lead to the deposition of abnormal proteins within neurons, causing irreversible neuronal death, which is the main reason for familial Alzheimer’s disease. The second category is sporadic Alzheimer’s disease, for which no clear pathogenesis has been identified. Research suggests that factors such as oxidative stress, trauma, cerebrovascular disease, cerebral ischemia, and other factors, including metabolic conditions leading to dementia, are related to the occurrence of sporadic Alzheimer's disease. Therefore, the causes of Alzheimer’s disease include two main categories: the first is caused by genetic mutations, and the second is caused by various adverse factors leading to neuronal death.

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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.