How is dementia diagnosed in the elderly?

Written by Zhang Hui
Neurology
Updated on September 27, 2024
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Alzheimer's disease is a degenerative disease of the nervous system. The diagnosis of this disease mainly relies on the clinical manifestations of the patient, as well as some corresponding scales and some corresponding imaging examinations. In terms of examinations, it is necessary to check some neurofunctional scales, mainly cognitive function scales, common scales include some MMSE scales, and some MoCA scales. These scales are very important for diagnosing this disease. In addition, some imaging examinations need to be improved, mainly including cranial magnetic resonance imaging examinations. Cranial MRI can reveal atrophy in the patient's temporal lobe, hippocampus, and other areas, which also have an important reference value for the diagnosis of the disease. Moreover, an electroencephalogram can be performed to see some mild abnormalities, and lumbar puncture tests can also reveal some abnormally increased protein deposits.

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Written by Zhang Hui
Neurology
1min 9sec home-news-image

What is the greatest fear in Alzheimer's disease?

Dementia in the elderly is a common neurodegenerative disease worldwide. It is a clinical syndrome caused by the irreversible death of brain neurons due to various factors. Initially, the main symptom in patients is impaired memory function, which at this stage does not significantly affect work and life, and is not overly concerning. As the disease progresses, the cognitive functions of the elderly, including visuospatial skills, calculation abilities, and executive functions, are notably impaired. Changes in personality and behavior also occur. What is most feared in dementia? It is particularly concerning when elderly individuals go out on their own and then cannot find their way home, leading to situations where they may become lost. If the elderly are unable to find adequate food outdoors, or if the weather is too cold or too hot, their life safety can be severely threatened. Additionally, dementia patients might inadvertently turn on the gas at home and forget to turn it off, which can easily lead to accidents. These are the most feared incidents related to dementia in the elderly.

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Written by Zhang Hui
Neurology
1min 9sec home-news-image

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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How is Alzheimer's disease treated?

Senile dementia, also known as Alzheimer's disease, is the most common neurodegenerative disease worldwide. The pathogenesis of this disease is not particularly clear so far and may be related to genetic and environmental factors. Multiple factors act on neurons causing irreversible and progressive death of neuronal cells. Currently, the treatment of this disease mainly includes two aspects. The first aspect is general treatment, mainly including family care. Family members must pay attention to the care of the patient, prevent the patient from accidentally wandering off, prevent the patient from falling, and prevent some accidents that cause injuries. In addition, it is important for the patient to listen to music, interact with others, and exercise more, all of which can delay the progression of senile dementia. The second aspect is pharmacological treatment, mainly using drugs that inhibit the reduction of acetylcholine. These drugs can increase the content of acetylcholine and improve the cognitive functions of patients to a certain extent, but so far, these treatments cannot reverse senile dementia.

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Written by Guan Yu Hua
Orthopedic Surgery
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Is spinal bifida prone to dementia?

Spina bifida is a common congenital malformation caused by incomplete closure of the vertebral canal during embryonic development. If the spina bifida is occult, it does not affect anything and does not cause dementia. If it is overt spina bifida, it can be diagnosed through physical examination, and confirmed with radiographic examination, CT, or MRI. Typically, the patient has a swelling along the midline of the back, which grows as they age. The cystic tension increases when the child cries, and may be accompanied by varying degrees of flaccid paralysis of the lower limbs and incontinence. Occult spina bifida generally has no symptoms and does not require intervention. However, overt spina bifida is best treated surgically, or if the occult spina bifida is accompanied by spinal cord tethering, then surgical treatment is recommended as it would be for all cases of overt spina bifida. In cases where the cyst wall is very thin and ruptured, emergency surgery is necessary and can be curative. For other cases, surgery within one to three months is optimal to prevent aggravation of the condition due to cyst rupture. Generally, adult patients with stable conditions in recent years may not need surgery.

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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.