precursors of senile dementia

Written by Zhang Hui
Neurology
Updated on September 05, 2024
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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 Zhang Hui
Neurology
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Can dementia be cured?

The most common disease causing dementia in the elderly is Alzheimer's disease. This disease has a very high prevalence rate both in China and globally. Currently, there is no cure for this disease, and the symptoms typically worsen progressively. However, there are measures that can be taken to possibly slow the progression of the disease, improve the cognitive functions of patients, enhance their quality of life, and reduce the burden on families. The common treatment methods for dementia are as follows. The first point involves pharmacological treatments, mainly using cholinesterase inhibitors, which can improve cognitive levels to some extent. If the patient exhibits psychiatric symptoms, some antipsychotic medications can be applied. Secondly, these patients should also engage in behavioral therapies, such as learning more, reading more, participating in more outdoor activities, and interacting more with others, which can also achieve the effect of slowing the progression of the disease. (Please use medication under the guidance of a professional physician and do not self-medicate.)

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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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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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Neurology
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Early signs of Alzheimer's disease

Patients with dementia manifest a noticeable decline in memory. Many patients or their families regard this as a normal age-related phenomenon and do not pay much attention, resulting in delayed treatment and lack of timely intervention, which may lead to severe clinical consequences. Therefore, it is very important to pay attention to dementia and its early signs. The early signs of dementia mainly include mild memory impairment. For instance, patients might occasionally forget where they have placed things, such as forgetting where a wallet was placed in the bedroom. These occurrences, while sporadic, do not significantly impact daily life. Thus, it is crucial to take these signs seriously and intervene early, including consulting a neurologist. Additionally, other early signs of dementia may include a decline in learning ability and work efficiency, which could also indicate early symptoms of the condition.

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Neurology
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Methods for Examining Dementia in the Elderly

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.