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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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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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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Late-stage symptoms of dementia

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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Neurology
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How is dementia diagnosed in the elderly?

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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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.