Alzheimer's disease is also called dementia.

Written by Zhang Hui
Neurology
Updated on September 22, 2024
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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 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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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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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 Zhang Hui
Neurology
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What to do about senile dementia?

When dementia occurs in the elderly, there is a noticeable decline in cognitive function. Initially, it is important to identify the cause of the dementia; some cerebrovascular diseases can also cause dementia. For example, cerebral infarction in certain specific areas of the brain can lead to dementia if it affects the intelligence center. For dementia caused by these reasons, it is recommended to treat with antithrombotic medications, including antiplatelet aggregation drugs and brain cell protective medications. Additionally, if the dementia is caused by Alzheimer's disease, close care is needed to prevent incidents like the patient getting lost. It is advisable to write contact numbers in the pockets of their clothes and administer acetylcholinesterase inhibitors to increase the levels of acetylcholine in the brain, which can improve cognitive function to a certain extent. (Note: This answer is for reference only. Medication should be prescribed and managed under the guidance of a professional physician, and self-medication should be avoided.)

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Written by Zhang Hui
Neurology
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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.