Dementiaa Essays - Cognitive Disorders, Dementia, Free Essays

Dementiaa Essays - Cognitive Disorders, Dementia, Free Essays Dementiaa IntrodWhat is Dementia ?uction Dementia is an organic brain syndrome which results in global cognitive impairments. Dementia can occur as a result of a variety of neurological diseases. Some of the more well known dementing diseases include Alzheimers disease (AD), multi-infarct dementia (MID), and Huntingtons disease (HD). Throughout this essay the emphasis will be placed on AD (also known as dementia of the Alzheimers type, and primary degenerative dementia), because statistically it is the most significant dementing disease occurring in over 50% of demented patients (see epidemiology). The clinical picture in dementia is very similar to delirium, except for the course. Delirium is an acute transitory disorder. By contrast Dementia is a long term progressive disorder (with the exception of the reversible dementias). The course of AD can range anywhere from 1.5 to 15 years with an average of about 8.1 years (Terry , 1988). AD is usually divided into three stages mild, moderate, and severe. Throughout these stages a specific sequence of cognitive deterioration is observed (Lezak, 1993). The mild stage begins with memory, attention, speed dependent activities, and abstract reasoning dysfunction. Also mild language impairments begin to surface. In the moderate stage, language deficits such as aphasia and apraxia become prominent. Dysfluency, paraphasias, and bizzare word combinations are common midstage speech defects. In the severe stage the patient is gradually reduced to a vegetative state. Speech becomes nonfluent, repetitive, and largely non-communicative. Auditory comprehension is exceedingly limited, with many patients displaying partial or complete mutism. Late in the course of the disease many neuropsychological functions can no longer be measured. Also primitive reflexes such as grasp and suck emerge. Death usually results from a disease such as pneumonia which overwhelms the limited vegetative functions of the patient. According to the Encyclopedia of Neuroscience dementia is defined as a sustained, multidimensional loss of cognitive function secondary to organic central nervous system damage, unaccompanied by evidence of an acute superimposed state of clouded consciousness as occurs with delirium or reduced arousal. Dementia is not a disease but rather a symptom of many conditions causing brain dysfunction. It arises as a result of severe and diffuse brain damage. The essential feature of dementia is an intellectual decline resulting from a progressive deterioration in brain functioning. Dementia can occur as a result of a variety of neurological diseases. These include: Alzheimers disease (dementia of the Alzheimer type), cerebrovascular disease in particular Multi-infract dementia (vascular dementia), alcohol related diseases such as Marchiafava-Bignami disease (alcoholic dementia), AIDS (AIDS dementia complex), Creutzfeldt-Jakob disease (myoclonic dementia), Picks disease, Huntingtons disease, Parkinsons disease, normal pressure hydrocephalus (NPH), and progressive supranuclear palsy (PSP). Dementia is commonly differentiated along two dimensions: age and cortical level. The first dimension, age, distinguishes between senile and presenile dementia. Senile dementia is used to describe patients who become demented after the age of 65, whereas presenile dementia applies to patients who become demented prior to that age. Late onset AD (LOAD)Alzheimers disease also known as senile dementia Alzheimers type (SDAT) is the predominant cause of senile dementia. Early onset AD (EOAD)lzheimers disease is the most frequent cause of presenile dementia,; but HDuntingtons disease, Picks disease and Creutzfeldt-Jakob disease though not as frequent are also important causes in presenile dementia. The second dimension, cortical level, differentiates between cortical and subcortical dementia. Cortical dementia is used to describe dementia which results from brain lesions at the cortical level, whereas subcortical dementia describes dementia resulting from subcortical brain lesions. ADlzheimers disease (AD) and Picks disease are the best known examples of cortical dementia; whereas HD, Parkinsons disease (PD),ntia; while Huntingtons disease (HD), Parkinsons disease (PD), and progressive supranuclear palsy (PSP)PSP are good examples of subcortical dementia (Mayke, 1994). Dementia with both cortical and subcortical features is also possible, in that case the term mixed dementia is used. Multi-infract dementiaID is a common example of mixed dementia. Historical developments in dementia Pre-Modern Developments The use of the term dementia dates back to Roman times. The Latin word dementia, derived from the Latin demens , did not originally have the specific connotation that it does today. It meant being out of ones mind and, as such, was a general term for insanity or insanitymadness (Pitt, 1987). It was the encylopedist Celsus who first used the word