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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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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Alzheimer's disease is also called dementia.

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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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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Determination of Senile Dementia

The assessment of dementia primarily encompasses three aspects: The first aspect mainly involves relevant neurological scales, which can scientifically and effectively measure the cognitive functions of elderly patients. These scales include the MSE (Mini-Mental State Examination) and the MoCA (Montreal Cognitive Assessment). The second aspect of the assessment involves some imaging tests, mainly cranial MRI scans. Cranial MRI can determine if there is brain atrophy in the elderly and examine for any related lesions in the temporal lobes and hippocampi. The third major aspect involves the analysis of cerebrospinal fluid, assessing the levels of amyloid proteins, which also play an important role in the assessment of dementia. In summary, the assessment of dementia primarily involves evaluations using neurological scales, cranial MRI, and cerebrospinal fluid analysis.

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What is dementia called?

The commonly mentioned senile dementia, also known as Alzheimer's disease, is the most common type of dementia. Its incidence generally increases in people over the age of 65 and continues to increase with age. It is a degenerative disease, with risk factors including age and gender, usually higher in women than in men. It is also related to educational level, whether there has been trauma, genetics, thyroid function, exposure to toxic substances, as well as vascular factors. Diabetes and depression are also risk factors for senile dementia.