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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How is Alzheimer's disease treated?

Firstly, attention must be paid to pharmacological treatment. In terms of pharmacological therapy, the main treatments include cholinesterase inhibitors, which can increase the amount of acetylcholine in the central nervous system and improve the patient’s cognitive level. Glutamate receptor antagonists can also be used, and they have a certain therapeutic effect on moderate to severe dementia. Secondly, patients with dementia may exhibit psychiatric symptoms in the later stages, such as hallucinations. Under a doctor's advice, appropriate amounts of antipsychotic drugs can be used for treatment. Thirdly, medications that protect brain cells and nourish nerves can be administered to the elderly. Additionally, close nursing care is necessary to prevent accidents. (Please undertake medication under the guidance of a professional physician.)

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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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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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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.

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Early signs of dementia

Dementia in the elderly, mainly refers to Alzheimer's disease. Early signs of this condition may manifest as some forgetfulness. For example, a patient might forget to add salt while cooking, or forget to bring their keys when leaving the house. These clinical signs should be highly alarming and should not be dismissed as mere forgetfulness, ignoring further examinations and treatments. It is recommended that if the elderly show signs of diminished memory function, they should promptly visit a hospital. Comprehensive assessments and further tests, including brain MRI scans, should be conducted to check for significant atrophy in brain areas such as the temporal lobes and hippocampus. If dementia is diagnosed, prompt intervention and treatment should be pursued.