progression of Alzheimer's disease in the elderly

Written by Zhang Hui
Neurology
Updated on March 16, 2025
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The progression of dementia in the elderly mainly includes the following aspects. The first is the pre-stage of mild cognitive impairment, during which patients show no clinical symptoms. Some may only report slight memory impairment, with a possible slight decline in learning ability and a mild decrease in the capability to learn new things. As the disease progresses to the second stage, the period of mild cognitive impairment occurs, where patients will experience impaired memory, but it is not particularly obvious, and daily life is not affected at all. Then, entering the third stage, some periods of dementia occur, during which patients' memory, executive abilities, computational skills, and judgment are significantly impaired. Patients might even get lost or possibly forget their own names. As the disease further progresses into the later stages of dementia, the elderly may exhibit some psychiatric symptoms. They become delirious, talk to themselves, and may see things that do not exist. Eventually, the elderly may end up bedridden, with complications such as pulmonary infections and bedsores.

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Written by Zhang Hui
Neurology
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probability of senile dementia

Dementia primarily refers to Alzheimer's disease, which has a relatively high incidence rate. In China, among the elderly population over 65 years old, approximately 3% to 7% are affected; this rate can rise to over 20% among those over 85 years old. Suffering from dementia places a heavy burden on the patient, their family, and society. Initially, patients with dementia will experience a decline in memory function. As the condition progresses, there will be a decline in various cognitive functions. For example, spatial dysfunction might occur, such as getting lost on the way home, personality changes, and the emergence of psychiatric symptoms and 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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Is senile dementia hereditary?

Dementia primarily refers to Alzheimer's disease, which mainly has two types: The first type is sporadic Alzheimer's disease, which does not have a clear familial history. It is caused by the degeneration and death of neurons due to various reasons, leading to certain clinical symptoms. This type of sporadic dementia does not have a genetic predisposition. The other type of dementia has a clear family history, where patients typically exhibit mutations in the APP gene, leading to increased secretion, which in turn causes the death of neurons and results in the symptoms of dementia. This familial type of dementia has a genetic predisposition. Dementia is a common condition in neurology and is the most common neurodegenerative disease. Currently, there are no effective treatments available. Family members must pay attention to caregiving, and patients can take cholinesterase inhibitors, which can improve symptoms to a certain extent.

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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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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.