yogabook / pathologie / dementia

Dementia

Definition of

Acquired chronic (at least 6 months) psychiatric syndrome with deficits in cognitive, social and emotional areas and resulting limited social and occupational competence in degenerative and non-degenerative brain diseases. Very few forms of dementia are reversible, but a delay is often possible. The most common form of dementia is Alzheimer’s dementia. In addition to mnestic disorders, another disorder is required to make a diagnosis:

1. Aphasia (speech disorder)
2. Apraxia (impaired motor skills)
3. Agnosia (impaired recognition/identification of objects)
4. Dysexecutive syndrome: disturbance of executive functions (planning, organizing, sequencing)

ICD F00-F03

Cause

1. Alzheimer’s disease (60% of dementias)
2. Lewy body dementia (20% of dementias)
3. vascular (arteriosclerotic as multi-infarct dementia (MID, presumably 100 g is the critical brain volume) or, more rarely, subcortical arteriosclerotic encephalopathy (SAE))
4. Chroea Huntington
5. Creutzfeldt-Jakob disease (rarer)
6. Korsakov syndrome due to alcohol abuse (rarer)
7. Accompanying atypical Parkinson’s disease (usually only bradyphrenia, i.e. pseudodementia)
8. Space-occupying processes in the brain such as tumors or hematomas
9. Acquired hydrocephalus (pathological dilation of the cerebrospinal fluid space), possibly reversible if the cause is removed
10. Pick’s disease
11. AIDS
12. Syphilis stage 4 (neurolues)
13. Panarteritis nodosa
14. SLE
15. Vit-B12 deficiency
16. Epilepsy
17. Hypercalcemia
18. Hypothyroidism (underactive thyroid)
19. MS
20. Intoxications
21. Wilson’s disease (copper storage disease)

Symptoms

1. disturbed mnestic
2. impaired thinking
3. impaired speech
4. impaired speech
5. impaired motor skills
6. Changes in the personality structure
7. disturbed orientation
8. Impaired decision-making ability
9. Change/reduction in motivation
10. altered affect
11. No clouding of consciousness
12. No restrictions on sensory perception
13. The earliest and often most severe limitation is that of memory, usually beginning with short-term memory („where did I put the key?“)
14. In the course of the progression, short-term mnestic disorders also lead to the loss of many of the knowledge and skills acquired in the course of life; memories of childhood and youth are often retained for a relatively long time

Therapy

1. the benefits of many medications available to date are controversial, as are the benefits of memory training
2. for vascular dementia antidementia drugs: acetylcholinesterase inhibitors and memantine