DEMENTIA everything u need to know

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<ul><li> 1. WELCOME </li></ul> <p> 2. DEMENTIA PRESENTED BY DR. AHMED TANJIMUL ISLAM GHORAR DIM, SOMCH 3. DSM IV Criteria for Dementia Memory Impairment plus APHASIA (Deterioration of Language function) APRAXIA (inability to Execute Motor function) AGNOSIA (inability to Recognise or Naming of Object) Disturbance in executive functioning with Impairment in occupational or social functioning 4. 70% of dementia is Alzheimers 10-15% is Vascular dementia 10-15% Lewy Body dementias 5-10% Others Overall Situation: Alzheimers disease 70 % Vacular Dementia 15-20% Lewy Body Dementia 10-15 % Others 5 % 5. Classification : Types : Dementia Classification: Primary (degenerative) dementia Secondary dementia DementiaTypes: Cortical dementia Subcortical dementia 6. Psudodementia A group of disease due to functional disease rather than organic dementia Depression Hysterical Dementia Psychogenic amnesia 7. Causes of Dementia Primary Degenerative Dementia: Alzheimers Disease Frontotemporal dementia Dementia with Lewy Body 8. Secondary Dementia: VITAMIN Deficiency ENDOCRINE Chronic Infections Thiamine B1 Hypothyroidism Neurosyphilis B3 Adrenal deficiency HIV B12 Cushing Syndrome Prions Hypoparathyroidism 9. TOXIC HeadTrauma: Neoplastic DIALYSIS DEMENTIA Chronic Subdural Heatoma Primary Brain Tumor Drug Poisoning Post Encephalatis Secondary Brain Tumor Heavy Poisoing Normal Pressure Hydrocephalitis Paraeoplastic 10. CORTICAL SUBCORTICAL MIXED Alzheimers Parkinsons Vascular Dementia Frontotemporal Dementia Huntingtons disease Lewy body dementia CJD Normal pressure hydrocaphalus Neurosyphilis 11. SUBCORTICAL CORTICAL Memory impairment moderate Severe Mathemetical skills Preserved Impaired Mood depressed Normal Motor speed Slowed Normal Movements abnormal Common Rare mutism Absent Present 12. ( REVERSIBLE DEMENTIA IRREVERSIBLE DEMENTIA D= Drugs, Delirium Alzhemer E= Endocrine disorders Lewy Body dementia M= Metabolic Frontotemporal Dementia (Picks disease) E= Emotional Parkinsons disease N= Nutritional Huntingtons disease T =Toxic,Tumor,Trauma Cruze feltd jakob disease A= Alcohol 13. IS IT DEPRESSION OR DEMENTIA?? VS 14. Depression Dementia: Little effort on tasks Struggles to complete tasks Dont know answers Attempts answers, but incorrect Absence of Dyspraxia, Have Dyspraxias, Agnosias, No language problem Language problem 15. IS IT DELIRIUM or DEMENTIA ?? 16. Is it Dementia?? Is it Depression or Dementia Is it Delirium or Dementia Is it Alzheimers?? IsThere any Reversable Cause?? If not Alzheimers What is it?? 17. ALZHEIMERS DISEASE : 18. video 19. Alzeimers Disease Loss of cholinergic neurons Senile plaques &amp; neurofibrillary tangels Glutamate transmission dysfunctiion 30% symptoms 70% Symptoms 20. Alzheimers Staging: 21. Alzheimers Pathology (Gross) : Every part of cerebral cortex is involved with relative sparing of occipital pole Marked Atrophy. Widened Sulci Shrinkage of Gyri Ventricular Dilatation 22. AD: a progressive CNS disorder) Brain Atrophy **Senile Plaque **Neurofibrillary Tangles Pathology (HALLMARK) 23. Pathology of AD (Microscopic) 24. Pathology of AD (Microscopic) 25. Pathology of AD (Microscopic) 26. video2 27. Cholinergic deficit progressive loss of cholinergic neurones progressive decrease in available ACh impairment in ADL, behaviour and cognition Hippocampus Cortex N. basalis Meynert Pathophysiology of AD (Biochemical) 28. ALZHEIMERS VASCULAR Onset Incidious Sudden Risk factors Family history CVD risks Mental status Recent Memory Psychomotor slowing Neuro exam No Focal neuro deficit Behavioral Delusion, Poor insight Apathy, Depression MRI Diffuse / Temporal atrophy Stroke 29. ALZHEIMERS VASCULAR LBD FTD Short term Memory Loss Personality change Parkinsonism Prominent Behavior change Dysphasia Dyspraxia Labile Mood Fluctuating Alertness Expressive Dysphasia Wandering Preserved Insight Visual Hallucination Early loss of insight 30. DEMENTIA: Common diagnostic strategies: Clinical : History (from patient, family) Bedside Examination (e.g. MMSE) Physical Examination Neuropsychological Assessment. Imaging. Lab Screening for other causes. 31. History : Nature of the problem Memory? Behavioral Emotional Who perceives the problem? Patient? Family? Tempo of the illness Gradual Fast Stepwise Family history Other medical problems Neurological (e.g. movement disorder) Systemic (e.g. thyroid disease, vascular disease) 32. Examination of Higher Functions BEDSIDETESTS : MMSE CLOCK DRAWING ADAS cog (Alzeimerd disease assesment scale cognitive) Detailed Psychometry 33. COGNITIVE FUNCTION BEHAVIOUR &amp; PSYCHOLOGICAL FEATURES ACTIVITY OF DAILY LIVING DEPRESSION MMSE Neuropsychiatric inventory Bristol Scale Cornel Scale Clock Drawing Test Behave AD AD functional Assesment scale Geriatric Depression Scale Seven Minute Screen Cohen Mansfield Aggression Inventory Disability Assesment Dementia MentalTest Score 34. Mini Mental State Examiation : Staging of Disease by MMSE Normal 27-30 Mild 25-26 Mild- Moderate 10-24 Moderate- Severe 6-9 Very Severe</p>

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