Professional Documents
Culture Documents
Outline
• What is Dementia?
• What are risk factors?
o Can you do anything about them?
• How is dementia diagnosed?
• Treatments for Dementia
o Lifestyle
o Medications
• Living with Dementia
o Safety
o Caregivers
• Future Research
What is Dementia?
Dementia
• A group of symptoms
o Memory loss
o Problems with reasoning, judgment, language
AND
• Problems with day to day functioning
(work, driving, social relationships)
o AND
• A progressive illness
DSM Criteria
1. Memory impairment
2. At least one of the following:
– Aphasia
– Apraxia
– Agnosia
– Disturbance in executive functioning
3. Disturbance in 1 and 2 interferes with daily
function
4. Does not occur exclusively during delirium
Activities of Daily Living
• Genetic
• Vascular
• Lifestyle
Family History
• Most cases of dementia are NOT genetic,
inherited or running in the family
• Some cases of dementia
run in the family where
multiple members in
several generations have
dementia
• Often dementia comes on at
younger age
• Can come on at older age and
look like usual Alzheimer’s
disease
Cardiovascular
(Heart and Blood Vessels)
• High blood pressure
• High cholesterol
• Diabetes
• Smoking
o All of these increase the
o risk of stroke
• These are risk factors for both AD and vascular
dementia
o What can do to help with this?
Exercise, healthy diet, quit smoking
Managing the above medical conditions well
Lifestyle
• Investigations
o Usually blood work is done to make sure there isn’t a medical cause for the
memory change
o Blood work to check vitamins and thyroid levels
• Imaging
o CT or MRI scans
o Not every person needs a head scan
o Scans are only done if there are signs of stroke, bleeding in the brain or other
worrisome signs
Diagnosis of Dementia
• Triad:
– Gait disturbance
– Urinary incontinence
– Cognitive dysfunction
NPH
• Non-medication treatment
• Medication treatment
Non-Medication Treatment
• Lifestyle
• Regular exercise and socializing
• Keep a regular routine
• Sleep
• Meals
• Dressing and bathing
• Toileting
• Keep enjoyment in life
• Massage and aromatherapy
• Pets
• Music
• Photo albums and happy
memories
Non-Medication Treatment
• Sleep problems
• Limit daytime naps
• Encourage physical activity in the day (not night)
• No alcohol or caffeine in the evenings
• Keep a night light in the bedroom or hall
• Keep a calm and regular night-time routine
• Hot milk and an evening snack
• Sleeping medicine
• Use if cannot sleep even with a
good routine
• Side effects like increasing
confusion
Medical treatment
• No medication can CURE dementia
• Medication may slow down the dementia
• In some people medication does not work at all
• Some people cannot take medication because of side
effects
• Medication is started when memory changes
interfere with day-to-day activities
• What medication can do:
• Make people a little more organized and able to function
day-to-day
• May not actually improve memory
Medical treatment
• Cholinesterase Inhibitors
• Approved for Alzheimer’s, Vascular, Mixed and
Parkinson’s Dementias
• Donepezil, Rivastigmine, Galantamine
• Side effects include nausea, diarrhea, slow heart
beat and dizzy spells
• Memantine is also used in more severe
Alzheimer’s
• Has side effects such as dizziness, and can worsen
aggression and confusion
Take Away Points
• Dementia is common
• Dementia is a memory
problem that interferes with
day-to-day activities
• There are many different
causes of dementia
o Alzheimer’s and Vascular
most common
• Not all memory problems
are dementia
Take Away Points
• Risk factors
o Cardiovascular
o Genetics
• Prevention
o Healthy diet and exercise
o Social activities
o Controlling medical conditions
o Prevent strokes
Take Away Points
• Treatment of dementia
involves
o Support systems for the
patient and caregivers
o Medication
• Safety and planning for the
future are important
• The Alzheimer’s Society is
wonderful resource for
families