dementia'

docx

School

The Community College of Vermont College of Vermont *

*We aren’t endorsed by this school

Course

123

Subject

Anatomy

Date

Dec 6, 2023

Type

docx

Pages

Uploaded by Mariahc6718

Jessica Sartor Human Anatomy Jessica Sartor Human Anatomy I Dementia: The Umbrella of Cognitive Disorders Jessica Sartor

Alzheimer’s disease (AD) is known as a progressive neurodegenerative disorder and is the most common source of dementia universally (Haque & Levey, 2019). Dementia is known as a clinical syndrome that is characterized by impairments in several cognitive domains which in turn, prevents patients from being able to live a life that is fully functional and independent (Haque & Levey, 2019). AD is the sixth leading cause of death and is the most common cause of dementia in nearly 60-80% of all cases, this is shown in nearly 30 million people worldwide (Haque & Levey, 2019). When it comes to risk factors of AD age is the most important of them, ages 65-85 increases the prevalence in percent from 3-32. Statistics show that in 2019 there was an estimated total of 5.6 million Americans over the age of 65 suffering with Alzheimer’s, and due to the increases of population and lifespan by the year 2050 the number would be tripled to 13.8 million. Caring for a family member that has this disease is not easy, or cheap, over time it will include multiple hospital stays, behavioral changes, and at some point, most likely they will need a long-term facility. Most individuals qualify for Medicare, and those expenses as of 2019 have spent an estimated $195 billion and is estimated to triple by the year 2050 (Haque & Levey, 2019). AD and dementia have many aspects that come with it, including medical care, and the issues it comes with when it comes to an individual’s mental health and physical health. Over time these issues will only be intensified because there is such a lack in therapies and adequate direction of treatment, let alone any type of cure. Being characterized as a clinical syndrome that is a progressive cognitive decline which interferes with a person’s ability to independently function, that is what dementia is known as (Duong, Patel & Chang, 2017). The symptoms of dementia are a progressive persistent and gradual decline, and will change a person cognitively, their function and behaviors. No one person is the same when they present with dementia some of these presentations can be memory

loss, communication deficits, language impairments, inability to recognize objects (agnosia), inability to perform learned tasks (apraxia), loss of reasoning, judgment, or planning. Injuries to the cerebral cortex can present in cognitive impairments that are caused by synaptic failures, inflammation or change in cerebral metabolism (Duong, Patel & Chang, 2017). When patients are showing signs of deficits, but they are not severe enough to “qualify” as dementia they are known as MCI, or mild cognitive impairment, this is also an objective cognitive impairment that has preserved function. Patients with MCI will show signs the same as dementia, but they are more the signs of aging that what comes with dementia, because they are not affecting the patient’s independence or activities of daily life. Just like AD patients that have MCI are at a higher risk to end up with dementia (or one of the other dementias) than someone that does not end up being diagnosed with MCI (Duong, Patel & Chang, 2017). There are several symptoms of dementia behavioral and psychological to watch for including lack of interest or boredom, agitation, psychosis, delusions, and hallucinations these symptoms can cause a person high amount of anxiety and can cause safety concerns for not only the patient but the people caring for them as well. Behaviors such as wandering, or any inappropriate behaviors have not shown any response to medications, so the only way to help a patient as of now with these behaviors as of now is redirection (Duong, Patel & Chang, 2017). Dementia behaviors and psychological symptoms are considered complications as of now, and sadly a lot of times family members have a very hard time seeing their family member acting in such a manner because it is so different than they may have ever acted before the disease progressed. Patients with dementia can also have highly inappropriate behaviors whether they be sexually or eating inappropriate objects, dementia is something that can be very difficult to watch deteriorate over time. Dementia is considered and “umbrella” term, there are 4 other common dementia’s that are classified by their

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

cause, these dementias are, AD, vascular dementia, Lewy body dementia and front temporal dementia (Duong, Patel & Chang, 2017). AD is the most common neurodegenerative disease responsible for dementia, characteristically the first sign of AD is short-term memory loss, if there end up being any signs at all. Over time steady deficits in cognitive performances will occur to multiple cognitive domains. When looking to assess and treat AD, there are two classifications, cognitive that present throughout the disease and noncognitive end up less predictable throughout (Duong, Patel & Chang, 2017). Cognitively AD affects memory loss, apraxia, aphasia, agnosia, and includes impaired perception of time or unable to recognize people close to them. AD can also show noncognitive signs, for example hallucinations and delusions, depression, physical and verbal aggressiveness, wandering, combativeness and many others (Duong, Patel & Chang, 2017). Early onset symptoms can be shown through memory issues, or such things as getting lost in familiar areas (i.e., neighborhood). As the disease progresses many families will see their family members change in personality and their behaviors become more aggressive especially when they are confused. Understanding how AD affects our body physically is sometimes not talked about enough, and it is quite clear as the disease progresses, and the body deteriorates. During the early stages not, much will change physically with AD, and many people are still able to keep up the same physical activity they have always done. While we start moving into the next stage of AD, or the middle stage, the decline of physical ability will begin to become noticeable. Feeding yourself or using your muscles to walk correctly will begin to become more difficult because the patient’s brain will forget how to do such actions (Heerema, 2021). Our body and muscles also start to lose control of holding our bladder or bowels, so interpreting any of the body signals we are receiving begins to decline. Where I work, we always use the phrase “use it

or you will lose it” because if we have a resident that stop trying to walk or used their muscles, they will start to deteriorate, and the resident will quite literally lose their abilities to do the task at hand. Late stages of Alzheimer’s are the hardest to watch develop, the physical ability that someone once had has severely deteriorated. In many cases in this stage of AD patients will now need to be fed their meals, and even this will be a risk because they might be at risk for aspiration (choking or swallowing difficulties). Walking or any type of range of motion is either extremely limited, if possible, anymore, in some cases a person’s body begins to contract and their muscles tighten so it is impossible to straighten their arm or leg out (Heerema, 2021). When this becomes where a person is in life, many families are talked to about either comfort care or hospice, this ensures that their family member can be comfortable for the remainder of their life. Vascular dementia (VaD) is known as the second most widespread disease after AD, at 20% worldwide (Duong, Patel & Chang, 2017). VaD is a result of neuronal deprivation of oxygen that has been caused by a condition either blocking or reducing the blood flow to the brain, VaD is also call multi-infarct dementia. The most common cause of VaD is stroke, and the symptoms are widely varied, they all depend on what regions of the brain are affected and how severe the damage is to the blood vessel (Duong, Patel & Chang, 2017). When a person has a stroke, they may have symptoms that include difficulty with speech and comprehension of, confusion, vision loss, disorientation. Sometimes memory has not been affected with vascular dementia, whereas like with most stroke symptoms it is thinking and reasoning that is affected. When there is a presence of both Alzheimer’s and vascular dementia, they call it mixed dementia (Duong, Patel & Chang, 2017). In some cases, with VaD many of the symptoms are just like AD and dementia, but in some cases due to the blockage of blood to the brain, some people might see that in later stages they may have epileptic episodes (Krivec, 2021). In the middle stages of VaD

some physical symptoms that can be seen are things like loss of bowel and bladder control, and body tremors. When people are starting to move into the middle stages their muscles will also begin to become weaker, so walking starts to become harder, so fully picking up their feet becomes harder, and instead of full steps, they make take small quick steps (Krivec, 2021). Other signs in the middle stages of VaD that will be noticeable as well are things like lack of sleep, impulsive, repetitive, or obsessive behaviors and their activities day to day become harder and harder to maintain independently. At the final stages of VaD symptoms are the most severe and stressful on the body every symptom that related to AD becomes more severe (memory loss, confusion, communication). People will become clumsy, violent, and demanding of people around them. Many will have a large amount of weight loss because at this stage most will begin to have difficulty swallowing and eating, communication skills may have decreased or completely severed. At the end-of-life stage of VaD some patients may end up having heart attack, or a massive stroke that can potentially take their lives (Kriovec, 2021). Lewy body dementia (LBD) is the type of dementia that is caused by having abnormal deposits of alpha-synuclein protein or Lewy bodies inside neurons. LBD is shown to account for 5-15% of the dementia that we know about. LBD has distinct characteristics of fluctuations in cognitive impairments that have variations in their attention and alertness. LBD differs from AD in the fact that patients with LBD will have episodes of exhaustion, or periods of time where they stare into space (Duong, Patel & Chang, 2017). In the early stages of LBD, the patient is usually accompanied with REM sleep disorder, and will attempt to act out their dreams during sleep, or have delusions and hallucinations (Hereema, 2022). As Lewy body progresses the symptoms will start to bear a resemblance to that of Parkinson’s disease. Some of the symptoms that bear resemblance include, delusions, paranoia, swallowing issues, falls, increased issues with motor

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

functions, cognitive decline, and speech difficulties. Once a patient reaches the late stages of LBD the muscle in the body will become rigid and sensitive to touch. Speech is almost nonexistent or to the point of whispers, the activities of their daily lives will need full assistance. Many people with LBD end up susceptible to pneumonia among other infections due to the weakness of their bodies, there is no way to know how long someone can withstand through this it could be two months up to one year (Hereema, 2022). It is difficult with Lewy body dementia because the symptoms are so like the other forms of dementia that sometimes it is misdiagnosed (Hereema, 2022). Frontotemporal dementia (FTD) is a broad phrase used to label disorders, such as Pick’s disease, that affect the frontal and temporal lobes of the brain. Where AD tends to occur in the ages of 65 and older, FTD shows more in younger ages of 40-75. Early in the disease there are changes in behavior and personality that are key in FTD (Duong, Patel & Chang, 2017). FTD, or Pick’s ended up being named in 1892 after Arnold Pick first identified the abnormal tau protein collections in the brain Pick’s bodies). FTD ends up breaking down into four of it’d own categories of disorders as well: *Primary Progressive Aphasia: This FTD has a primary component of aphasia, or impairment of language that affects communication and understanding (Hereema, 2021). * Corticobasal Degeneration: The symptoms of this usually appear with muscle weakness and tremors on one side of the body. With progression of this disorder there will be issues with memory and behaviors (Hereema, 2021). * Behavioral Variant Frontotemporal Dementia: This will significantly affect behavior and cause behaviors and emotions that are considered socially inappropriate (Hereema, 2021)

* Progressive Supranuclear Palsy: This disorder affects balance and movement, as well as affecting cognitive abilities. Eye movement is an apparent symptom of this disorder (Hareema, 2021) When people have been diagnosed with FTD and start showing symptoms some of these will be behavioral changes, these will include socially inappropriate behavior like sexual comments. Other symptoms of behavior changes are low energy, poor hygiene, or their faces show no expressions of emotion (Hereema, 2021). Patients with FTD will find issues in the ability to use words expressing themselves and understanding speech, or expressive and receptive speech. Physically patients will find that the ability to control their movements will be affected and it is found that people with FTD will fall more frequently or have more shakiness in their legs and arms (Hereema, 2021). FTD differs from AD because especially in early stages the memory stays intact, and where AD affects the temporal lobe in early stages and through progression will affect most of the rest of the brain, FTD mainly will affect frontal and temporal lobes. Dementia, although an umbrella term, is something that affects many individuals every day worldwide. While doing research there were many things found about how dementia affects the brain, but not enough about how it affects our body physically. Through this paper I wanted to be able to prove that over time dementia does end up deteriorating our body physically as well as the brain. Although research is still happening every day there is still no cure for dementia, and in many aspects there still isn’t pharmaceutical help for it either. With having so many branches of dementia, I hope someday that there will be a way to figure out a way to at least slow the progression of such a heart wrenching disease. Dementia and AD are very hard to decipher between just regular aging, and then the smaller branches of dementia can be even

harder to decipher because they show some of the same symptoms as AD or dementia. Family and friends can be a huge support system through the progression of the disease but over time and towards the middle to late stages it can get to a point where it is overwhelming, and a long- term care facility may be needed.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

References: Duong, S., Patel, T., & Chang, F. (2017). Dementia: What pharmacists need to know. Canadian pharmacists journal: CPJ = Revue des pharmaciens du Canada: RPC , 150 (2), 118–129. https://doi.org/10.1177/1715163517690745 Haque, R.U., Levey, A.I., (2019. December, 23,), Alzheimer’s disease: A clinical perspective and future nonhuman primate research opportunities Proceedings of the National Academy of The Sciences of the United States of America, Internet Page: https://www.pnas.org/doi/10.1073/pnas.1912954116 Heerema, E., Reviewed by: Metrus, N.R., (2021 September 26,), How Alzheimer’s Affects Physical Ability and Functioning, In: Very Well Health; Dotdash Meredith Internet Page: https://www.verywellhealth.com/does-alzheimers-disease-affect-physical-functioning-98581 Krivec, R. (2021, February 8,), Vascular Dementia Stages and Progression, In: ReaDementia by WordPress, Internet Page: https://readementia.com/vascular-dementia-stages/ Hereema, E., Reviewed by: Sheikh, H., (2022, September 28,), Stages of Lewy Body Dementia What to expect as the condition progresses, In: Very Well Health; DotDash Meredith Internet Page: https://www.verywellhealth.com/lewy-body-dementia-stages-progression-98735

Hereema, E., Reviewed By: Apetauerova, D., (2021, August 31,), Frontotemporal Dementia Overview: Pick’s Disease, In: Very Well Health; DotDash Meredith Internet Page: https://www.verywellhealth.com/what-is-frontotemporal-dementia-98747

dementia'

Related Documents