Pathologies Dementia Can Result - Research Paper Example

? Dementia Dementia is a condition that affects the nervous system of the individual. It is mainly labeled to be a disease of the old people but it may occur in the younger age groups as well. Dementia mainly presents with loss of memory and the condition deteriorates with time. The functioning of the cerebral hemisphere is affected in this condition and thus the day to day performance of the individual greatly suffers as a result of dementia. Dementia can result owing to many underlying pathologies which include Alzheimer's disease, Huntington’s disease and Creutzfeldt-Jacob disease. There is no definitive cure for this disease but early diagnosis can make a difference. Dementia Dementia is a degenerative neurological disorder. Previously dementia was considered to be a normal part of aging but researches and studies have proved that it is a pathological condition that results from varying illnesses or disorders present in the body. As a number of disorders or factors can be responsible for causing dementia, it is better known as a syndrome rather than a disease. It can also present as a clinical sign or symptom of an underlying disorder. Dementia is sudden or spontaneous in onset and progresses with time and age. The risk of onset of dementia is most likely at the age of 60 and it is seldom seen before this age. The risk of onset increases with the advancement in age. Dementia seriously affects the emotional behavior and social attitude of the victims of this disorder and sometimes it can also be associated with life threatening consequences. It is a pathological condition of the brain which causes impairment of normal mental activity and deterioration of cerebral functions with difficulties in carrying out the routine chores due to regression of certain areas of brain that maintain and regulate the normal functions of life. The individual suffering from dementia faces memory loss and the magnitude of loss is directly related to the severity of the disease. The disease affects the patient's personality and alters the emotional and social behavior. (Cox, 2007; Jacques & Jackson, 2000) Dementia involves gradual deteriorating changes in the brain of an individual which results in the decline of cerebral functions with time. The patient undergoes these changes for quite a long time before presenting with some solid differences in his or her personality. The patient can present with complaints which include deterioration of memory, decreased rate of performance at any type of work, compromised skills, mismanagement of personal or business affairs, uncertain and unreliable attitude, the decline in social activities, varying moods and delirium. The dementia is divided into two types depending on the time of its onset. These two types are pre-senile and senile dementia. The two groups differ as the pre-senile dementia is seen in mostly young patients while senile is in much older individuals. Both the disease processes however, follow the same course of development with very little differences in the signs and symptoms shown by the patients suffering from pre-senile or senile dementia (Boon & Davidson, 2006; Jacques & Jackson, 2000). The causes of dementia vary according to the type. Dementia may either be resulting from vascular pathologies which include disease of the small blood vessels, numerous emboli in the vessels or inflammation of the vessels in the brain. Degenerative or the inherited type of dementia results due to pathologies which include Alzheimer’s disease, Huntington’s disease, Wilson's disease, cortical Lewy body disease and mitochondrial encephalopathies. Dementia may also be associated with cancerous conditions. The tumors may spread from distant sites and lead to dementia or there may be tumors originating with the brain itself for example the primary cerebral tumor. Sarcoidosis and Multiple Sclerosis lead to inflammation and thus they are classified as inflammatory causes of dementia. Trauma can also be an underlying cause of dementia and it may be due to chronic subdural hematoma or following an injury to the head. Hydrocephalus as well as certain dietary modifications which include alcohol consumption, reduced thiamine and B12 is also an underlying cause of dementia. Infectious agents can also affect the brain and hence result in dementia. Examples include syphilis, HIV as well as Whipple's disease (Boon & Davidson 2006; Jacques & Jackson 2000) Four neuropsychological profiles have been proposed by Weintraub and Mesulam (1993) for patients suffering from dementia to analyze the part of the brain affected due to this condition. The classification is based on the symptoms which are seen in the early stages of the disease in the patient. This criterion indicates the part of brain that has been affected in the beginning of the disease course. It can help to obtain information by correlating the initial signs and symptoms shown by the patient with the corresponding parts of the brain and thus the clinician can reach to a conclusion with regard to the originating site of dementia. The first clinical profile to be recognized is amnestic dementia which is mostly seen around the age of 65 years. The patient with this clinical profile presents with the most common problem of impaired memory which concludes that the part of brain involved in forming temporary memory for a short time that is hippocampus is affected. The aphasic dementia is the second clinical profile which is also known as primary progressive aphasia. In this type, the patient presents with communicating problems. The patient is unable to produce his thoughts well by oral or verbal means. The area that has been affected in this type of dementia is associated with language and communication skills which is the speaking and writing center of the brain. The third clinical profile is known as executive/comportmental dementia. The other name for this type of dementia is behavioral variant. This type is symbolized by problems with the behavior, conduct and personality of the patient. The fronto-temporal region seems to be affected in this type of dementia which gradually spreads to involve various other parts of brain. The fourth clinical profile shows progressive visuo-spatial dysfunction. The alternative name for this profile is posterior cortical atrophy. In this type of dementia the patient presents with the problems of perception of visual records when he or she is not suffering from any ocular pathology. Such medical problems are commonly appreciated above the age of 65 years, where an individual experience the silent wounds of memory loss, disorientation of language and poor visual records. The classification helps a lot in understanding the symptoms that have appeared and those which are yet to appear due to the spreading of the effects from the primary site. It makes it easy for the physician to explain the changes that are appearing in the attitude and mood of the patient. The consultant can also be appraised with the assistance of these profiles with regard to the future problems that the patient may suffer from. (Cox, 2007) Dementia may be associated with many underlying pathologies. Creutzfeldt-Jakob disease is one such pathological condition which can lead to dementia. This disease has been named after two physicians who proposed this cause of dementia. They were Hans Gerhard Creutzfeldt and Alfons Maria Jakob. Creutzfeldt-Jakob disease is a very rare condition and very few cases of this disease have yet known to occur but it progresses very rapidly. The disease process involves a definite etiological agent which is a virus named as prion. This virus was earlier discovered in the cow and the disease was known as 'mad cow disease'. The virus invades the brain tissue and causes severe damage to the cerebral system of the individual by infecting the brain. This condition is rare but life threatening and often results in death of the patient. The patient undergoes different problems which keep on increasing in severity. Initially, there is great memory loss and mental disability followed by jerks and fits due to uncontrolled muscular activity. This is followed by serious brain infection which can cause problems of respiration, coma and finally death of the patient. Death, in this condition mostly occurs in the first year of disease. The disease is mostly seen in patients above the age of 60 years but it can also affect the young individuals in their third or fourth decade of life. An effective treatment for the resolution and cure of this condition had not been established. (Edwards, 1993; Tasman & Mohr, 2011) Huntington's disease is another important disease that results in dementia. The disease is hereditary in nature and is inherited in an autosomal dominant pattern. Men and women are equally affected. The disease affects a large population. The disease process involves general atrophy of cerebral mass or wearing out of brain nerve cells with specific degeneration of basal ganglia that eventually leads to dementia along with other accompanying symptoms. The assessment of severity of the disease can be done using Unified Huntington's Disease Rating Scale which quantifies the disease on the basis of four characteristics. These characteristics are cognition, motor function, behavior and functional abilities of the patient. The very early signs of the disease are extreme tiredness or exhaustion and decline in the abilities to concentrate. In this condition, the neurons are continuously degenerating that makes the condition worse with time and the prognosis also remains poor. The defects in the perception of visual data are present. The fluency of letter pronunciation and phonetics are highly affected. The errors in naming are related to the defects in the visual perception. Decreased speech output is also related to motor dysfunction seen in Huntington’s disease. The motor lesion produces involuntary and undesirable gestures and movements which correspond to the disturbed dopamine levels in the brain. In these patients with altered levels of dopamine, the Huntington’s disease is known with an alternative name which is Huntington’s chorea. Sudden jerky joint movements are also present. Lastly, the atrophy of brain leads to depression and psychiatric problems with unstable personality and eventually leads to the death of the patient. Treatment can provide benefits in the early stages where the expired neurotransmitters are replaced to provide for sufficient levels of the neurotransmitters in the brain. Transplantation therapies are under experiment but still there has been no major breakthrough in this field. (Larner, 2008; Wilbourn & Prosser, 2003) The Alzheimer's disease is a degenerative disease of the central nervous system and it is marked to be the most common cause of dementia. It accounts for 55-65% of all causes of dementia. Alois Alzheimer, a German neurologist, was the first one to describe this cerebral disorder. This is another degenerative disorder characterized by atrophy of brain due to obliteration of nerve cells and shrinkage of neurons causing dementia. The affected areas of the central nervous system are hippocampus, locus ceruleus and nucleus basalis of mynert. The disease is characterized by the marked deterioration of mental powers, disorientation in general behavior and confused mental status and severe memory loss. The memory loss is explained by symptoms of the patient which include repeatedly asking of the same questions, misplacing of things and missing events and occurrences. The etiology of the disease is not specifically known but the presence of certain unwanted proteins that accumulate to form amyloid plaques, neurofibrillary tangles and Hirano's bodies in the brain tissue are suspected to be an underlying reason. Neurochemical studies have shown decreased acetylcholine levels in the brain of Alzheimer’s patients. This condition has a sudden onset and it occurs most commonly in the late 60s. The patient suffers from remarkable memory loss, speech difficulties and inability to carry out daily tasks. The remote memory remains intact and problems originate with retaining short term memory. Care has to be taken of such patients as they cannot carry out their daily chores and sometimes there is complete dependence before death. Personal hygiene of the patient is also disturbed and occasionally there is withdrawal from social responsibilities. Severe social malfunctions are seen which render the patient incompetent to perform under different circumstances. The patients with Alzheimer’s disease can live as long as 20 years or more after the onset of the condition. Drugs can be given to treat to the disease to some extent no definitive cure is seen. However, it has been seen that if the drug therapy is initiated at the right time it can prevent the progression of disease. Improved memory has been seen with the employment of drugs. (Edwards, 1993; Nagelhout & Plaus, 2005) Dementia is a pathological condition which affects the normal functioning of the patients. It results in memory loss owing to the inactivity of the specific areas of the brain. The patient faces problems in carrying out his daily activities and emotional, social as well as psychological impairment is seen. Dementia can be led to by many causes include, infections, trauma, cancers and degenerative conditions of the brain. The condition may also run in the family. Huntington’s disease, Creutzfeldt-Jakob and Alzheimer’s disease are important causes of this condition. No definitive treatment for these conditions is found. References Boon, N. A., & Davidson, S. (2006). Davidson's principles & practice of medicine. Edinburgh: Elsevier/Churchill Livingstone. Cox, C. B. (2007). Dementia and social work practice: Research and interventions. New York: Springer Pub. Edwards, A. J. (1993). Dementia. New York: Plenum Press. Jacques, A., & Jackson, G. A. (2000). Understanding dementia. Edinburgh: Churchill Livingstone. Larner, A. J. (2008). Neuropsychological neurology: The neurocognitive impairments of neurological disorders. Cambridge, UK: Cambridge University Press. Nagelhout, J. J., & Plaus, K. L. (2005). Handbook of nurse anesthesia. St. Louis, MO: Elsevier Saunders. Tasman, A., & Mohr, W. K. (2011). Fundamentals of psychiatry. Chichester, West Sussex, UK: John Wiley & Sons. Wilbourn, M., & Prosser, S. (2003). The pathology and pharmacology of mental illness. Cheltenham: Nelson Thornes. Read More