परिभाषा

Dementia is a general loss of mental abilities. It can include a loss of ability to think, reason, learn, and understand. To be considered dementia, these mental losses must be severe enough to interfere with day-to-day activities. Dementia must also have:

  • Memory problems
  • Mental loss that is severe enough to cause problems with one or more of the following:
    • Language
    • Visuospatial function
    • Executive function (foresight, planning, anticipation, insight)
    • Praxis (learned motor skills)

पागलपन

का कारण बनता है

Causes of dementia include:

  • Alzheimer’s disease—the most common cause of dementia
  • Brain damage after multiple small strokes (also called vascular dementia)
  • Lewy body disease
  • शराब
  • एड्स
  • मल्टीपल स्क्लेरोसिस
  • Huntington’s disease
  • पार्किंसंस रोग
  • Creutzfeldt-Jakob disease and other prion disorders
  • Front-temporal dementia (including Pick’s disease)
  • Normal pressure hydrocephalus
  • Untreated syphilis
  • Toxic levels of metals, such as aluminum (can sometimes occur in dialysispatients)
  • Vitamin B12 deficiency
  • Thiamine deficiency
  • Thyroid dysfunction

जोखिम कारक

Risk factors for dementia include:

  • बढ़ती उम्र
  • Family members with dementia
  • Down syndrome
  • Apolipoprotein E status (a genetic risk)
  • Elevated cholesterol
  • Multiple strokes
  • उच्च रक्तचाप
  • मधुमेह
  • उच्च कोलेस्ट्रॉल
  • मोटापा
  • शारीरिक गतिविधि का अभाव
  • Vitamin deficiency
  • Chronic drug use
  • Long-term use of hormone replacement therapy
  • Repetitive head trauma (may occur with contact sports)
  • Overweight or obese

लक्षण

Symptoms often begin mildly. They often get more severe over time. Symptoms vary according to the cause of the dementia, but often include:

  • चीज़ों को याद रखने में परेशानी बढ़ना, जैसे:
    • परिचित स्थानों तक कैसे पहुंचें
    • परिवार और दोस्तों के नाम क्या हैं?
    • जहाँ आम तौर पर सामान्य वस्तुएँ रखी जाती हैं
    • सरल गणित कैसे करें
    • सामान्य कार्य कैसे करें, जैसे खाना बनाना, कपड़े पहनना, नहाना आदि।
    • How to drive
    • How to pay bills
  • कार्यों पर ध्यान केंद्रित करने में कठिनाई होना
  • Having difficulty completing sentences due to lost/forgotten words (may continue to a complete inability to speak)
  • Forgetting the date, time of day, season
  • परिचित परिवेश में खो जाना
  • मूड स्विंग होना
  • अलग-थलग रहना, सामान्य गतिविधियों में रुचि खोना
  • व्यक्तित्व में बदलाव आना
  • धीरे-धीरे, घिसटते हुए चलना
  • ख़राब समन्वय होना
  • उद्देश्यपूर्ण आंदोलन खोना

निदान

Your doctor may diagnose dementia through:

  • An extensive medical history from you and your family
  • Observing your behavior
  • एक शारीरिक परीक्षा
  • Tests for your nervous system
  • Mental status and psychological tests

There are no blood tests or exams that can diagnose Alzheimer’s disease. Certain types of brain imaging such as a SPECT or a PET scan may aid in a diagnosis. Tests to rule out other causes of dementia and other medical conditions that may mimic dementia include:

  • Blood tests—to look for syphilis, vitamin B12, folate, thiamine (B1) thyroid, liver, and kidney function
  • CT scan—a type of x-ray that uses a computer to make pictures of structures inside the head
  • एमआरआई स्कैन- एक परीक्षण जो सिर के अंदर संरचनाओं की तस्वीरें बनाने के लिए चुंबकीय तरंगों का उपयोग करता है
  • PET or SPECT scans—tests that use dyes to measure the activity levels of various areas of the brain (used in some cases)
  • Lumbar puncture—a test of the fluid around the brain and spine to look for infection or bleeding, prion diseases, and potential markers of Alzheimer’s disease and other disorders
  • Electroencephalogram (EEG)—a test that records the brain’s activity by measuring electrical signals from the brain

The doctor will also check to see if you have depression. It can often present like dementia.

उपचार

Currently, there are no treatments to cure many types of dementia. Some medication may help to decrease the symptoms of dementia or slow its course.

दवाएं

Two types of medicines that may be used to reduce the symptoms of Alzheimer’s disease include:

  • Cholinesterase inhibitors—approved and recommended for mild to moderate Alzheimer’s disease (such as donepezil [Aricept], rivastigmine [Exelon], galantamine [Reminyl])
  • N-methyl-D-aspartate (NMDA) receptor antagonist—approved for moderate to severe Alzheimer’s disease (such as memantine)

जिन उपचारों का अध्ययन किया जा रहा है उनमें शामिल हैं:

  • गामा-स्रावी अवरोधक
  • ताऊ फाइबर एकत्रीकरण अवरोधक
  • Herbs and supplements (such as vitamin E, ginkgo biloba, huperzine A)—The evidence is mixed as to the effectiveness of these natural remedies.

जीवन शैली प्रबंधन

This type of support is critical for people with dementia. Behavioral and environmental support includes:

  • Keeping you safe in your home
  • एक शांत, शांत, पूर्वानुमानित वातावरण प्रदान करना
  • Providing appropriate eyewear and hearing aids, easy-to-read clocks, and calendars
  • Participating in music therapy and/or dance therapy
  • Participating in physical and occupational therapy for daily activities
  • Encouraging light exercise to reduce agitation and relieve depression
  • Eating a healthy diet (such as Mediterranean diet)
  • Discussing healthcare wishes with family members and doctors and appointing a healthcare proxy and a legal power of attorney

Psychiatric Medications

People with dementia often develop psychiatric symptoms. You may need appropriate treatment, such as:

  • एंटीडिप्रेसन्ट
  • Anxiolytics—to treat anxiety
  • Antipsychotics—to treat severe confusion, paranoia, and/or hallucinations
    • Must be used with caution. Generally not recommended in people with dementia.
    • These medications may cause an increased risk for stroke or death in elderly patients with dementia.
  • Mood stabilizers—to treat dangerous or disruptive behaviors

देखभालकर्ता का समर्थन

Caring for a person with dementia is very difficult. Those providing care will needsupport. The Alzheimer’s Association is an excellent resource for families and caregivers.

रोकथाम

While the exact cause of dementia is not known, these steps may help to reduce your risk:

  • Eat a healthy diet. This will help you to maintain good levels of vitamin B12 and cholesterol.
  • Exercise regularly. This can also enhance cardiovascular health, which may delay the onset of vascular dementia.
  • Alcohol may have some benefits if you use it in moderation. This means no more than two drinks per day for a man, and one drink per day for a woman. Moderate amounts of alcohol may decrease your risk of dementia. But higher amounts of alcohol can increase your risk of dementia.
  • Avoid drug abuse and practice safe लिंग. This can reduce the risk of AIDS-related dementia.
  • Engage in mentally stimulating activity. This may also reduce the risk ofAlzheimer’s disease.

कीवर्ड:

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