HEALTHCARE

Healthcare for older people with Vascular Dementia or Depression Mini Mental

Healthcare for older people with Vascular Dementia or Depression Mini Mental

Dementia is an organic brain syndrome which results in global cognitive impairments. Dementia can occur as a result of a variety of neurological diseases. Some of the more well known dementing diseases include Alzheimer's disease (AD), multi-infarct dementia (MID), and Huntington's disease (HD). Throughout this essay the emphasis will be placed on AD (also known as dementia of the Alzheimer's type, and primary degenerative dementia), because statistically it is the most significant dementing disease occurring in over 50% of demented patients.

Healthcare for older people

The overwhelming factor emerging from genetic studies of the dementias and other central nervous system neurodegenerative conditions is abnormalities of protein handling. This age cutoff is defining, as similar sets of symptoms due to organic brain syndrome or dysfunction, are given different names in populations younger than adult. Up to the end of the nineteenth century, dementia was a much broader clinical concept. Well into the second half of the twentieth century, dementia of the elderly was called senile dementia or senility and viewed as a normal aspect of growing old rather than as being caused by any specific diseases, while Alzheimer's disease was seen as a rare disease of middle age, until the neurologist Robert Katzmann signaled a link between "senile dementia" and Alzheimer's(Raina et al., 2008, 397).

Dementia is a non-specific illness syndrome (set of signs and symptoms) in which affected areas of cognition may be memory, attention, language, and problem solving. It is normally required to be present for at least 6 months to be diagnosed;[4] cognitive dysfunction that has been seen only over shorter times, in particular less than weeks, must be termed delirium. In all types of general cognitive dysfunction, higher mental functions are affected first in the process.

The Mini-Mental State Examination (MMSE) is widely used to screen for cognitive impairment in clinical practice and dementia studies. The Mattis Dementia Rating Scale (MDRS) is also commonly employed and has often been used as an alternative to the MMSE by neuropsychologists in clinical settings. Both measures are sensitive to the effects of age and education. Consequently, age- and education-adjusted scores have been developed for these measures in order to improve their utility in the identification of cognitive impairment.

The clinical picture in dementia is very similar to delirium, except for the course. Delirium is an acute transitory disorder. By contrast Dementia is a long term progressive disorder (with the exception of the reversible dementias). The course of AD can range anywhere from 1.5 to 15 years with an average of about 8.1 years. AD is usually divided into three stages mild, moderate, and severe. Throughout these stages a specific sequence of cognitive deterioration is observed. The mild stage begins with memory, attention, speed dependent activities, and abstract reasoning dysfunction. Dementia is commonly differentiated along two dimensions: age and cortical level. The first dimension, age, distinguishes between senile and presenile ...