Dementia
Definition
According to DSM-IV, dementia is characterised by multiple cognitive deficits that are severe enough to cause significant impairment in social or occupational functioning. These deficits must show evidence of decline from previous levels of functioning, include memory impairment, and at least one other cognitive disturbance (aphasia, apraxia, agnosia, or a disturbance in executive functioning). The rate of occurrence is higher in later life; the highest prevalence is above age 85. Dementia is classified as being progressive, static, or remitting. The subtypes of dementia are listed below.
Aetiology / Risk Factors
- Family history of Alzheimer's disease and other dementias
Down's syndrome
Head trauma (especially with loss of consciousness)
Other factors sometimes associated with dementia include age (onset at age 65 and above); late maternal age; history of depression; strokes, especially with a history of hypertension; alcohol or drug abuse; and history of CNS infection.
Symptoms & Signs
- Memory impairment
- Language deterioration (aphasia)
- Motor activities impairment (apraxia)
- Impaired ability to recognise objects (agnosia)
- Inability to think abstractly, i.e., to plan, initiate, sequence, monitor, and stop complex behaviour (disturbances in executive functioning)
- Spatial disorientation
- Suicidal behaviour
- Motor disturbances
- Disinhibited behaviour
- Anxiety, mood, and sleep disturbances
- Hallucinations
- Increased susceptibility to physical stressors such as illness or bereavement that worsen intellectual deficits and other problems
- Incontinence
- Tremor
- Seizures