The development
of multiple cognitive deficits such as manifested by both, Impaired
memory, long or short-term, can't learn new information or can't
recall information previously learned and is distinguished
by:
one (or more) of the following cognitive disturbances:
Aphasia
(language disturbance).
Apraxia (impaired ability to carry out motor activities despite
intact motor function).
Agnosia (failure to recognize or identify objects despite
intact sensory function).
Disturbance in executive functioning (i.e., planning, organizing,
sequencing, abstracting)
The cognitive
deficits above each cause significant impairment in social or
occupational functioning and represent a significant decline
from a previous level of functioning.
The decline in mental functioning begins gradually and worsens
steadily.
The cognitive deficits above are not due to any of the following:
Other
central nervous system conditions that cause progressive deficits
in memory and cognition (e.g., cerebrovascular disease,
Parkinson's disease, Huntington's disease, subdural hematoma,
normal-pressure hydrocephalus,
brain tumor).
Systemic conditions that are known to cause dementia
(e.g., hypothyroidism, vitamin B-12 or folic acid deficiency,
niacin deficiency, hypercalcemia, neurosyphilis, HIV infection).
Substance-induced conditions.
They aren't better explained by another Axis I disorder such
as a Depressive
Disorder or Schizophrenia.
Associated
Features:
Learning
Problem
Dysarthria or Involuntary Movement
Hypoactivity
Psychosis
Depressed
Mood
Somatic
or Sexual Dysfunction
Hyperactivity
Addiction
Sexually
Deviant Behavior
Odd
or Eccentric or Suspicious Personality
Anxious or Fearful or Dependent
Personality
Dramatic or Erratic or Antisocial
Personality
Differential
Diagnosis:
Some disorders have similar or even overlapping symptoms. The
clinician, therefore, in his diagnostic attempt has to differentiate
against the following disorders which need to be ruled out to
establish a precise diagnosis.
Normal
Process of Ageing;
Delirium;
Schizophrenia;
Major Depressive Episode;
Factitious Disorder
with Psychological Symptoms.
Cause:
Alzheimer's
Disease is defined by the National Institute on Ageing as progressive,
irreversible declines in memory, performance of routine tasks,
time and space orientation, language and communication skills,
abstract thinking, and the ability to learn and carry out mathematical
calculations. Other symptoms include personality changes and
impaired judgment. Although a direct cause of Alzheimer's is
not known certain common factors are found in the clinical picture
of suffers. These include; prior personality organisation of
the individual and stressfulness of their life situation.
Treatment:
Although
there is no cure for Alzheimer's, and various psychotherapies
appear to be ineffective, there are ways to treat some of the
symptoms of the disease:
Use of
medications to treat cognitive decline and memory loss.
Appropriate activities such as exercise, recreation, and adult
day care services appear to assist in the management of the
patient.
Caregiving
[ See
Caregiving Issues Section ] :
At times,
a person may display behavior problems such as wandering, paranoia,
suspiciousness, combativeness or resistance to maintaining personal
hygiene. These behavioral problems can seem overwhelming to
the caregiver. Suggest strategies to assist in daily care giving
tasks can consist of:
Enrolment
in the Alzheimer's Association's Safe Return Program, an identification
program for memory impaired adults.
Modifying
the person's environment in order to reduce confusion caused
by over stimulation such as reducing noise and bright lights.
Explaining
a task before you do it by such as saying, "I am going
to help you put on your shirt."
Providing
a predictable routine at home with structured time for meals,
bathing, exercise, and bedtime.
Providing
reassurance to the confused patient without challenging their
accusations or misperceptions and by redirecting their attention
If it
appears that the above situational strategies are not successful
a combination of situational activities combine with drug therapy
to manage symptoms of depression, restlessness, hallucinations,
hostility and agitation may be required
Pharmacotherapy
[ See
Psychopharmacology Section ] :
Cognex
(tacrine hydrochloride)
Aricept
(donepexil hydrochloride)
