Dementia (frailty)

Dementia (dementia) is a persistent defect or progressive decay of the intellect. It occurs as a result of organic damage to the brain of inflammatory, traumatic, toxic and other genesis. There are residual organic dementia and progressive dementia.

Dementia of residual organic origin develops with meningoencephalitis, encephalitis of various etiologies, severe traumatic brain injury, drug and other CNS poisoning.

Progressive dementia is considered as an independent disease (senile dementia of Alzheimer’s, Heller’s dementia) or it is included in the structure of progressive hereditary degenerative and demyelinating diseases of the central nervous system (neurolipidoses, leukodystrophy, leukoencephalitis, multiple sclerosis, Huntington’s chorea, etc.), vascular lesions of the brain. In clinical practice, dementia syndrome is classified by the name of the disease form that led to these manifestations of dementia. Lacunar dementia is also distinguished, emphasizing the focality of the process in the brain and the loss of memory that occurs with all this, which cause a low level of intelligence, for example, in case of vascular, traumatic brain damage .. At the same time, an incomplete critical assessment of one’s condition by the patient is saved.

Symptoms, signs of dementia (dementia)

A characteristic feature of dementia is its development after a period of normal functioning of the brain. Common signs of dementia are more or less pronounced mosaic of mental disorders, uneven decline in individual cognitive functions with the likelihood of relative safety of one or more of them, the presence of a certain stock of information, ideas and vocabulary, indicating a period of unimpaired cognitive functions, a discrepancy between the existing stock of knowledge and low probabilities of their implementation, also between the depth of personality disorders (pronounced decrease in criticism, loss of higher emotions, sharp weakness of motives) and intellectual insufficiency.

An important sign of dementia should also be considered significant violations of the prerequisites of intelligence: memory, attention, mental activity, purposefulness of mental activity, which do not often prevail over disorders of understanding and comprehension.

In young children, the loss or weakening of previously acquired skills (motor, neatness, self-service), as well as speech disorders – from the weakening of expressive speech with impoverishment of the vocabulary to its complete loss (motor and sensorimotor aphasia) come to the fore.

Often the level of urges to activity decreases, which does not often become unfocused, aimless motor excitation prevails. Not often the differentiation of emotions is weakened, the feeling of attachment to relatives is lost, the child becomes indifferent.

In school-age children, mental performance decreases, comprehension is disturbed, and a distinct insufficiency of the generalization function is observed. With dementia, the lack of concentration of attention is sharply expressed, memory is weakened. Despite the relative clarity of the criteria for distinguishing between dementia and oligophrenia as congenital dementia, diagnostic difficulties appear in the first years of life. In young children, the processes of impaired development of cognitive functions traditionally prevail over the value of damage and decay of the prerequisites of intelligence, which, as a rule, are still insufficiently developed and rudimentary. Therefore, dementia, which arose in the first years of life due to early organic lesions, schizophrenia, epilepsy, phenylketonuria and other diseases, acquires similarities with oligophrenia.

Dementia (dementia) treatment

Treatment is carried out differentially depending on the etiology and course of the underlying process. To reduce the degree and rate of development of dementia, it is advisable to take products that improve the metabolism of brain nerve cells and cerebral blood flow. With residual organic dementia, psychological and pedagogical studies become important.

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