Dementia:

Chronic brain syndrome characterized by generalized impairment of intellect, memory, thinking, personality, orientation, calculation, learning capacity, language and judgment without clouding of consciousness.

Type:

Senile dementia-after 65 year of age

Pre senile dementia- before 65 years of age

Primary dementia- intrinsic degenerative disease of the CNS

Secondary dementia- where secondary causes are present

Etiology:

a)    Degenerative causes: Alzheimer’s disease (70%)

                                       Pick’s disease

                                        Huntington’s chorea

                                         Creutzfeld- Jacob disease

                                          Normal pressure hydrocephalus

                                         Parkinson’s disease

                                           Multiple sclerosis

b)ICSOL-----> tumour, subdural hematoma, infections ie. encephalitis,  

                         neurosyphilis, cerebral sarcoidosis

c)Endocrine--->Hypothyroidism, cushing syndrome

d ) Epilepsy

e) Repeated head injury in Boxers, Alcohol, poisoning with  heavy                     metals

f) Metabolic----> sustained uraemia, liver failure, renal dialysis.

g) Vascular ---> multi-infarct dementia, cranial arteritis, occlusion of carotid artery.

h) Nutritional ----> sustained lack of  vit-B12, folic acid, vit-B1  

Clinical features:

Behaviour---> Inappropriate, distractable, restless, anti-social activity, sexual disinhibition, rigid, stereotyped  routine, neglect social convention, lack of personal care, may be  disoriented, sudden explosion of  anger.

Thinking---> slow, judgement is  impaired, false persecutory ideas

Speech---> dysphasia, irrelevant, mute.

Mood----> anxious , irritability, depression

Memory---> loss of recent  memory

Attention & concentration---->impaired

Insight---> lost

Management---> Plans for long-term care include doctors, nurses and social workers.

Amensticdisorder: