With age, the human brain loses a certain number of cells, but such a loss is physiological and permissible. However, when the number of lost neurons exceeds a certain limit, and the brain decreases in size, a condition occurs that can be called cerebral atrophy.
The brain gradually decreases in size with every decade of life, however, until the age of 60, the rate of such loss is very slow and almost invisible. In the year from the initial volume is lost from 0,5 to 1% of brain tissue.
At the age of 75, the brain is on average 15% smaller than at the age of 25.
The areas of the brain responsible for short-term memory are usually more susceptible to degenerative processes, in addition, in men, the loss of neurons occurs more actively than in women, which means that degenerative processes occur more intensively.
To detect anomalies, the following diagnostic manipulations are used:
- CT scan;
- PET (positron emission tomography);
- SPECT (single-photon emission computed tomography).
Cerebral atrophy can only be one of many signs indicating a serious illness: a brain tumor, neurodegenerative processes, early Parkinson’s disease, or other disorders.
Loss of brain neurons is a highly undesirable process, as it inevitably entails behavioral and cognitive impairment. When the brain tends to lose neurons, patients are required to undergo diagnostics once every six months – to monitor processes and to control or prevent symptoms caused by this condition.
Senile brain degeneration is a condition that is synonymous with senile dementia. Senile dementia is a disease caused by degeneration of brain cells. This disease is different from the usual insanity that develops in the elderly. In the case of senile degeneration, the patient’s brain function activity gradually decreases, which leads to progressive memory loss and inhibition of mental abilities, as well as noticeable personality changes.
Talking with the patient and conducting an examination, the doctor reveals signs of senile dementia in him.
Diagnosis of senile dementia is difficult only at the initial stage of the disease, especially in the case of its debut at an early age. Under such conditions, differential diagnosis with somatic diseases with similar symptoms is required. At the stage of developed clinical manifestations, the diagnosis of senile dementia is not difficult and, if necessary, can be confirmed by CT.
Unfortunately, senile dementia is an incurable disease, but proper care and adequate supportive care can slow the progression of atrophy processes and significantly improve the quality of life of the patient and his relatives.
First of all, I want to say that it is desirable to carry out treatment in the usual conditions for the patient, that is, at home, and not in a hospital. Changing these conditions for sick leave is fraught for the patient with stress, new emotional experiences, and therefore his condition can deteriorate sharply, and the disease will progress.
The active lifestyle of the patient is extremely important. A person should not lie day and night, but, on the contrary, should be engaged in the usual household chores, as far as his condition allows: to clean the house, cook, walk on the street.
If there is no possibility of permanent home care, or if dementia is very severe, the patient is placed in a hospital or in a special boarding school.
His nutrition should be regular, rational and balanced. Bed of a bed patient – equipped with a special table. The duration of sleep is 7-8 hours a day or more, if desired. Before going to bed – a walk in the fresh air or just along the corridor.
Since the coordination of movements and visual acuity of a patient with senile dementia are reduced, the risk of domestic injuries increases. Therefore, it is necessary to remove excess furniture from his room, put the protection on the corners or mechanically round them. The floor must be dry and not slippery. Handrails are required in the bathroom. Slippers are on the patient’s feet, but not slippers.
Of the medicines at the initial stage of the disease, nootropics can be prescribed. These drugs increase the adaptation of the nervous system to mental and physical stress, improve mental activity, stimulate memory, and reduce the oxygen demand of brain tissue.
In sleep disorders, small doses of tranquilizers are indicated.
In the case of severe depressive moods, antidepressants are prescribed (also in small doses).
An important role is played by psychotherapy, when a specialist helps the patient restore or re-form certain behavioral reactions.
All of the above symptoms, although they are characteristic of brain death, are not enough to make such a diagnosis, since they are sometimes noted with a deep coma. In order to unambiguously diagnose the total death of brain neurons, there are several diagnostic criteria that can be divided into hardware and clinical (provocative).
There are several provocative tests and criteria to identify a condition such as brain death:
- Test with atropine. Intravenously, 1 ml of a 1% solution of atropine sulfate is administered. If the heart rate does not increase, or, on the contrary, slows down, this confirms the fact of brain death.
- Sample with bemegrid. Intravenously 1 ml of a 0,5% solution of bemegrid is administered. With an outrageous coma, an increase in the frequency of respiratory movements will not be noted, which is also a confirming factor.
- Cold (vestibular) test. 5-10 ml of ice-cold water is injected into the external auditory meatus using a syringe. In the presence of brain death, this does not lead to the appearance of nystagmus, and also does not cause absolutely any changes in the facial expressions of the patient.
- There is another variant of a provocative cold test. Pouring 60-100 ml of ice water into the patient’s left or right ear using a large syringe, they rinse the external auditory canal with it. Turning the eyeballs in the direction of washing eliminates the state of brain death.
The medical report on the intravital death of the brain in most countries is drawn up with the participation of a resuscitator, neurologist, forensic expert, and a representative of the management of the medical institution. In some countries where developed institutions of advocacy are functioning, the presence of a patient’s lawyer is also mandatory.
Intravital death of the brain should be differentiated primarily from severe coma. The condition of deep coma, although accompanied by hypoxia of organs and tissues, however, due to compensatory mechanisms, in the absence of complete respiratory arrest, proceeds for a long time without brain death. Diagnostic criteria by which it can be distinguished from brain death have been given above.
It is also necessary to distinguish brain death from a chronic vegetative state in which the cerebral cortex and some zones associated with it die completely or partially, but the diencephalic region and stem structures continue to function.
Due to this, in the chronic vegetative state, the phenomenon of the loss of mental functions is observed while the autonomic ones are preserved: the patient cyclically wakes up and falls asleep, breathing and the cardiovascular system continue to function, but there are no cognitive capabilities, understanding, speech, and perception through the senses. If a vegetative state is inherently a decortication, then brain death is a complete decerebration.
- Diagnostic criteria
- Causes of cerebral atrophy and senile brain degeneration
- Characteristic symptomatic criteria
- The mechanism of development of senile dementia
- Causes of Senile Dementia
- Moral, legal and other aspects
- Types and stages of violation
- Causes and clinic of dystrophic processes
- Establishing diagnosis
- What can modern medicine offer?
- Features of care
The symptomatology characteristic of the state of the respiratory brain is in many ways similar to the clinical picture of a very deep coma, differing from it in its complete irreversibility.
As a consequence of this, this condition is sometimes called the “beyond coma”. There is a complete loss of central nervous system functions (consciousness, speech, reaction to external stimuli) while maintaining cardiac activity. Blood pressure is maintained or maintained medically.
Respiratory function is ensured by mechanical ventilation. Complete loss of skeletal muscle tone, total areflexia, hypothermia, urinary and fecal incontinence are characteristic. A very typical symptom is puppet eyes: when the head is turned in any direction (up, down, to the sides), the eyes involuntarily move in the opposite direction.
First of all, it is necessary to refute the common misconception that a person who is supposedly in a state of brain death is a “vegetable” and can only breathe.
This means that when you turn off devices that support vital functions, a person dies. In our country, the following series of signs has been adopted that can characterize the death of neurons:
- the presence of a coma, or the complete absence of any consciousness (verbal contact, eye movement, a conscious ability to communicate without words);
- lack of response to pain, in the event that the afferent and efferent part of the reflex arc passes through the structures of the brain (trigeminal points, pharyngeal and corneal reflex arc);
- the presence of a diffuse decrease in the tone of all striated, skeletal muscles;
- the absence of spontaneous movements of the eyeballs, as well as the expansion of the pupils without the use of midriatics, for example, atropine.
This symptom is reliable, and indicates the death of the pupil sphincter, or its complete relaxation. Paralysis of the arc of the pupillary reflex indicates irreversible mesencephalic changes, which is typical for vegetative status.
In addition to corneal and pain trigeminal reflexes, a number of others are evaluated, for example, oculovestibular and oculocephalic. With the death of nerve tissue, they are all absent.
It is important to remind once again that in the presence of a diagnosis of “brain death” there is no independent spontaneous breathing. In addition, according to the American method of diagnosing this condition, breathing should not resume after disconnecting the patient from the ventilator.
Causes of cerebral atrophy and senile brain degeneration
- craniocerebral trauma;
- Alzheimer’s disease;
- Peak’s disease;
- frontotemporal dementia;
- cerebral palsy with impaired coordination;
- Huntington’s disease (Huntington);
- hereditary diseases that are associated with genetic mutations;
- Crabbe disease and other disorders in which the myelin sheath that protects axons is destroyed;
- mitochondrial encephalomyopathies, for example, Kearns-Sayre syndrome;
- multiple sclerosis, causing inflammation and damage to the myelin sheath, as well as damage to brain tissue;
- infectious diseases such as encephalitis, neurosyphilis;
Senile dementia is always caused by the underlying disease. Brain tissue is damaged, which means that the functional capacity of the body decreases. The most common cause of dementia is Alzheimer’s disease, a neurodegenerative disorder that causes impairment of cognitive functions, in particular, memory and thinking.
The main causes of senile degeneration are as follows:
- Alzheimer’s disease;
- vascular dementia, the second most common cause of dementia, which accounts for approximately 20% of all dementia;
- Huntington’s disease, a progressive degenerative disease;
- atherosclerosis or hardening of the arteries;
- multiple sclerosis;
- various types of immunodeficiencies;
- Parkinson’s disease;
- Creutzfeldt-Jakob disease;
- Peak’s disease;
- viral or bacterial encephalitis;
- Levy’s disease;
- hydrocephalus (accumulation of fluid in the brain);
- a brain tumor;
- Wilson’s disease (a rare disease that causes the accumulation of copper in the liver, brain, kidneys and cornea of the eye);
- progressive supranuclear palsy, also known as Steel-Richardson-Olszewski syndrome (manifests itself after the age of 35);
- metabolic disorders.
Such metabolic disorders or conditions can cause senile dementia:
- thiamine deficiency;
- B12 deficiency;
- B3 deficiency;
- chronic alcoholism;
- chronic exposure to metals;
- exposure to dyes (e.g. aniline);
- drug treatment and its side effects;
- the interaction of incompatible drugs.
In some of these cases, dementia can be prevented by removing a toxic agent. As a result of such manipulations, the state of the brain returns to normal.
Characteristic symptomatic criteria
Many diseases that cause cerebral atrophy are accompanied primarily by the development of dementia.
The main symptoms are:
- speech disorders or aphasia;
- memory impairment;
- impaired intellectual ability;
- the impossibility of accurate planning (distraction);
- disorientation in space;
- repetitive movements;
- loss of consciousness;
Symptoms of Senile Degeneration
Symptoms of the early stage:
- forgetfulness about recent events;
- difficulties in making simple calculations;
- poor orientation in time, location and direction of movement;
Symptoms of the middle stage:
- cognitive impairment (learning, computing, calculating, logic, thinking, memory);
- emotional instability;
- excessive agitation or passivity;
- the impossibility of carrying out ordinary daily activities (patients need help with household matters – cleaning, cooking, going to the store, etc.);
- violation of sleep rhythms;
- disorientation in time of day.
Symptoms of the late stage:
- loss of all cognitive abilities;
Senile dementia is dementia that develops in old age as the final pathological involution of the body, arising from progressive diffuse atrophy of brain structures. The people know this disease as senile dementia, senile dementia, senile dementia. This pathology is an urgent problem of psychiatry, since it affects about 3-5% of people over 60 years of age and 20% of 80-year-old patients. We will talk about how senile dementia manifests itself, what are the principles of its diagnosis and treatment in our article.
The development mechanism (i.e. pathogenesis) of involutional mental disorders is quite complicated. The primary link is a change in the work of the structures of the hypothalamus, especially those that regulate the metabolic and endocrine functions of the body, in particular the pituitary gland. As a result of hormonal imbalance, the functioning of many organs of the body is disrupted, in addition, it negatively affects the cortex and subcortical structures, making them vulnerable to many external factors that do not pose a danger to a healthy person. That is, minimal psycho-traumatization, domestic stresses lead to a breakdown of higher nervous activity in predisposed individuals.
Gradually, the neurons responsible for mental, mental activity and social adaptation die: the patient loses his memory, learning ability, cannot think logically, he loses interest in others and life, in the later stages even the ability to self-service is lost.
Morphologically, with senile dementia due to atrophy, the volume and mass of the brain decrease. Furrows and ventricles expand, the convolutions are sharpened, and the configuration of the brain regions and the proportions between them are preserved, that is, atrophy is uniform.
Neurons are reduced in size, compressed, but their contours remain the same. The nerve processes die and are replaced by connective tissue (sclerosis), stick together.
Typical for senile dementia are multiple foci of round necrosis, in the center represented by a brown homogeneous mass, and on the periphery – by threads. These are the so-called foci of desolation and senile drusen.
Depending on how severe the symptoms of the disease are, in its course there are 3 stages:
- initial (the patient’s intelligence is reduced, however, the ability to self-criticize is preserved; the patient is able to serve himself independently);
- moderate (a person’s intellectual abilities are reduced, elementary skills to use household appliances surrounding him (a stove, an iron, door locks, etc.) are reduced — a patient can inadvertently harm himself and his home, but cannot cook for himself; at this stage, the patient is very undesirable leave unattended, but caring for it is not very difficult yet, since the person is still capable of self-care and personal hygiene skills are preserved);
- severe dementia (the patient loses the ability to perform basic actions, cannot serve himself, does not recognize relatives; needs round-the-clock care).
Dementia patients often suffer from insomnia.
As a rule, the first signs of this pathology occur at the age of 65-78 years, and for 1 sick man there are 2-3 sick women. The onset of the disease is almost imperceptible, but it is steadily progressing up to complete dementia.
At an early stage of dementia, there is an intensification, aggravation of certain traits of the patient’s character: the thrifty ones begin to be greedy, become mean, the persistent ones become stubborn, the incredulous ones become suspicious. Over time, new features that are not characteristic of a particular person appear: excessive egoism, callousness towards others, even close people, a sharp narrowing of the circle of interests. Emotions are lost.
Sick gloomy, critically lowered level. Their instinctive drives, on the contrary, are disinhibited: hypersexuality is noted, the patient can expose the genitals at all, and even molest children.
The sleep is disturbed: often the sick are sleepy during the day and worry from insomnia at night, while wandering around the apartment, scurrying around, trying to cook, move furniture and more, which greatly interfere with households and neighbors.
A gradual disintegration of the human mental activity is observed, and first of all, complex, abstract levels of thinking, creativity and critical capabilities, recently acquired, loose skills and knowledge are violated, while simple, solidly held and long-acquired knowledge, ideas and skills are significantly lost later.
In the later stages of the disease, patients often perceive themselves as if in their youth, those around them – those who were close in the past years; they lose their orientation in time and, as it were, are transferred to the past life stage. At the final stage, a person does not recognize others, confuses children with siblings, perceives the latter as parents and, in the end, does not even recognize himself in the mirror, because he considers himself a child and sees in the reflection an old man (he is called a stranger or grandmother / grandfather).
Also typical in the late stages of senile dementia are delusional ideas of robbery, impoverishment, and persecution. The patient accuses his relatives of theft, claims that everything was stolen from him – money, things, food, and now he has nowhere to live and nothing to eat, and he remained on the street, alone, without a livelihood. Where he is (on the street, in the hospital department, at home) the patient collects all the rubbish, ties him into a knot, hides him in bed, forgets where he hid him; in a state of excitement at night, he suddenly gathers with this node “on departure”, takes it with him for walks and more.
The mood of patients varies from discontented, gloomy at the beginning of the disease to indifferent, indifferent, up to emotional dullness at its late stage.
From other organs and systems in patients with senile dementia, there is a labile (unstable) pulse and blood pressure with a tendency to increase it. Turgor of tissues is reduced, wrinkled skin, gray hair and fall out. Patients look older than their age. Depletion, senile cataract, senile arc on the cornea, bedsores and other disorders of nutrition of body tissues are noted.
Neurological disorders are not so pronounced as with other degenerative diseases of the central nervous system, and are manifested by a certain muscle parity (because of this, the facial expression of the patient is as if frozen, the expression on the face is lethargic, the tremor of the hands and the uncertain slow walk with small steps are determined). The pupil’s response to light is reduced. Gross neurological disorders are absent.
Such patients die, as a rule, from intercurrent (occurring simultaneously) diseases against the background of complete physical exhaustion and mental insanity.
The current stage of development of medicine does not represent any opportunities for curing the patient after brain death. In some cases, a way out of states similar to brain death, for example, from a deep coma, or from a vegetative state (in case of incomplete decortication) is possible.
As for the direct death of the brain, the terminology itself implies the irreversibility of this condition, so until recently there were no studies at all in the field of therapeutic options.
The possibility of a brain transplant remains purely hypothetical for modern medicine – among other problems, it is almost impossible to imagine the availability of a donor organ for such an operation.
Only in 2016, studies in the field of curing brain death using modern biomedical technologies began to be carried out by several groups of American scientists, but the success of such work even in the long term seems very doubtful.
The mechanism of development of senile dementia
Since this condition occurs a second time against the background of other pathologies and diseases, measures to prevent it mainly come down to timely diagnosis and adequate treatment of causal disorders.
It is important for the patient to follow the doctor’s recommendations, to undergo the necessary examinations on time, and not to violate the rules for taking the prescribed drugs.
In some cases, when there is good reason to fear the development of life-threatening conditions, it will be appropriate for the attending physician to pay attention to drugs that activate brain activity (for example, nootropic drugs).
Of course, this will not eliminate this threat, but it can slightly reduce it, or increase the time during which the patient can be helped.
Causes of Senile Dementia
Senile brain degeneration is also known as senile dementia or dementia. The first prerequisites for the development of brain dystrophy can occur in a person after 60 years, although a weakening of memory over time is not a normal phenomenon.
The concept of degeneration means the weakening or loss of special functions of the body. Dementia (dementia) is a chronic disorder of mental activity in which behavioral disorders and the loss of basic self-care skills are possible.
Thus, there is a violation of higher cortical functions. Senile (senile) brain degeneration is most often diagnosed in people who have reached the age of 65.
Today it is impossible to reliably say why this disease develops. It is believed that the rate of involutive processes in the brain depends on the complex effect of a number of factors on it.
One such factor is heredity. It is known that the risk of developing senile dementia is increased in those individuals whose parents or grandparents suffered from this disease.
The second factor is an age-related violation of the functions of the immune system, as a result of which the body produces special autoimmune complexes that destroy brain cells.
Undoubtedly, external pathogenic factors play a role:
- somatic diseases, in particular atherosclerosis of the cerebral vessels, due to which the cells lack the nutrients they need for the full functioning and are destroyed;
- infections (especially neuroinfection – meningitis. encephalitis. neurosyphilis and others);
- oncological diseases;
- intoxication, in particular alcoholic nature;
- head injuries;
- mental injuries.
Moral, legal and other aspects
Undoubtedly, the state of intravital death of the brain is closely connected with a number of moral, ethical, legal, religious, and other aspects.
There are two main reasons for this:
- Often, after the death of the brain, the vital functions of other organs can be maintained for a long time (sometimes months and years). However, on the other hand, this seems meaningless, since a person as a person has died. Consequently, sooner or later, the question inevitably arises of disconnecting from parenteral nutrition, mechanical ventilation systems, etc.
- Human organs after brain death can be used for transplantation to other people. Medical laws in most countries recognize brain death as the equivalent of human biological death. In particular, the Ministry of Health of Russia approved such an instruction by order No. 100/30 of 02.04.01//. The right to consent to the use of organs for transplantation is usually granted to close relatives. As for the attitude of representatives of various religions to this problem, there is no consensus, however, the opinion that equates brain death with human death is also prevailing.
Types and stages of violation
In medical practice, there are three degrees of degenerative disorders in the brain:
- Easy degree. It is characterized by the loss of professional skills, apathy for what is happening around. The patient is not interested in objects that were previously considered his hobby. In this degree of illness, orientation and consciousness are preserved.
- Medium degree. The patient copes with personal hygiene skills, but may forget the rules for using household appliances. Such people often need help; leaving them unattended is dangerous.
- Severe degree. Patients lose their orientation in space and are not able to serve their own needs.
Degenerative diseases of the brain can be expressed in total or lacunar form.
- The total form of the disorder is characterized by scant emotionality and apathy. There is a degradation of personality.
- The lacunar (partial) form is characterized by a violation in short-term memory. But the “core of personality” is retained.
The course of the disease occurs in stages:
- Prementia is the stage of the disease, which is characterized by a decrease in memory. distraction and apathy. The ability to think is abstractedly reduced. Thus, violations affect fresh layers of memory.
- Early degeneration (the second stage of the disease) is characterized by more pronounced disorders. A progressive disease is expressed in impaired motor activity, incoherent speech. The patient can not always express his thoughts, his movements are absurd, but at the same time the remnants of memory and sanity are preserved.
- Moderate dementia (the third stage) manifests itself in the fact that a person begins to confuse words, does not recognize his loved ones, partially loses reading and writing skills. Elements of delirium may occur. An elderly person is able to leave home, and returning for him, due to impaired consciousness, is not possible. In addition to these symptoms, patients no longer control the body’s natural needs.
- After these stages, severe dementia sets in. A person practically does not talk, does not get out of bed and loses the ability to perform the most elementary movements. In this case, depletion of the body occurs. Death occurs due to pneumonia or pressure sores arising under such conditions.
Causes and clinic of dystrophic processes
The causes of weakening of brain functions in old age can be:
- In the case of vascular dementia, a history of hypertension, atherosclerosis. stroke. Thus, the cause of this pathology is a disturbed blood supply to the brain. For this reason, mass death of neurons occurs. In this case, the pathology is considered incurable. Cells have a low ability to recover in old age.
- With the atrophic type of dementia, a history of Peak’s disease should be noted. Alzheimer’s. Parkinson’s. Here cerebrovascular insufficiency takes place. Alzheimer’s disease often affects older women. The prerequisites for this are genetic predisposition, alcohol and smoking, severe stress, thyroid pathology or traumatic brain injury.
- The mixed type is characterized by a combination of vascular pathologies with atrophic changes.
Among the causes of the disease, brain tumors are also noted. chronic alcoholism, severe viral infections.
Vascular dementia accounts for 25% of cases. It develops in chronic oxygen starvation of brain cells due to vascular disorders in the organ. The cause may be congenital vascular malformations, diabetic angiopathy and stroke.
At risk are people leading a sedentary lifestyle, with malnutrition and alcohol dependence. Patients with obesity, diabetes mellitus, arterial hypertension and atherosclerosis are subject to vascular degeneration.
With this pathology, the patient has a disturbed thinking process, he is not able to distinguish the logical connection of events. A man loses his things that are in sight. Appearance loses neatness. In this state, tearfulness, apathy, and an unpredictable change of mood are often observed. Due to a decrease in motor activity, a person sleeps a lot.
Despite the fact that this type of disease is the most common, it is very difficult to distinguish from vascular dementia. Often the correct diagnosis is determined after the death of the patient.
At risk are women after 70 years old, patients with atherosclerosis and diseases of the endocrine system, people with adverse heredity.
At the beginning of the development of Alzheimer’s brain degradation, there is a decrease and partial loss of short-term memory, and later long-term memory.
An aggressive state may prevail in patients. They behave rudely, they lack the attention of loved ones.
A progressive pathology further causes delusions of persecution, megalomania and other similar deviations.
The tendency to vagrancy is manifested by frequent leaving home. The sight of the patient is messy.
This condition develops in people with alcohol dependence within 10-20 years. It is characterized by aggressive behavior, violation of intellectual qualities and apathy.
But in rare cases, when refusing harmful dependence, the pathological process regresses.
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Elderly people become distracted and grouchy, intractable. Forgetfulness and behavior changes occur due to aging and extinction of brain cells.
Patients may suffer from insomnia at night, during the day they tend to sleep. Mental disorders, touchiness and tearfulness are typical for them. Apathy and even hallucinations can be observed.
The cause of these disorders can be jumps in blood pressure and hyperglycemia.
This is a secondary disease with epilepsy. It is also called functional dementia.
Oxygen starvation and the consequences of traumatic brain injury lead to this condition. brain tumors. There is a decrease in memory and a violation of mental abilities, accompanied by an indifferent attitude to what is happening.
Patients become rude, selfish, and vengeful. A characteristic feature is the use of most of the words of a poor vocabulary in a diminutive form. With this form of the disease, therapy is aimed at eliminating the underlying cause.
A history is collected for an accurate diagnosis. Based on it, the symptoms are differentiated with depression, severe asthenia and iatrogenic mental disorders (delirium. Simulation and others).
A neurologist examining a patient reveals focal symptoms, extrapyramidal disorders and walking disorders.
The final diagnosis is made according to the results of magnetic resonance imaging and laboratory tests of the patient.
What can modern medicine offer?
Senile degeneration of the brain is treated taking into account concomitant diseases, which by this age the patient may have many. These include hypertension, pneumonia, heart attacks and strokes, and many others. They treat patients with herbal preparations and synthetic ones.
The first group of drugs includes psychostimulants. Their action is aimed at increasing the ability of the nervous system to adapt to stress. The second group of drugs are nootropics. whose action is aimed at restoring memory and improving cognitive functions. This group is able to reduce the oxygen demand of the brain.
Treatment of senile dementia involves the use of drugs that are able to restore nutrition of the nerve tissue of the brain. Their effect is somewhat weakened with combinatorial treatment with drugs that improve blood supply to the organ. But the results of treatment still have a positive trend.
Feeling of causeless fear, anxiety. insomnia is treated with tranquilizers. Patients may need psychotherapeutic methods of exposure that can return a person to normal behavior.
Features of care
Drug therapy will not produce the expected effect without proper care. Relatives of the patient should know that at home it is almost impossible to create the necessary conditions.
This is due to the fact that at home there are a large number of dangerous objects for the patient (cutting, piercing, electrical and fire hazardous). In addition, due to the possible aggression of the patient, it is very difficult to maintain calm in the house. The nutrition of patients should be monotonous.
Their cognitive abilities are impaired, and the variety of dishes can cause unpredictable confusion. Older people need help using the toilet. You may have to use special hygiene items (diapers).
From all this it follows that the best option is to place the patient in a specialized medical facility or to care for a professional nurse.
The patient should be treated with respect. His behavior is a manifestation of a serious illness, not a character trait. With a positive attitude, good, patient care, a significant improvement is observed.
Some conditions may give rise to the erroneous establishment of this extremely important, and the last diagnosis in life. In the case of disconnecting a living person from support systems, it may be a matter of manslaughter or negligence, which led to the death of a person.
As you can see, the diagnosis of “brain death” is very close to the concept of “human death”, and, in fact, differs only in the presence of spontaneous cardiac activity. So, a pronounced decrease in body temperature, severe intoxication, including drugs for anesthesia, can lead to such errors. Taking atropine can cause dilated pupils.
In the absence of therapy, approximately 7 years pass from the onset of the manifestations of the disease to the final stage.
With the rapidly progressing vascular form of senile brain degeneration, death can occur within a few months after the first symptoms of the disease are detected, due to the fact that patients in the last, severe stage of the disease refuse motor activity and food, become apathetic, which leads to complete exhaustion.
They have tremor of limbs. speech is present in the form of fragments of phrases. They remember very little about themselves. All the time the patient is in a prone position, as a result, bedsores, sepsis and pneumonia occur. A weakened body stops fighting, and a lethal outcome occurs. Mortality from the total number of cases is approximately 5,6%.
The life expectancy of an inoperable patient with a malignant brain tumor, where senile degeneration is considered secondary, can be predicted by an oncologist according to laboratory studies and MRI results.
By the age of 70, an illness in different stages is observed in 5-10% of the world’s people. Women suffer 2 times more often than men. After 85 years, the disease is characterized by slight progress, which increases life expectancy.
Special prevention of senile dementia in medicine does not yet exist. To avoid brain damage, people over 40 are advised to take a complex of vitamins and minerals.
There are biologically active additives, the action of which is aimed at improving memory and mental ability. An important aspect is the rejection of bad habits that adversely affect the brain and cardiovascular system.
Effective therapy for the manifestation of somatic pathologies in the elderly can also play the role of prevention. It is important that measures are taken in a timely manner.
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