Dementia is a broad category of brain diseases that cause a long term and often gradual decrease in the ability to think and remember such that a person's daily functioning is affected. Dementia is acquired global impairment of intellectual, memory and personality but without impairment of consciousness.

1. By-
Mr. Kishor Supet
MSc. (N), PSN (SMHS)
BSP C.G.

2.  Dementia is a broad category of brain
diseases that cause a long term and often
gradual decrease in the ability to think and
remember such that a person's daily
functioning is affected.
 Dementia is acquired global impairment of
intellectual, memory and personality but
without impairment of consciousness.

3. According to “DEBR’S” –
 “Dementia is defined as loss of intellectual
abilities of sufficient severity to interfere with
social or occupational functions.”

4.  It is characterized by the following main
features:
 Impairment of intellectual function
 Impairment of memory (predominantly of
recent memory, especially in early stages).
 Deterioration of personality with lack of
personal care.

5.  In 2010, dementia resulted in about 486,000
deaths up from 141,000 in 1990.
 Rates increase significantly with age.
 Dementia affecting 5% of the population
older than 65 and 20–40% of those older than
85.

6.  Reversible causes -
 The important causes of organic mental
syndromes – using mnemonic
Mnemonic “VINDICTIVE MAD”

7. REVERSIBLE CAUSE
There Are Four
Main Causes Of
Easily Reversible
Dementia:
HYPOTHYROIDISM,
VITAMIN B12
DEFICIENCY,
LYME DISEASE, & NEUROSYPHILLIS.

8. V- Vascular-Hypertensive ancephalopathy, cerebral arteriosclerosis, shock.
I- Infection- encephalitis, meningitis
N - Neoplastic – space occurring lesions, gliomas, abscesses.
D - Degenerative – senile and pre senile dementia , Alzheimers, pick.
I- Intoxication – chronic intoxication, bromides, , opiates, transquilizers, anticholinergic .
C - Congenital – epilepsy and post ictal status, aneurysm,
T- Traumatic – subdural and epidural hematoma, confusion, heat stroke.
I- Intraventricular- normal pressure hydrocephalus.
V- Vitamin – deficiencies of thiamine, niacin and B12 .
E- Endocrine metabolic – diabetic coma and shock, myxedema, acid-base disturbances and
auto immune disorders.
M- Metals – lead poisons.
A- Anemia – hypoxia and anoxia secondary to pulmonary/cardiac failure, anemia , etc.
D- Depression – other, hysteria , catatoxia, post - operative status, sleep deprivation , heat,
electricity and radiation.

9.  Degenerative diseases of the central nervous
system –
 Intra cranial causes
 Vascular causes –
 Metabolic and endocrine disorders-
 Nutritional causes-
 Traumatic causes –
 Infections and related conditions.

10.  INTELLECTUAL DETERIORATION WITH
FAILURE OF –
 Memory
 Orientation –
 Language –
 Thinking and judgment
 Comprehension of learning
capacity –
 Calculation –
 EMOTIONAL CHANGES –
 DETERIORATION OF PERSONALITY –
 AGE RELATED BODY SYSTEM CHANGES
–

12.  HOSPITALIZATION
 HISTORYTAKING
 PHYSICAL EXAMINATION –
 PHYSICAL INVESTIGATION
 PSYCHOLOGICALTESTING –
 MENTAL STATUS EXAMINATION –

13.  The dementia in these conditions may be
reversible or partially reversible even if the
underlying disease or damage is not –
 Basic Investigations:
 Treatment Of Underlying Cause If Reversible

14.  Complete blood count, urinalysis, blood
glucose, serum electrolytes, renal function
tests, thyroid function test, X-ray skull, EEG,
lumbar puncture, RT scan/ MRI scan of brain.

15.  Some underlying causes of dementia are
treatable. (Reversible dementia)
 Treatment
 Thyroxine – hypothrome dementia
 Levodopa - Parkinsonism

16.  Except for the cholinesterase inhibitors, the US food and Drug administration
(FDA) has not approved any drug specifically for dementia. The drugs listed here
are some of the most frequently prescribed from each class.
 Cholinesterase inhibitors. – Tacrine (Cognex), donepezil (Aricept).
 Antidepressants/anxiolytics – fluoxetine (Prozac), sertraline (Zoloft),
citalopram (Celexa).
 Antipsychotics – Haloperidol (Haldol), risperidone (risperdal),
quetiapine (seroquel).
 Anti convulsants- valporic acid (Depakote), carbamazepine (Tegretol).
 All drugs cause side effects. In prescribing drug, doctors weigh whether the
benefits of the drug outweigh the side effects.

17.  Occupational therapy may help persons with dementia
with activities of daily living such as feeding oneself.
• Physical therapy may improve mobility by teaching
patients to use canes or walkers properly and showing
them how to get in and out of chairs or beds.
• Music and art activities may be soothing and rewarding
for some people with dementia.

18.  Psychotherapy –the specific psychotherapy
treatments divided in to 4 broad of range:
A. Behavior Oriented,
B. Emotion Oriented,
C. Cognition OrientedAnd
D. StimulationOriented .

19.  Nursing care should be given according to its
cause, onset of illness and severity.
 The main aim of nursing care is to make the
patients life easier and pleasant.