What is Alzheimer's type dementia, symptoms and treatment. Moderate to severe dementia of Alzheimer's type

- most common reason memory impairment in people over 65-70 years of age. This disease has hereditary predisposition, so relatives run the risk of getting sick much more than others, but this is not fatal and can be avoided. In addition to factors such as elderly age and heredity, predispose to development: left without treatment hypertonic disease, obesity, diabetes mellitus, sedentary life and insufficient intellectual activity in youth and middle age.

general information

The basis of Alzheimer's disease is gradual (decreasing its size). This becomes the cause of a developing progression of memory loss, with memory for recent events first suffering, and childhood and youth memories long time will remain safe. Gradually, spatial disorientation, difficulties in carrying out intellectual operations are added to the number of memory disorders, and sometimes misunderstanding of speech appears. Dementia develops, and patients need outside help in everyday life.

Alzheimer's disease is a progressive disease. As a rule, the period from the first symptoms of forgetfulness to the stage of deep dementia is 5-10 years. Although sometimes (in 20% of cases) dementia progresses quite slowly, then the patient can maintain independence and autonomy for a long time ordinary life. There may also be long-term pauses in the course of the disease - temporary periods without a visible increase in symptoms. Of course, this will largely depend on the timeliness of the treatment provided.

The diagnosis of "" is established by a neurologist or psychiatrist, based on characteristic symptoms, and in the presence of brain atrophy according to magnetic resonance or computed tomography data. There are techniques effective therapy, which are not always able to stop progressive dementia, but thanks to them you can slow down its pace, reduce the severity of symptoms, have a beneficial effect on behavior, and reduce the need for help from outsiders. Treatment is most effective when carried out on the early stage diseases.

Alzheimer's disease is not the only disease that leads to gradual atrophy of the brain. According to its symptoms similar diseases similar to, but differ in some nuances. Results and prognosis after therapy may also vary. To establish accurate diagnosis you will need the help of a specialist.

Scientists from the American National Institute of Aging have identified the following: early signs Alzheimer's disease:

  • the person repeats the same question;
  • repeats the same story many times, word for word;
  • everyday skills, such as cleaning or cooking, are lost;
  • loss of ability to conduct financial affairs, for example, pay bills;
  • a person is unable to navigate a familiar place or place ordinary everyday objects in their places;
  • neglects personal hygiene, claiming that “I’m already clean”;
  • the patient instructs someone to make simple decisions life situations problems that I had previously dealt with on my own.

Dementia early. As the disease progresses, memory and cognitive abilities continue to deteriorate. Symptoms of early dementia typically include:

  • A person is unable to remember where he is or find the usual road.
  • He finds it difficult to handle money and pay bills.
  • The patient constantly asks the same questions.
  • He spends more time doing normal daily activities.
  • He assesses events incorrectly and with difficulty.
  • The person loses things or puts them in unusual places.
  • His behavior and personality changes.

For most patients, the first symptoms of Alzheimer's disease begin at age 60. Often the diagnosis is made at an early stage.

Moderate dementia. At this stage, there is damage to the areas of the brain that control speech, intelligence, are responsible for processing external information (visual and auditory), and thinking. The most common symptoms in the moderate stage are:

  • Progression of memory loss and the phenomenon of general confusion.
  • Problem with recognizing relatives and close people.
  • A person is unable to learn new skills and abilities.
  • He has difficulty performing multi-step tasks, such as getting dressed.
  • The patient is unable to cope with the new situation.
  • The patient has delusional ideas and persecution mania.
  • The person becomes hot-tempered.

Severe dementia. People at the stage of severe dementia are unable to communicate and are completely dependent on the help of others. Most patients spend time in bed. The most common symptoms at this stage are:

As a person ages, they may develop various diseases, they often affect the brain and affect its functions. Irritability may increase, aggression may appear, memory may deteriorate, and the ability to think may be impaired. Similar symptoms are typical in cases where Alzheimer's type dementia occurs.

In this case, a gradual disintegration of the personality occurs; the pathology is mainly observed in people over 65 years of age. IN in rare cases pathology can occur in younger people, as a rule, it is associated with injuries and other diseases.

Alzheimer's dementia is dementia, which is most often observed in old age and is caused by brain damage.

With this pathology, there is a loss of intelligence, the ability to remember, as well as cognitive functions. As a result, a person gradually degrades and becomes unable to even take care of himself. The pathology progresses slowly, but ultimately leads to a complete loss of basic abilities.

Dementia in Alzheimer's disease is characterized by the deposition of proteins in neuronal cells, as well as in the strands of neurofibrillary tangles. Because of this, the connections between cells are destroyed, which leads to disorders in the brain.

This pathological process leads to a gradual loss of mental function and, as a result, to complete personal degradation. Over time, more and more parts of the brain die, causing a person’s well-being to deteriorate.

The likelihood of encountering the disease after the age of 85 is significantly higher. In elderly people it is observed in approximately 50% of cases. Moreover, after 75 years, the probability increases to 15%. One feature of the pathology should be taken into account.

Presenile dementia, which began at age 65, develops rapidly. With it, you can notice obvious cognitive impairment. If senile pathology appeared after 70 years, then it will slowly progress, and memory deterioration is mainly noted.

If dementia occurs due to Alzheimer's disease, timely measures must be taken. You will definitely need to see a doctor to start treatment in a timely manner. In this case, it will be possible to prolong a person’s life as much as possible.

Doctors give different forecast, some patients live for 5 years, while others can last another 15 years or longer. Much will depend on the quality of care and the efforts of the patient.

Varieties

Exist different types Alzheimer's type dementia, and when diagnosing, doctors determine the specific type. The disease is divided by time of onset and severity. The treatment regimen and prognosis will depend on this. What types of dementia in Alzheimer's disease exist.

Presenile. It is characterized by early onset before the age of 65, with the pathology progressing rapidly. Symptoms such as speech disorders, impaired practical skills, and loss of the ability to read and write are present.

Senile. It has a late onset, so it is observed after 70 years. Manifestations progress slowly, and the main symptom is a memory problem.

Initial. Alzheimer's type dementia has just appeared and therefore has mild symptoms. A person may be less able to navigate familiar places, perform ordinary tasks more slowly, and also have a worse understanding of money matters. In general, loved ones may not notice negative changes, because they can be explained by old age.

Moderate. The pathology develops and new symptoms arise. A person remembers information much worse, especially those things that just happen. It becomes difficult for the patient to recognize his loved ones, even those with whom he lives. The patient is unable to dress himself or use household items.

Heavy. The person cannot carry on a conversation, does not answer questions and does not talk about his needs. He spends most of his time sleeping or half asleep. He cannot eat food on his own, and his swallowing function is impaired. The patient does not control bowel movements or urination. Such people need to be constantly looked after and cared for.

Alzheimer's dementia is best treated when it is in its early stages. If the patient is in serious condition, then it will be much more difficult to improve his condition. For this reason, it is important to act promptly and not ignore alarming symptoms.

Symptoms

To better understand what dementia of the Alzheimer's type is, we should separately consider general symptoms. If they appear, you should immediately go through medical diagnostics for staging correct diagnosis. If this is not done, then the pathology will progress, and the person will begin to fade before our eyes.

Main features:

  • The patient forgets important dates, as well as events that have already occurred.
  • Loses the ability to perceive speech that is on TV.
  • The patient cannot remember the names of his friends, relatives, and forgets the names of ordinary things.
  • Repeats the same words several times, may often ask again after receiving an answer.
  • A person loses the full ability to think and remember. He cannot analyze events, solve any problems and absorb new information.
  • Present frequent change moods. The patient becomes angry, depressed, or indifferent to his surroundings.
  • Have problems reading or writing. A person gradually loses these abilities.
  • The patient feels constant worry even in a familiar environment.

Relatives should prepare for the fact that the elderly will require constant care, because they themselves will not be able to satisfy even basic needs. Staying in the hospital is not recommended, because an unfamiliar environment can significantly worsen the condition.

Diagnostic methods

For dementia of the Alzheimer's type, it is necessary special diagnostics, thanks to which the disease can be identified. Just knowing the symptoms will not be enough; you will need to undergo a series of examinations.

At the first symptoms, you should consult a neurologist or psychiatrist. They will be able to guess what kind of disease the person had to face. Next, studies will be ordered that will confirm or refute the diagnosis.

Patients are prescribed because this procedure allows you to get detailed information about the state of the brain. It will be possible to determine whether there are any abnormalities that may give similar symptoms.

If there are no diseases, then we can assume the presence of dementia of the Alzheimer's type. In addition, it is carried out CT scan, which also allows you to obtain information about the state of the brain.

For patients, a biochemical blood test is performed, because with its help it will be possible to identify some abnormalities. Experts determine whether there is vitamin B12 in the blood, as well as folic acid. An electrocardiogram is also performed to identify other pathologies.

A specialist can refer you for a puncture cerebrospinal fluid, as well as to study the reaction of the pupils. If necessary, the condition of other organs is studied if there is a suspicion of their pathology.

May be required, based on the results of which the presence of the disease is determined. For example, a drawing procedure is used to search for hidden meaning. Neuropsychological testing is also performed to detect dementia due to Alzheimer's disease.

Based on the results of the completed procedures, it will be possible to understand exactly what problem you are dealing with. It may be that characteristic symptoms gives by the vascular system. Sometimes the diagnosis remains unspecified, but this happens quite rarely. As soon as it is possible to understand what exactly is happening to the person, it will be necessary to begin treatment.

Therapy methods

As already mentioned, senile dementia of the Alzheimer's type cannot be cured, but it is important to take measures to improve the person's well-being. It will be necessary to eliminate negative manifestations diseases, as well as slow down the development of pathology. If there are concomitant ailments that can affect the state of the brain, then they will need to be eliminated.

Therapy is required diabetes mellitus, high blood pressure and atherosclerotic changes in cerebral vessels. If a person has excess weight, then you will need to get rid of it. Prescribed by a doctor special drugs, which have a positive effect on the well-being of patients.

What means are used:

  • Medicines to improve blood circulation.
  • Nootropic drugs that help normalize brain activity.
  • Ontioxidants such as Omega-3 and Mexidol.
  • Homeopathic medicines as a supplement.
  • Means that stimulate the work of the central nervous system and improve memory.
  • Anti-anxiety medications when a person suffers from anxiety and aggression.

At the same time, with Alzheimer's dementia, a specialist conducts conversations with the person that help them accept their condition. It is necessary to develop special exercises that train memory and mental activity.

These measures are relevant at the initial stage of the disease. If the disease is at the last stage, then constant monitoring from loved ones will be required, because the patient becomes incapacitated.

Alzheimer's type dementia can be prevented by promptly treating other diseases, eating right, exercising, and monitoring arterial pressure. If the pathology already exists, then you will need to regularly see a doctor and carry out complex therapy.

– acquired dementia caused by organic brain damage. It may be a consequence of one disease or be of a polyetiological nature (senile or senile dementia). Develops with vascular diseases, Alzheimer's disease, trauma, brain tumors, alcoholism, drug addiction, central nervous system infections and some other diseases. Persistent intellectual disorders, affective disorders and decreased volitional qualities are observed. The diagnosis is made based on clinical criteria And instrumental studies(CT, MRI of the brain). Treatment is carried out taking into account the etiological form of dementia.

After complete refusal from alcohol and treatment of alcoholism is possible partial restoration however, such cases are very rare. Due to a pronounced pathological craving for alcoholic beverages, decreased volitional qualities and lack of motivation, most patients are unable to stop taking ethanol-containing liquids. The prognosis is unfavorable, the cause of death is usually somatic diseases caused by alcohol consumption. Often such patients die as a result of criminal incidents or accidents.

Diagnosis of dementia

The diagnosis of dementia is made if five mandatory signs are present. The first is memory impairment, which is identified based on a conversation with the patient, special research and interviewing relatives. The second is at least one symptom indicating organic brain damage. These symptoms include the “three A” syndrome: aphasia (speech disorders), apraxia (loss of the ability to perform purposeful actions while maintaining the ability to perform elementary motor acts), agnosia (perceptual disorders, loss of the ability to recognize words, people and objects while maintaining the sense of touch , hearing and vision); reduction of criticism towards own condition and surrounding reality; personality disorders (unreasonable aggressiveness, rudeness, lack of shame).

Third diagnostic sign dementia – a violation of family and social adaptation. The fourth is the absence of symptoms characteristic of delirium (loss of orientation in place and time, visual hallucinations and delusions). Fifth – the presence of an organic defect, confirmed by instrumental studies (CT and MRI of the brain). A diagnosis of dementia is made only if all of the above symptoms are present for six months or more.

Dementia most often has to be differentiated from depressive pseudodementia and functional pseudodementia resulting from vitamin deficiency. If a depressive disorder is suspected, the psychiatrist takes into account the severity and nature of affective disorders, the presence or absence of daily mood swings and feelings of “painful insensibility.” If vitamin deficiency is suspected, the doctor examines the medical history (malnutrition, severe lesions intestines with long-term diarrhea) and eliminates symptoms characteristic of a deficiency of certain vitamins (anemia due to deficiency folic acid, polyneuritis due to a lack of thiamine, etc.).

Prognosis for dementia

The prognosis for dementia is determined by the underlying disease. With acquired dementia resulting from traumatic brain injury or space-occupying processes (hematomas), the process does not progress. Often there is a partial, less often a complete reduction of symptoms due to the compensatory capabilities of the brain. IN acute period It is very difficult to predict the degree of recovery; the outcome of extensive damage can be good compensation with preservation of ability to work, and the outcome of minor damage can be severe dementia leading to disability and vice versa.

In dementia caused by progressive diseases, there is a steady worsening of symptoms. Doctors can only slow down the process by providing adequate treatment of the underlying pathology. The main goals of therapy in similar cases becomes the preservation of self-care skills and adaptive abilities, prolonging life, providing adequate care and eliminating unpleasant manifestations diseases. Death occurs as a result of a serious impairment of vital functions associated with the patient's immobility, his inability to perform basic self-care and the development of complications characteristic of bedridden patients.

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Alzheimer's type dementia refers to one of the types senile dementia. The condition develops against the background of degenerative changes in the structure of the brain, leading to a gradual disruption of the functionality of the organ and the disintegration of personality. According to statistics, this form of dementia accounts for 60% of all registered cases of senile dementia. It takes years from the moment the first signs of organic problems appear until the full clinical picture develops. On average, a significant deterioration in the patient’s quality of life occurs 8-10 years after the diagnosis of the pre-dementia condition.

Dementia of the Alzheimer's type is one of the types of senile dementia that develops against the background of degenerative changes in the structure of the brain, leading to the collapse of personality.

What is Alzheimer's type dementia

The definition refers to a pathology that leads to the development of a special form of senile dementia. It occurs against the background of degenerative processes in the brain, characteristic of Alzheimer's disease. The patient has problems with the perception and processing of information, memory, and control of emotions. The picture is complemented by obvious cognitive impairment. Typically, persistent symptoms occur in people over 65 years of age, but under the influence of a number of external and internal factors its early development is possible.

Mandatory signs of senile dementia of the Alzheimer's type:

  • short-term memory suffers - problems with remembering recent events, dates, conversations, people;
  • perception changes - understanding of conversations addressed to the patient or simply going on as background is impaired;
  • memory for general events becomes dulled - the victim forgets the names of objects, finds words with difficulty, does not remember the names of loved ones and the dates of important events;
  • speech disorders - decreased literacy, clarity of articulation, repetition of the same words or phrases due to rapid forgetting of what has already been said;
  • impairment of reading and writing functions;
  • mood swings, irritability, apathy, feeling of anxiety;
  • problems with orientation even in the usual habitat, deterioration of coordination.

A mandatory sign of senile dementia of the Alzheimer's type is mood swings.

With all of the above disorders, the patient retains clear consciousness and there are no signs of confusion. The victim is more comfortable alone; the company of other people, even the closest ones, gives him discomfort. The persistence of these symptoms for six months allows one to suspect dementia of the Alzheimer's type. The diagnostics carried out exclude the presence of other diseases that can provoke such clinical picture.

How is dementia different from Alzheimer's disease?

Senile dementia is one of the clinical manifestations degenerative lesion brain. For this reason, there are no differences between dementia and Alzheimer’s disease, and it is not entirely correct to separate the concepts. Sometimes age-related pathology for a long time proceeds without obvious signs of personality change, but in any case they gradually increase. Alzheimer's disease and senile dementia are closely related. The main thing is to learn to distinguish them from other CNS lesions that follow a similar scenario.

Difference between Alzheimer's type dementia and Pick's disease

Pick's disease is very rare disease central nervous system, which is characterized by a chronic progressive course. It affects the cerebral cortex, leading to tissue destruction. Unlike Alzheimer's disease, this pathology manifests itself more malignantly and aggressively - the patient's lifespan rarely exceeds 5-7 years.

The main difference is the fact that memory impairments are not observed or are minimal.

Even with Pick's disease, patients often experience hallucinations. Personality changes are clearly expressed already at initial stages, and with Alzheimer's this manifests itself only in the later stages. They are accompanied by attacks of extreme agitation, aggression, foul language and even delirium.

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Stages of Alzheimer's type dementia

Senile dementia in Alzheimer's develops gradually, going through three stages, each of which is characterized by a special clinical picture. Correct assessment of manifestations in 90% of cases leads to the correct diagnosis, adequate assessment of the stage of the disease and prognosis for the patient. Dementia in late-onset and early-onset Alzheimer's disease is characterized by all general signs. The only difference is that in the first case, symptoms appear after 65 or even 75 years, and in the second - before 65 years. With early onset of pathology, symptoms progress much faster than with late onset.

The only difference between Alzheimer's type dementia and Alzheimer's disease is that in the first case, symptoms appear after 65 or even 75 years of age, and in the second, before 65 years of age.

Early stage

The symptoms are mild, but already attract the attention of the patient himself or others. They are often identified by neurologists or doctors of other specialties during an examination of a person for another reason or a medical examination. Personality changes are minor. Timely start complex therapy allows you to slow down the rate of spread of brain damage and slow down the development of pathology.

Clinical picture of early stage Alzheimer's dementia:

  • the appearance of problems with orientation in familiar terrain;
  • repeating the same question several times even after receiving an answer;
  • the desire to constantly tell the same stories, to retell events already described before;
  • Difficulty solving simple mathematical problems, leading to problems in the financial sector. Already at the early stage of Alzheimer's, patients are unable to pay in a store or perform usual banking transactions;
  • reduction in the speed of performing simple everyday actions that were previously performed automatically;
  • inability to draw conclusions in some situation, correctly assess the state of affairs, or summarize what has been read or heard;
  • loss of interest in activities that previously brought great pleasure - work, hobbies, study, sports, caring for pets or gardening;
  • forgetting information related to everyday life. Victims are forced to keep a diary so that their schedule does not get disrupted. Many experience constant problems due to the loss of small items.

The clinical picture of the early stage of Alzheimer's dementia is a decrease in the speed of performing simple everyday actions that were previously performed automatically.

Early manifestations of Alzheimer's disease do not turn a person into a disabled person, but they already slightly reduce the quality of his life. If you work in a hazardous industry or need to constantly drive vehicles, already at this stage you should think about changing your occupation.

Moderate

Even with the most careful care and complex treatment Alzheimer's disease will progress. This will manifest itself in the exacerbation of basic clinical manifestations, the addition of new warning signs, worsening everyday and social problems.

Transition period from initial stage on average ranges from 5 to 10 years.

For moderate severity of dementia of the Alzheimer's type, the following symptoms are characteristic:

  • The amount of short-term memory is significantly reduced. Sometimes the problem reaches such an extent that the patient cannot remember a sequence of 2-3 words;
  • the ability to lead a normal life without outside help is lost due to the loss of basic skills. He forgets the rules for using household appliances, dishes, and hygiene products. Often, those affected by dementia due to Alzheimer's disease cease to recognize ordinary things, forget their name, purpose;
  • Social connections are disrupted. The patient ceases to recognize family and friends;
  • signs of apathy or depressive disorders appear. Sometimes patients become irritable, hot-tempered, and aggressive;
  • manifestations characteristic of confusion occur. Often with dementia due to Alzheimer's, patients develop crazy ideas, delusions of grandeur develop;
  • performing any sequential actions is difficult even under the control of outsiders;
  • there are frequent manifestations of hypersexuality, pathologically liberated behavior against the background of the disappearance of moral boundaries in the consciousness;
  • eating disorders in the form of bulimia, complete refusal of food or certain food groups;
  • “vagrancy syndrome,” in which the patient leaves home, disappearing for several hours or days.

For moderate severity of dementia of the Alzheimer's type, it is characteristic that the person completely refuses to eat.

At this stage, the patient already needs constant external monitoring. In its absence, the patient poses a danger to himself and others. Where possible, it is recommended that a person with Alzheimer's dementia be given freedom of action to positive influence on his psyche.

Severe degree

The last stage of senile dementia as a result of degenerative brain damage. Often such a patient does not receive enough care from loved ones and requires the help of medical personnel.

Clinical manifestations of severe dementia in Alzheimer's disease:

  • loss of the ability to speak coherently or pronounce at least individual words;
  • severe or complete disability motor activity– the patient cannot leave the bed without assistance or eat or drink on his own;
  • inability to control natural physiological processes - involuntary bowel movement Bladder, intestines;
  • development of paralysis leading to the inability to swallow;
  • weight loss;
  • the appearance of rashes, suppuration, irritation on the skin;
  • serious mental disorders;
  • there is a high probability of developing convulsive attacks;
  • Almost all the time the patient sleeps or is in a sleepy state.

Patients with severe dementia of the Alzheimer's type often die from complications associated with the forced position. Sometimes they fall into a coma due to massive damage to the central nervous system, which ends in death.

Diagnostics

Diagnosing dementia due to Alzheimer's disease begins with a visit to a neurologist. The doctor collects general and family history, conducts an examination, psychological and neuropsychological tests. Additionally, the specialist interviews the patient’s relatives to assess the degree of damage to the central nervous system.

To confirm preliminary diagnosis The following approaches are used:

  • MRI or CT;
  • general and biochemical tests blood;
  • blood for glucose levels, the presence of vitamins B9 and B12;
  • EEG – to exclude other diagnoses in the early stages of dementia or to establish the extent of brain damage at subsequent stages;
  • biochemical analysis of cerebrospinal fluid.

As an auxiliary approach, the study of genetic material for the presence of mutated genes is increasingly being used. Additionally check functionality thyroid gland, do an ECG for evaluation general condition patient.

Treatment

The principles and methods of therapy are selected individually in each individual case. They should be aimed not only at treating Alzheimer’s type dementia, but also the cause of its development – ​​degenerative damage to nerve tissue. A complex approach is based on taking medications that stimulate cerebral circulation and metabolism in the brain. It is complemented by physiotherapy techniques, physical therapy, dietetics.

Additionally, measures are taken to combat concomitant pathological factors - atherosclerosis, obesity, hypertension, diabetes, depression. For a general positive effect on the body, vitamins, antioxidants, homeopathic remedies. In moderate and severe stages of Alzheimer's, pathogenetic drugs are used.

Like the underlying disease itself, dementia of the Alzheimer's type is incurable. Timely initiation of treatment increases the patient’s life span, improves its quality indicators, and makes life easier for the patient’s relatives.

At a certain stage, even such actions cease to bring desired result, because of which the victim’s personality completely changes, he literally ceases to be himself.

Drawing conclusions

Strokes are the cause of almost 70% of all deaths in the world. Seven out of ten people die due to blocked arteries in the brain. And the very first and main sign of vascular blockage is a headache!

Dementia is a decrease in mental abilities associated with organic pathology of the brain. Symptoms of the disease can develop gradually or occur instantly, which depends on the location of the pathological focus, its size and the general condition of the body.

Dementia of the Alzheimer's type occupies a predominant position among all types of senile dementia and occurs in 60% of cases! The disease is the reason why a person receives a disability group, which negatively affects not only the condition of the patient himself, but also the mental health his relatives. The disease cannot be cured completely, but with the help medicines and following the recommendations of your doctor, you can increase your life expectancy and improve its quality. Dementia is currently one of the main problems modern medicine, which is why it is so important to visit the hospital on time at the first symptoms and undergo the necessary diagnostic procedures in advance.

The etiology of the disease is varied:

Dementia in Alzheimer's disease differs from that in Pick's disease in a number of symptoms:

  • Memory impairment occurs in the early stages of the disease;
  • Possible depression and apathy, anxiety;
  • Speech is not impaired until stages 2-3.

With Pick's disease, all of the above symptoms are exactly the opposite. The MRI picture is also different: in Alzheimer's disease, diffuse atrophy of the cerebral cortex is observed, while in Pick's disease, there is diffuse atrophy of the temporal and frontal lobe.

Types of dementia

Depending on location organic damage dementia can be:

  • Cortical. Diffuse damage to the cerebral cortex, characteristic of Alzheimer's disease, Pick's disease, sometimes occurs with alcohol abuse;
  • Subcortical. Neurological symptoms are pronounced due to damage to subcortical structures. In particular, pathological changes in the substantia nigra in Parkinson's disease, the presence of clinical manifestations in the form of tremor, muscle stiffness, lack of facial expressions;
  • Cortical-subcortical. It is a lesion of both the cerebral cortex and subcortical structures. It is a consequence of vascular pathology;
  • Multifocal. Pathological changes observed not only in the brain, but also in spinal cord. This includes Creutzfeldt-Jakob disease, which will be accompanied by speech impairment, amnesia, changes in spatial orientation and the inability to make purposeful movements.
  • – a pathology characterized by multiple lesions in all parts of the central nervous system. Steadily progressing dementia is accompanied by severe and varied neurological symptoms.

Forms of dementia

  • Lacunarnaya. Is an isolated lesion brain structures. Characteristic of Alzheimer's disease. Patients complain about short-term loss memory, during a conversation they usually talk about it themselves, since criticism of their condition is preserved. In addition to disturbances in the intellectual sphere, suppression of the emotional-volitional component appears. A person becomes irritable, sensitive, and his mood changes very quickly. At this stage, it is important not to confuse Alzheimer's disease with a number of mental illness with similar symptoms ( bipolar disorder, schizophrenia, etc.);
  • Total. This form of dementia is a breakdown of personality, expressed in changes in behavior, speech impairment, and gait. A person cannot perform basic actions, his memory and other cognitive processes decrease, and there may be outbursts of unreasonable aggression. Total dementia occurs when vascular disorders, Pick's disease and volumetric processes in the brain (hematoma, tumor).

Degrees of the disease

Symptoms of Alzheimer's type dementia depend on the severity of the disease:

  • Easy. The intellectual sphere is impaired, but the patient is able to take care of himself, orients himself in space, is critical of his condition, turns to doctors and relatives for help;
  • Moderate. The violations are more severe in nature, the patient copes poorly with household chores, and criticism towards his health gradually decreases. At this degree, it is extremely undesirable to leave the patient unattended, because he may harm himself;
  • Heavy. With it, there is a complete collapse of emotional-volitional impulses and the intellectual sphere. The person becomes extremely aggressive and irritable, so it is recommended that they be cared for in specialized institutions to avoid possible injuries.

Risk factors

The following risk factors are identified that may affect the development of the disease:

  • Age over 70 years;
  • Female;
  • Genetic predisposition;
  • Availability concomitant pathology(diseases of the cardiovascular, endocrine, respiratory systems);
  • Obesity;
  • History of traumatic brain injury;
  • Poor social, economic and environmental conditions;
  • Bad habits such as regular consumption alcoholic products, smoking cigarettes, drinking narcotic substances and off-label use of medications;
  • Insufficient intellectual development throughout life (reading literature, solving all kinds of puzzles and tasks have a positive effect on the state of neurons, which strengthens their connections and helps prevent the development of dementia).

Early signs of the disease

The first symptoms may appear several years before the development of Alzheimer's type dementia. The person will complain of memory loss for recent events. This greatly affects the patient’s mental well-being and makes him think about his own health and consult a doctor. Depressive episodes predominate, although anxious forms of the disease also occur. Memory is violated according to Ribot's law: first, events that took place very recently are erased, and then everything else. Sometimes a person may not remember at all what happened to him for several years, but he can accurately tell about some childhood event that was significant to him.

Late signs of the disease

Unlike the early stage, the late stage has a number of significant differences. This has important diagnostic significance in making the correct diagnosis. Firstly, there is a decrease in criticism of one’s condition. A person does not consider himself sick, although he may notice some oddities in himself. Secondly, the patient “replaces” lost memory fragments with actions that are familiar to him. For example, he does not remember what he did this morning, however, if you ask a person this question, he will tell you with full confidence what he did 10 years ago, projecting images for today. This phenomenon is called confabulation. The emotional-volitional sphere suffers greatly, the person becomes more irritable, he develops delusional ideas, develops suspicion and conflict. Subsequently, patients become depressed, stop experiencing hunger and thirst, a slowdown occurs, and then a complete stop. motor functions. Death occurs either from prolonged immobilization or from the presence of severe concomitant diseases. It is very difficult to distinguish from dementia vascular origin, because in old age, as a rule, most patients have atherosclerosis and hypertension.

Treatment

Treatment of dementia of the Alzheimer's type is symptomatic and is aimed at reducing the manifestations of the disease and stabilizing pathological process. In the presence of concomitant diseases, therapy includes correction of the necessary physiological processes(treatment of atherosclerosis, diabetes, etc.). At the early stage of the development of dementia, drugs from the group of nootropics (Cerebrolysin, Piracetam), which improve blood circulation in the vessels of the brain (Nicergoline), and dopamine receptor stimulants (Piribedil) are recommended. It is also possible to prescribe Actovegin (improves oxygen utilization), Phosphatidylcholine (stimulates the functioning of neurons in the cerebral cortex). At the moderate and severe stage, an acetylcholinesterase inhibitor (Donepezil) is added to the above treatment. In the presence of depressive disorder or increased anxiety– antidepressants and tranquilizers, respectively. Additionally, it is recommended to train your memory every day, solve crossword puzzles, and read books.

A comprehensive approach to dementia can improve social adaptation, smooth out the clinical picture and ease the burden on those caring for the patient.

Conclusion

Alzheimer's type dementia is chronic disease with a steady, progressive course. The earlier it was detected, the greater the chance to improve the prognosis and achieve stable remission. Patients under 60-65 years of age often develop neurological symptoms in the form of disturbances in gait, speech, and loss of the ability to recognize previously familiar objects. Listen to your loved ones and take care of your health!