dementia based on DSM-IV includes: - vascular dementia - dementia associated w/ medical conditions - head trauma - pick's disease - creutzfeldt-jakob's disease - parkinson's disease - HIV - huntington's disease

1. DEMENTIA
(continued)
Commonly called “childishness.”
It is a condition of mental
declination that occurs in
certain older persons. The basic
change is a progressive
deterioration of the nerve cells
within the brain in which the
person affected was
progressively having difficulties
in intellectual activities;
defective memory, reduced
ability to understand what is
taking place, and disorientation
for time and place.

2. 290.4x
VASCULAR
DEMENTIA
(formerly MULTI INFARCT
DEMENTIA)

3. • A permanent cognitive impairment caused by
an interruption of the blood supply to the
brain.
• Stroke may increase the risk of dementia but
not all who had strokes will proceed to have
vascular dementia.
• Onset is earlier than Dementia of the
Alzheimer’s
• More common in males

8. RISK FACTORS FOR VASCULAR DEMENTIA
DIABETES OBESITY
HEART DISEASE LACK OF EXERCISE
UNHEALTHY DIET WITH HIGH
AMOUNTS OF SATURATED FATS
SMOKING
LONG TERM ALCOHOL ABUSE INCREASING AGE
ATHEROSCLEROSIS HIGH CHOLESTEROL
ATRIAL FIBRILLATION
HISTORY OF HEART ATTACK,
STROKES, OR MINI STROKES

9. DEFINITE RISKS
AGE APOE - E4 (whites)
ATRIAL FIBRILLATION DEPRESSION
DOWN SYNDROME FAMILY HISTORY

10. POSSIBLE RISKS
DELIRIUM HEAD TRAUMA
HEAVY SMOKING HYPERCHOLESTEROLEMIA
HYPERTENSION LOWER EDUCATIONAL LEVEL
OTHER GENES
POSTMENOPAUSAL HORMONE
THERAPY

11. NEUROPSYCHAIATRIC SYMPTOMS
PSYCHOTIC SYMPTOMS
(HALLUCINATION, DELIRIUM)
DEPRESSIVE SYMPTOMS
APATHY AGITATION AND AGGRESSION

12. DIAGNOSTIC CRITERIA
A. The development of multiple cognitive deficits manifested by both
1. Memory impairment
2. One or more of the following cognitive disturbances
a. Aphasia
b. Apraxia
c. Agnosia
d. Disturbance in executive functioning

13. SUBTYPES
• With Delirium (290.41) – if delirium is
superimposed on the dementia
• With Delusions (290.42) – delusions are the
predominant feature
• With Depressed Mood (290.43) – if
depressive mood (including presentation of
symptoms of Major Depressive Episode) is
predominant
• Uncomplicated (290.40) – if none of the other
subtypes predominates

14. Dementia Associated with
Other Medical Conditions

15. (294.1)
Head TRAUMA

16. Traumatic Brain Injury
• Commonin both young and old but for the
dementia,the old aged are more at risk.
• 2 most common causes of TBI: driving and falls
• May also be caused by penetratinghead injuries
• Dementiapugilistica – a sports related type of
dementiadue to repetitivehead injuries
– Characterized by cognitive symptoms of dementia,
various personality changes, extrapyramidal symptoms
(e. i, Parkinson’s disease).

17. Traumatic Brain Injury

18. Pick’s Disease
(290.10)
• Similar to Alzheimer’s except that the first symptom of
this disease is personality change followed by memory
loss.
• People with this disease have Pick cells inside nerve
cells in the damaged area of the brain.
• Protein tau is normally found in nerve cells but people
with this disease have an abnormal amount of this
protein.
• May also be hereditary.
• It can occur in people as young as 20, but usually
begins between ages 40 and 60. The average age at
which it begins is 54.

19. • This disease gets worse slowly for the tissues in
the frontal and temporal lobes start to shrink over
time
• People with Pick's disease tend to behave the
wrong way in different social settings. The changes
in behavior continue to get worse and are often
one of the most disturbing symptoms of the
disease. Some patients will have more prominent
difficulty with decision making, complex tasks, or
language (trouble finding or understanding words
or writing).

21. Creutzfeldt-Jakob Disease
(290.10)
• A form of brain damage that leads to rapid decrease
of mental function and movement
• May be associated with mad-cow disease (cattle),
chronic wasting disease (deer), Kuru (in New Guinea
women who ate the brains of dead relatives as part of
a ritual), scrapie (sheep), and fatal familial insomnia
(humans)
• Caused by prions – proteins that can produce on their
own and can be infectious. The diseases caused by
this proteins are called spongiform diseases for the
deterioration of the brain of an infected individual is
in the form of holes giving it a sponge-like appearance

22. • Occurs spontaneously in 1 out of a million people
• Strikes people at the age of 50-75
• Can be caused by exposure to contaminated
products. Other cases have occurred when people
were given corneal transplants, other tissues, or
blood transfusions from infected donors. It may
also have been caused by contaminated
electrodes used in brain surgery (before
instruments started to be properly disinfected).
• Symptoms are dementia, muscle twitching, and
vision problems

24. PARKINSON’S DISEASE
(294.1)

25. • It is a chronic progressive disorder that usually
occurs in middle-aged or elderly persons,
characterized by slow movement, muscle
rigidity, tremor, and progressive weakness.
• Early Parkinsonism may be a sequel of
encephalitis (serious inflammation of brain
tissue) or when the cells of the brain were
deprived of their supply of oxygen for at
least five to ten minutes resulting to
a permanent damage to the brain.

26. • This mainly results from the death of the cells
in the brain that produce the neurotransmitter
dopamine.
• There may be tremors, but the most common
tremor to the Parkinson’s patients is the
repetitive movement by which the tips of the
fingers brush past the ball of the thumb –
“pill-rolling movement”
• Tremors are worse when the patient
is tired or excited

28. Human Immunodeficiency Virus
(294.9)
• Also known as the Acquired Immunodeficiency
Syndrome
• HIV dementia complex is caused by the HIV itself
• HIV may affect the brain through several mechanisms.
Viral proteins may damage nerve cells directly or by
infecting inflammatory cells in the brain and spinal
cord. HIV may then induce these cells to damage and
disable nerve cells. HIV appears to cause generalized
inflammation, which causes chronic disease, memory
issues, accelerated aging processes, heart disease, and
other diseases.

29. • Common symptoms include decline in
thinking, or "cognitive," functions such as
memory, reasoning, judgment, concentration,
and problem solving.
• Other common symptoms are changes in
personality and behavior, speech problems,
and motor (movement) problems such as
clumsiness and poor balance.

31. Huntington’s Disease
(294.1)
• Huntington’s disease is a hereditary disease
characterized by disorders of
movement, progressive dementia, and
psychiatric/ behavioural disturbance.
– Chorea – purposeless jerking, involuntary
movements, and progressive mental
deterioration

32. Sub-cortical regions – thalamus, hypothalamus,
cerebellum, brain stem
• Patients with HD find challenges in accomplishing
cognitive tasks that require retrieval and
synthesis of known facts, such as forming
abstractions. They can accomplish tasks that
require semantic memory under the right
conditions, though, they have difficulties in
retrieving facts/ information and remembering
new information.

36. TREATMENTS FOR DEMENTIA
TREATMENTS WHEN DEMENTIA CAN BE REVERSED
TAKE VITAMINS OF A DEFICIENCY OF B12
TAKE TYROID HORMONES FOR HYPOTHYROIDISM
HAVE SURGERY TO REMOVE BRAIN TUMOR OR TO REDUCE
PRESSURE
STOP OR CHANGE MEDICINES THAT CAN CAUSE MEMORY LOSS
OR CONFUSION
TAKE MEDICINES TO TREAT INFECTIONS SUCH AS ENCEPHALITIS
TAKE MEDICINE TO TREAT DEPRESSION
GET TREATMENT FOR REVERSIBLE CONDITIONS CAUSED BY AIDS

37. TREATMENTS FOR DEMENTIA
TREATMENTS WHEN DEMENTIA CANNOT BE REVERSED
TIPS TO HELP THE PERSON BE INDEPENDENT AND MANAGE
DAILY LIVING
MEDICINES CANNOT CURE DEMENTIA BUT IT CAN HELP THE
PERSON IMPROVE MENTAL FUNCTION, MOOD, AND BEHAVIOR
A DIAGNOSIS OF DEMENTIA CAN CREATE FEELINGS OF ANGER,
FEAR, AND ANXIETY. A PERSON IN THE EARLY STAGE OF THE
ILLNESS SHOULD SEEK EMOTIONAL SUPPORT FROM FAMILY,
FRIENDS, AND PERHAPS A COUNSELOR EXPERIENCED IN
WORKING WITH PEOPLE WHO HAVE DEMENTIA.

38. Elyza Mae D.