dementia

2. What is dementia?

3. 


5. 

6. 
vascular dementia)
Global hypoxic ischemic injury)

Alzheimer disease)
(neurofibrillary tangles
NFTs (senile plaques
SPs)

9. 
2-10 1-3
Alzheimer’s disease:
AD)
Vascular dementia:
VaD)

96

12. 1.
normal ageing change)
2.
mild
cognitive impairment : MCI)
3. delirium)
4. depression:
pseudodementia)
5.

13. 

14.  1.
 2.
 3.
 4.

15. 

 basic
activities of daily living : basic ADL)

(instrumental activities of daily living : instrumental
ADL)


16. DSM
IV
American Psychiatric Association.
Diagnostic and statistical manual of mental
disorders , th edition. DSM-IV-TR.
Washington, D.C: American Psychiatric
Association;

17. 1. memory
impairment)
 aphasia)
 apraxia)
motor system
extrapyramidal system
 agnosia)
 disturbance of

18. 

delirium)


20. 
DEMENTIA
 Drug toxicity
 Emotional disorder
 Metabolic endocrine disorder
 Eye and Ear disorder
 Nutritional disorder (thiamine, folate, B and B
deficiency) / Normal pressure hydrocephalus
 Tumor (primary secondary brain tumor)
Trauma
 Infection
 Arteriosclerosis (vascular dementia) Alcohol

hydrocephalus)
VDRL
reversible arrestable dementia)

21. 
-
-
Alzheimer's Association. 2010 Alzheimer's
disease facts and figures. Alzheimer's &
Dementia. Mar 2010;6:158-194.

22. 
hydrocephalus;


23. 

24. 
motor sign)
tone)
hyperreflexia)
spastic gait,
hemiplegic gait, parkinsonian gait
posture abnormality)
stooped posture)
extended
posture)
movement

25. 
corticobulbar
tract, corticospinal tract
extrapyramidal pathway
subcortex

Subcortical

cortical
cortical AD frontotemporal
dementia (FTD)

26. 
 complete blood
count (CBC), chemistry panel (renal function
tests, liver function
test), electrolyte, Calcium, thyroid function test
, B folate level
ESR , Urinalysis,
Toxicology, CXR, Heavy metal screen, HIV
test, Syphilis serology, CSF
examination, EEG, PET or SPECT

28.  biomarkers
CSF
presemilin , presenilin amyloid
precursor protein mutation
Apolipoproteint E-

MoCA test, DemTect,
BNA, GPCOG MS

30. 4

cognitive dysfunction)




31. 
Mini Mental Status
Examination MMSE)
8
Time
oreintation)
5
Place
oreintation)
5
Registration)
3
Attention and
calculation)
5 serial sevens)
world
Recall) 3
Language) 2
1

32.  30 25

33. 
CT)
MRI)
infarction)
CT)
white matter)
MRI)
T1, T2 signal)

36. 
 1.
estrogen replacement therapy
( , NSAID
 2.
acetylcholinesterase
inhibitors)

37.  3. psychosis)
(1)
(2)
(3)
neuroleptic drug) 2
haloperidol (Haldol)
risperidone (Risperdal)
quetiapine (Seroquel) 15
1-2 olanzapine (Zyprexa) 2.5

38.  4. Anxiety)
“ ”
 1) Buspirone (BuSpar) 5 2
 2) Benzodiazepines Xanax
 3) trazodone 50

39.  5. Depression
 1) slow down
 2)
 3)
30 5
2
 4)
cognitive therapy
 (5)
 6) phototherapy)

40. 
(1) Selective serotonin reuptake
inhibitors (SSRI)
Sertraline (Zoloft) 25-50 Paroxetine
(Paxil) 10-20
(2) Tricyclic antidepressants
 SSRI (selective serotonin reuptake inhibitor)

41.  6..

Diphenhydramine (Benadryl) 25-50
Chloral hydrate (500-1000
Zolpidem 5-10

42.  7.

oxybutynin (Ditropan)
2.5 – 5 tolterodine (Detrol) 2
 Parkinsonism
levodopa carbidopa
NSAID )


43. 




44. 

45. 
3




46.  (
)

/


47. 


48. 
1.
2.
/ / /
3.
4.




49.  Folstein MF, Folstein SE, McHugh PR (1975). Mini-mental state. A
practical method for grading the cognitive state of patients for the
clinician". J of Psychiatric research 1975; 12 (3): 189–
98. doi:10.1016/0022-3956(75)90026-6.PMID 1202204.

 Jellinger KA. Morphologic diagnosis of "vascular dementia" - a
critical update. J Neurol Sci. Jul 15 2008;270(1-2):1-12. [Medline].
 Jellinger KA. The pathology of "vascular dementia": a critical
update. J Alzheimers Dis. May 2008;14(1):107-23. [Medline].
 Alzheimer's Association. 2010 Alzheimer's disease facts and
figures. Alzheimer's & Dementia. Mar 2010;6:158-194. [Medline]
 Savva GM, Wharton SB, Ince PG, Forster G, Matthews FE, Brayne
C. Age, neuropathology, and dementia. N Engl J Med. May
28 2009;360(22):2302-9. [Medline].
 Green RC, Roberts JS, Cupples LA, Relkin NR, Whitehouse PJ,
Brown T, et al. Disclosure of APOE genotype for risk of Alzheimer's
disease. N Engl J Med. Jul 16 2009;361(3):245-54. [Medline].
 Weintraub D, Rosenberg PB, Drye LT, et al. Sertraline for the
Treatment of Depression in Alzheimer Disease: Week-24
Outcomes. Am J Geriatr Psychiatry. Feb 2010;18(4):332-
40. [Medline].