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1. TOPIC:-
DEMENTIA
Guided By:- Kriti Boral
Presented By:- Satabdi
Mishra(BASLP, 2nd Sem)

3. DEFINITION
 Dementia describes a group of symptoms affecting memory, thinking
and social abilities severely enough to interfere with your daily life. It
isn't a specific disease, but several different diseases may cause
dementia.
(According to myoclinic.com)
 Dementia is a syndrome resulting from acquired brain disease. It is
characterized by a progressive decline in memory and other cognitive
domains that, when severe enough, interferes with daily living and
independent functioning.
(According to ASHA, 2005)

4. Dementia is an acquired global impairment of intellect, memory and
personality but without impairment of consciousness.
It is a progressive impairment of cognitive functions , memory and
attention.
It is an acquired neurological disorders.
Dementia is a group of disease characterised by impairment of
atleast two brain functions, such as memory loss and judgement.
Dementia is a syndrome in which there is deterioration in memory,
thinking, behaviour and the ability to perform everyday activities.

5. EPIDEMIOLOGY
The prevalence of dementia is rapidly increasing.
More than 25 million people suffered from dementia in 2000.
Age is the leading risk factor for dementia.
Alzheimer's disease accounts to about 50 to 75 percent of
dementia cases, Lewy bodies at 15 to 35 percent and vascular
dementia 5 to 20 percent of dementia cases.

6. CAUSES OF DEMENTIA
1. Alzheimer’s disease:- Alzheimer's disease is the most common cause of
dementia, accounts for an estimated 60-80 percent of cases. Lack of interest in
day-to-day activities, problems with language, problems with abstract thinking are
early signs of this disease.
2.Traumatic Brain Injury:- This condition is most often caused by repetitive head
trauma. Depending on the part of the brain that's injured, this condition can cause
dementia signs and symptoms such as depression, explosiveness, memory loss
and impaired speech. TBI may also cause parkinsonism. Symptoms might not
appear until years after the trauma.

7. 3. Neurological degenerative diseases:- Some neurodegenerative diseases
such as Pick’s disease, Huntington’s disease, Parkinson's disease are the main
causes of dementia.
a. Pick’s Disease/Frontotemporal dementia:- This is a group of diseases
characterized by the breakdown (degeneration) of nerve cells and their
connections in the frontal and temporal lobes of the brain, the areas generally
associated with personality, behaviour and language. Common symptoms affect
behaviour, personality, thinking, judgment, and language and movement.
b. Parkinson’s Disease:- Many people with Parkinson's disease eventually
develop dementia symptoms (Parkinson's disease dementia).
c. Huntington’s Disease:- Caused by a genetic mutation, this disease causes
certain nerve cells in your brain and spinal cord to waste away. Signs and
symptoms, including a severe decline in thinking (cognitive) skills, usually appear
around age 30 or 40.

8. Characteristics Of dementia
◦ Distraction.
◦ Forgetfulness and confusion.
◦ Problem setting goals and making plans.
◦ Problem following conversation.
◦ Trouble telling others what they want or need.
◦ Behaviour and personality changes.
◦ Depression.
◦ Trouble eating and swallowing.
◦ Sudden mood swings.
◦ Language and communication problems.

9. ◦ General confusing, disorientation.
◦ Problems with words in speaking and writing.
◦ Difficulty in problem solving skills.
◦ Difficulty completing familiar tasks.
◦ Decreased or poor judgement.
◦ Withdrawal from work or social activities.
◦ Troubling understanding visual images and spatial relationships.
◦ Misplacing things and losing the ability to retrace steps.
◦ Trouble doing familiar activities.
◦ Memory loss that disrupts daily life.
◦ Reduce concentration.

10. DIAGNOSIS
Case history.(Medical status, Demographic information, Spoken language)
Physical and neurological examination:-
Neurological examination mobility and balance.
Cranial nerve examination.
Audiological assessment:-
It is important that older people with dementia have regular hearing
check up . It can be more challenging to diagnose hearing loss for people with
dementia. A person has dementia may well find it hard to understand instructions
given during the diagnostic process or they may be unable to report the history of
their hearing loss because of their memory problem.

11. Neurological Evaluation:-
MRI and CT scan
◦ A CT scan can be used to check for signs of stroke or a brain tumour.
◦ An MRI scan is recommended to:-
Help confirm a diagnosis of dementia and the type of disease causing the dementia
Provide detailed information about the blood vessel damage that occurs in vascular
dementia.
Show shrinkage in specific areas of the brain – for example, the frontal and temporal
lobes are mainly affected by shrinkage in frontotemporal dementia, while usually just
the temporal lobes are affected in the early stages of Alzheimer's

12. Cognitive assessment:-
People with symptoms of dementia are given tests to check their
mental abilities, such as memory or thinking. Most tests involve a series of pen-
and-paper tests and questions, each of which carries a score. These tests assess
a number of different mental abilities, including:
◦ short- and long-term memory
◦ concentration and attention span
◦ language and communication skills
◦ awareness of time and place (orientation)
Evaluation for speech and language:-
The SLP determines the most appropriate assessment protocol based on the
stage of dementia and the individual’s communication needs and wishes.

13. The information gathered during the assessment will guide the development of
person-centered intervention focused on maximizing the individual’s ability to
participate in meaningful activities.
The protocol may include standardized and non standardized assessment tools
and a variety of other data sources, including clinical observations in the home or
long-term care setting.
 These observations provide personally relevant information about the
individual’s cognitive-communication strengths and needs in everyday situations.

14. Treatment
Cognitive stimulation therapy(CST) is a group treatment for individuals with mild to moderate
dementia. Group CST treatment involves 14 or more sessions of themed activities, which typically
run twice weekly. CST uses theme-based, mentally stimulating, relevant activities aimed at
improving cognitive function (e.g., thinking, concentration, and memory). Individuals are actively
engaged in optimal learning environments—typically, in a small-group setting.
Environmental modifications are changes or adaptations to the environment to improve overall
functioning in individuals with dementia. They are designed to support communication needs and
abilities by reducing barriers and minimizing the impact of impaired body function.
Hearing Assistive Technology Systems (HATS) can be used to enhance face-to-face
communication. HATS are available for individuals with hearing loss who currently use hearing
aids or have cochlear implants and for individuals with untreated hearing loss. HATS include FM
systems, induction loops, and personal amplification devices. HATS may be appropriate for
individuals with dementia who have hearing loss.

15. External memory aids in the form of tangible prompts (e.g., photographs, familiar
items, and music from the past) are used in reminiscence therapy to stimulate
conversations about past events, activities, and experiences. The customized
nature and individual focus of reminiscence therapy make it well suited for
individuals from diverse backgrounds (Harris, 1997).
Individuals progressing through the stages of dementia may experience
increasing difficulties surrounding mealtime, including behavioural challenges
(e.g., forgetting to eat)). Depending on the needs of the individual, goals may
focus on one or more of the following:
Improving the ability to eat and swallow safely
Increasing intake to improve nutrition and hydration
Encouraging engagement and participation in the mealtime experience