Dementialiterally means loss or deterioration of the mind, and is popularly called dementia. Dementia; It shows a course depending on the severity of impairment in basic abilities such as doing one's daily life activities, cooking, repairing, using household items, taking care of one's hobbies, and washing and dressing, which are self-care activities. Since patients with dementia tend to feel ashamed of their forgetfulness and cover up their own shortcomings in the early days, they can only be noticed by their relatives with good observation. First of all, due to the defect of forgetting names, confusing people, and losing and recording information related to recent memory, it is evaluated as "old age" and trivialized by its relatives. Later, in addition to kitchen accidents such as deficiencies in cooking or forgetting the food on the stove, forgetfulness comes to the fore, starting with not being able to do repair work that he used to be able to do, getting lost in the house, or not being able to find his way and getting lost. Problems such as slowing down in movements or speech, irritability due to decreased skills, anger, deterioration in sleep and appetite levels, and ultimately a decrease in self-care and inability to meet daily needs without help are observed. This situation is a sign that a very difficult process awaits both him and his relatives.
The symptoms specific to dementia, such as weakness, numbness, visual field loss, are not the symptoms that we are used to revealing with classical neurological examination; There will be symptoms such as forgetfulness, speech impairment, difficulty in finding direction, difficulties in judging and problem solving, recognition disorder, impairment in manual skills, personality changes, anxiety, anxiety, restlessness, aggressive attitude, delusions and hallucinations due to the destruction in the areas of the brain where mental functions are carried out.
The symptoms of Dementia Syndrome can be classified into three main categories:
1. Cognitive,
2. Behavioral,
3. Functional (activities of daily living).
Among cognitive symptoms, although not absolute, the most common symptom belongs to the memory area. The patient or his/her relative complains about repeating the same questions, the same topics, losing personal belongings, forgetting appointments, leaving food on the stove, forgetting the stove was on. He complains about being sick. The impairment of visual-spatial functions manifests itself first in unfamiliar places, and gradually in the form of difficulty finding direction and sometimes getting lost in familiar places. Language impairment begins at an early stage with difficulty in naming and a narrowing of the vocabulary, and gradually turns into a fluency disorder in which comprehension is impaired, which is more evident in Alzheimer's Disease, or a halting speech disorder in which grammatical structure is also impaired, as is more evident in progressive speech disorder. It should be taken into consideration that the main complaint of a patient with progressive speech disorder, which is difficulty finding words, will often be expressed as "forgetfulness" by the patient and the patient's relatives. Due to practical skill impairments, the use of simple current devices (comb, scissors, toothbrush, tableware, etc.) may be impaired. He can perceive objects with his five senses, but may have difficulty naming and describing them. For example, when we show him a pen, he sees it but cannot recognize that it is a pen, or he hears a phone call but cannot recognize that it is a phone call. He looks at the face of someone he knows very well but cannot recognize who it is. Due to impairment in the field of executive functions, the patient tends to lose mental flexibility; They cannot interpret some idioms or proverbs, they have difficulty in planning their behavior, reasoning about individual and social problems, and producing appropriate solutions to the problems they encounter in daily life.
Behavioral symptoms include meaninglessness in the patient's facial expression, speaking little, moving slowly, loss of vitality, excessive demands for sexual intercourse resulting in loss of impulse control, overeating or not eating at all, inappropriate behavior in social environments, abusive speech or sexual harassment and words. In addition, those with thought disorders; There are many disorders such as accusing relatives of theft, their spouse's infidelity, which can be at the level of jealousy even towards a ten-year-old child, complaints about being abandoned, sometimes thinking that this is not my house and you will poison me, medication incompatibility, and the idea that others are replacing their relatives. Talking to or seeing people he cannot see, food tastes like poison, perception can be seen. Depression, anxiety, restlessness, cries and laughter that are incompatible with the mood, as well as aggression and purposeless movements such as folding sheets by hand, wandering around rooms, opening and closing doors may be observed.
Functional symptoms include continuing to work, traveling outside the home, They have difficulty performing activities such as shopping, handling financial tasks (bill payments, banking, etc.), using daily devices, pursuing hobbies, running the house, paying attention to self-care or hygiene (dressing, washing, feeding, toileting, etc.). .
The destruction process in dementia, especially inAlzheimerType Dementia; It is said that the human developmental process works in reverse, namely infancy, early-late childhood and adolescence. Accordingly, before the onset of Alzheimer's Type Dementia, the patient is like an adolescent who, although largely independent, requires adult supervision for some decisions. He resembles a 7- to 12-year-old school child with mild dementia who has gained a certain degree of independence at home and in familiar places outside the home, but who still requires supervision in complex functions that require social relationships and judgment. The person with moderate dementia is roughly like a preschool child between the ages of 2-6 who still needs supervision in home life and basic daily life events such as dressing, washing and eating. It is similar to a 0-2 year old baby with severe dementia who is completely dependent on parents (caregiver) 24 hours a day to survive. The heavy universe itself, that is, in the final period of destruction when all motor and speech abilities are gradually lost and completely bedridden; It can be understood as the opposite of the dynamic development of infancy, where sitting, walking, speaking and toilet control develop, and can be divided into sub-stages. Sleep disorders observed in the patient include jumping out of bed while dreaming, beating, falling, talking, screaming, difficulty falling asleep, interrupted sleep, Excessive daytime sleepiness is observed with symptoms such as waking up too early in the morning.
Alzheimer Type Dementia is the most common as it covers nearly 60% of all dementias. Other causes of dementia are mostly seen secondary to diseases caused by medical reasons. For example, cerebrovascular diseases, Parkinson's disease, metabolic diseases.
Alzheimer Dementia affects brain cells. Alzheimer's Type Dementia is diagnosed by clinical examination and a number of tests. In addition, the diagnosis is clarified with supporting imaging techniques and laboratory findings.
The drugs used in Alzheimer's Type Dementia are drugs developed against this washing. This shows how important early diagnosis and treatment is and how much it affects the quality of life for patients and their relatives. Since this disease is rapid and destructive, it will cause a shortening of the current aging period, as it is a prerequisite for inadequate care and physical diseases. The aim of the treatment will be to prevent the aging process from being affected by this disease as little as possible and to prevent the disease from occurring in a severe and short time.
In addition to appropriate drug treatment after the examination of the physician, which is very important, supportive and informative therapy training for the patient and the patient's relatives will be provided with this disease. The importance of how to live a facilitating life and how patient care should be in treatment is shared.
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