TALKING ABOUT

SIGNS OF DEMENTIA

By:

GROUP 1

Ni Kadek Dian Karmila Yanti (P07120219056)

Putu Arsienda Dahata Ulmafema (P07120219060)

Dewa Ayu Putri Widyani (P07120219071)

Ni Nyoman Triyana Sari (P07120219079)

Putu Mia Rusmala Dewi (P07120219083)

Ni Kadek Yuni Anggreni (P07120219088)

Ni Komang Indah Kusuma Dewi (P07120219091)

Kadek Sari Savitri (P07120219094)

Komang Nova Sadana Yoga (P07120219102)

II.B S.Tr Keperawatan

Ministry Health of Republic Indonesia

Polytechnic of Health Denpasar
School Year 2021
 Talking About Dimentia

A. What is Dimentia?
Dementia is a global intelectual decline of sufficient severity to impaired
social and or occupational functioning that occurs in normal consciousness. Dementia
is a syndrome, usually of a chronic or progressive nature in which there is
deterioration in cognitive function (that is the ability to process thought) beyond what
might be expected from normal ageing. It affects memory, thinking, orientation,
comprehension, calculation, learning capacity, language, and judgement.
Consciousness is not affected. The impairment in cognitive function is commonly
accompanied, and occasionally preceded, by deterioration in emotional control, social
behaviour, or motivation.
B. Signs of dementia
Ten warning early signs of dementia :
1. Dementia and memory loss
It is normal to occasionally forget appointments and remember them later. A
person with dementia may forget things more often or not remember them at
all.
2. Dementia and difficulty with tasks
People can get distracted and they may forget to serve part of a meal. A person
with dementia may have trouble with all steps involved in preparing a meal.
3. Dementia and disorientation
A person with dementia may have difficulty finding their way to a familiar
place or feel confused about where they are, or think they are back in some
past time of their life.
4. Dementia and language problems
Everyone has troble finding the right word sometimes, but a person with
dementia may forget simple words or substitute inappropriate words, making
sentences difficult to understand. They may also have trouble understanding
others.
5. Dementia and changes in abstract thinking
Managing finances can be difficult for anyone, but a person with dementia
may have trouble knowing what the numbers mean or what to do with them.
6. Demential and poor judgment
 Many acivities require good judgement. When this ability is affected by
dementia, the person may have difficulty making appropriate decisions, such
as what to wear in cold weather.
7. Dementia and poor spatial skills
A person with dementian may have difficulty judging distance or direction
when driving a car
8. Dementian and misplacing things
Anyone can temporarily misplace a wallet or keys. A person with dementia
may not know what the keys are for.
9. Dementia and mood, personality or behavior changes
Everyone becomes sad or moody from time to time. Someone with dementia
can have rapid mood swings, for no apparent reason. They can become
disinhibited or more outgoing
10. Dementia and loss of initiative
It is normal to tire of some activities. Dementia may cause a person to lose
interest in previously enjoyed activities or require cues prompting them to
become involved.
C. Causes of Dementia
There are many brain disorders that cause dementia. The cur-rently recognized causes
of dementia are represented in the pie chart shown in Figure 1-2. Each type has a
distinctive profile of symptoms and course.

Figure 1-2 Causes of dementia by percentage of patients.

Alzheimer Disease

Alzheimer disease (AD) is the most common cause of dementia and thus the most
common type that nurses encounter in clin-ical practice. AD is an incurable
neurodegenerative disease. The

hallmark pathology of AD includes amyloid plaques and neu-rofibrillary tangles in

the brain. One also sees general shrinkage of the brain and a decrease in the number of
functioning neurons. Currently, there is no cure for Alzheimer disease, and treat-
ments that are available may impact the symptoms but do not slow down the disease
process. Alzheimer disease affects differ-ent patients in different ways, and progresses
steadily until patients are completely disabled. The disease typically pro-gresses
through three stages (Table 1-2).

Patients with AD live 4 to 20 years after diagnosis. The most common causes of death
are from aspiration of food or fluids into the lungs and from the complications of
immobility, as patients are unable to walk.

Vascular Dementia

Vascular dementia (VD), resulting from impaired blood supply to the brain, is the
second most common form of dementia. The most common cause of VD is a series of
small, often unde-tectable strokes in the brain. Such strokes disrupt the flow of blood,
oxygen, and nutrients to the affected area. The clinical picture of dementia emerges
when a total of 50 mL of brain tissue is damaged. VD can occur along with AD, and
is then called mixed dementia. The changes in functioning can occur suddenly or
gradually as more and more tissue is damaged.

Lewy Body Dementia

Lewy body dementia (LBD) is characterized by progressive cog-nitive decline. Other

features distinct to those with LBD are:

 Fluctuations in consciousness
 Recurrent visual hallucinations
 Parkinsonism motor symptoms4

The fluctuations in consciousness are evidenced by periods of drowsiness, lethargy,

and staring into space. Nurses are often concerned that the staring into space is an
early sign of aggres-sion. This is typically not a deliberate behavior to threaten the
nurse, but a result of the brain disease. Patients with LBD often prefer to spend long
periods of time in bed sleeping. The visual hallucinations are often quite vivid, and
patients can describe them in detail. In many cases, the hallucinations are not frighten-
ing or disturbing. Patients with LBD are very sensitive to neu-roleptic medications,
and thus hallucinations are difficult to treat. The parkinsonism motor symptoms result
in slowed move-ment and poor balance, resulting in falls and muscle rigidity. In some
cases these symptoms are helped by the use of the same medications used for
Parkinson disease such as levodopa.

Lewy body dementia is described as having three stages: early, middle, and late.

 Early stage: Forgetfulness, poor concentration, unstable gait and depression.

 Middle stage: Worsening cognition that fluctuates and is often worse at night.
Visual and auditory hallucinations and para-noid delusions. Falls become
more frequent.
 Late stage: Rapid progression of cognitive decline, increase in frequency of
behavioral disturbance, shouting, and aggression. Death occurs within months,
in many cases, and is most often secondary to aspiration pneumonia.

Treatment of LBD focuses on the Parkinson-like features and the hallucinations and
paranoid delusions. Medications approved for Alzheimer disease are often used and
are helpful for cognitive dysfunction in some patients.

Frontotemporal Dementia

Frontotemporal dementia (FTD) primarily affects the frontal and anterior temporal
lobes. In contrast to other types of dementia, personality, behavior, and language
ability are affected first, and memory is often normal until late into the disease. As a
result, the following features are characteristic of FTD:

 Disinhibited and inappropriate social behavior

 Inappropriate sexual behavior
 Loss of concern about personal hygiene and appearance
 Major increase in appetite and weight gain
 Apathy
 Lack of concern for others
 Compulsive and repetitive behaviors such as touching, collecting things
 Putting objects into mouth
 Memory loss (this evolves after the above symptoms)
Other Causes of Dementia Around 10% of dementia cases are caused by more
rare condi-tions described in Table 1-3.
 CONCLUSION

Dementia is a global intelectual decline of sufficient severity to impaired social and or

occupational functioning that occurs in normal consciousness. Dementia is a syndrome,
usually of a chronic or progressive nature in which there is deterioration in cognitive function
(that is the ability to process thought) beyond what might be expected from normal ageing.
There are ten warning signs of dementia viz Dementia and memory loss, Dementia and
difficulty with tasks, Dementia and disorientation, Dementia and language problems,
Dementia and changes in abstract thinking, Demential and poor judgment, Dementia and
poor spatial skills, Dementian and misplacing things, Dementia and mood, personality or
behavior changes, and Dementia and loss of initiative.
REFERENSI :
Cynthia D. Steele. 2010. Nurse to Nurse DEMENTIA CARE. Maryland; McGraw-Hill
Companies, Inc.
https://www.who.int/news-room/fact-sheets/detail/dementia
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/dementia-early-signs