PREDISPOSING DEMENTI A PRECIPITATING

FACTORS: General term for the impaired ability FACTORS:

- Advancing Age to remember, think, or make - Smoking
- Genetics decisions that interferes with doing - Alcohol Use
everyday activities. - Hypertension- Vascular
- Sex- Women have
higher risk dementia
- Mild cognitive - Diabetes Mellitus
impairment Etiology - Obesity
- Neurotransmitter - Lack of physical
changes- Acetylcholine activity and poor diet
- Vascular abnormalities - Low levels of cognitive
- Stress hormones PATHOPHYSIOLOGY OF PATHOPHYSIOLOGY OF engagement
- Circadian changes ALZHEIMER'S DISEASE (AD) VASCULAR DEMENTIA - Depression
- Seizure disorders - Traumatic brain injury
- Social isolation
Vascular insuficiency/ Vessel
Abnormal processing of pathology
amyloid precursor protein
- Reduction in Choline
Ischemic injury/ Vascular
Acetyltransferase
Hyperphosphorylation brain injury
(ChAT)
Aggregation of of
Inflammation - Reduction in
amyloid-ß microtubule-stabilizing Acetylcholinesterase Secondary
tau protein (AChE) neurodegeneration
- Extracellular deposition of
beta-amyloid (Aß) Formation of Decline in acetylcholine
- Extracellular neuritic/senile intracellular neurotransmitter SUBTYPES OF
Neuronal Dysfunction
plaques (amyloid-ß core neurofibrillary tangles VASCULAR DEMENTIA:
surruounded by activated (NFT) composed of - Muti infarct dementia
microglia and reactive hyperphosphorylated - Stroke induced
astrocytes) tau dementia
- Sub-cortical vascular
VASCULAR DEMENTIA dementia
- Disruption of Ca2+ - Mixed Dementia
homeostasis
- Free radical production Clinical
- Excitotoxicity Manifestations Behavioral Locomotor Loss of executive
- Inflammation Symptoms: Problems: function:
- Memory Loss - Gait - Problem solving
- Slowed disturbance - Working memory
- Neuronal Loss Impairments in nerve thinking - Dysarthia - Judgement
- Atrophy in temporofrontal cortex impulse transmission - Depression - Autonomic - Rasoning
- Anxiety dysfunction

Clinical ALZHEIMER'S DISEASE

- Mental Health - Mental Health - Mental Health
Manifestations Status Status Status
assesment assesment assesment
Lack of Deficit in Executive Motor Neuropsychiatric: - Health history - Health history - Health history
Inattention and
orientation to episodic and planning Dysfunction: Delusions, - Physical exam - Physical exam - Physical exam
lack of
person, time, semantic dysfunction: Myoclonic apathy,
concentration
and place memory visouspatial seizure, irritability,
abnormalities, primitive aggression
anosgosia reflexes,
- Physical - Physical PHARMACOLOGICAL MEDICAL MANAGEMENT:
incontinence,
Examination Examination - Mental Health MANAGEMENT:
- Mental Health apraxia - Mental Health
- Mental Health - Mental Health Status - Cholinesterase inhibitors-
Status Therapies to manage include:
Status Status Status assesment
assesment enhance acetylcholine uptake - Music Therapy
assessment assessment assesment - Health history - Physical
- Health history in the brain - Reminiscence therapy
- Health History - Health History Examination
- Antipsychotic agents - Cognitive stimulation therapy
- Mental Health
- Anticonvulsant (CST)
Status assessment
- Antidepressant; Selective
- Health History
serotonin reuptake inhibitors
- CT Scan, MRI
- Treatment of underlying cause:
Antihypertensives, -Statins,
anticoagulants, Antidiabetic
PHARMACOLOGICAL MEDICAL MANAGEMENT: medications
MANAGEMENT:
- Cholinesterase inhibitors- Therapies to manage include:
enhance acetylcholine uptake - Music Therapy
in the brain - Reminiscence therapy
- Antipsychotic agents - Cognitive stimulation therapy
- Anticonvulsant (CST)
- Antidepressant; Selective
serotonin reuptake inhibitors

DEMENTIA

Nursing Diagnosis 1: Impaired Memory Nursing Diagnosis 2: Disturbed thought Nursing Diagnosis 3: Risk for Injury
process
Nursing Responsibilities:
Nursing Responsibilities: Nursing Responsibilities:
- Assess the patient?s overall cognitive
- Assess the patient?s ability for thought - Assess the degree of impaired ability of
function and memory.
processing every shift. competence, the emergence of impulsive
- Assess the patient for sensory
- Assess the level of cognitive impairment behavior, and a decrease in visual
deprivation, concurrent use of CNS drugs,
- Assess the patient?s ability to cope with perception.
poor nutrition, dehydration, infection, or
events, interests in surroundings and - Assess the patient?s surroundings for
other concurrent disease processes.
activity, motivation, and changes in hazards and remove them.
- Orient the patient to the environment as
memory pattern. - Eliminate or minimize sources of hazards
needed if the patient?s short-term memory
- Maintain a regular daily routine to prevent in the environment.
is intact. The use of calendars, radio,
problems resulting from thirst, hunger, - Instruct family to apply protective guard
newspapers, television, and so forth are
lack of sleep, or inadequate exercise. over electrical outlets, thermostats, and
also appropriate.
- Allow the patient the freedom to sit in a stove knobs.
- Encourage the use of complementary and
chair near the window, utilize books and - Instruct family to double lock doors and
alternative therapies such as exercises,
magazines as desired. windows, swimming pool areas, and
guided meditation, massage.
- Provide positive reinforcement and install pressure-sensitive buzzers on
feedback for positive behaviors doors.
- Limit decisions that the patient makes. - Maintain adequate lighting and clear
pathways.