Diagnosis and treatment of dementia in the elderly

People with dementia often have an insidious onset. In some cases, the disease will recover on its own, or after treatment will be restored. Patients with Alzheimer's disease progress gradually.

People with dementia often have the following manifestations:
Impaired memory Cognitive function decline Intellectual ability decline Benign memory impairment in the elderly or mild cognitive impairment, symptoms Although this syndrome does not cause a decrease in daily functioning, it can progress to dementia within 18 months. Delirium: reduced attention and consciousness Currently, the diagnosis of dementia in the elderly will be based on the following factors:
1.1 Based on diagnostic criteria

Cognitive decline: Patients will be tested for dementia by reading the numbers forward and backward. Besides, the patient will probably hear three words, after about 5 minutes will ask to repeat. Or you can test the patient's memory by looking at three objects, then putting them away and asking the patient to read them again. Another test that can be given is to have the patient listen to a passage and then ask the patient to retell it.
To test the patient's long-term memory, it is possible to ask questions about the patient himself and then verify through the words of a loved one. Ask questions that are appropriate to the patient's background and culture to examine.
Cognitive disorders: Language disorders in people with dementia, including classical aphasia, difficulty finding words to express, also manifest in empty sentences, without complete nouns and verbs. When the patient is in the early stages, the patient should be asked to say as many animal names as possible. People with Alzheimer's disease will say no more than 10 animal names and will often have duplicate answers.
Difficulty performing movements even though motor function is still normal. Inability to identify objects although sensory functions are still normal Impaired ability to plan, organize... Abstract ability is impaired, the patient is unable to classify similarities and differences between objects... When the patient is delirium, these impairments will not occur. 1.2 Based on the patient's history It is necessary to find out the patient's history about information such as medical records, prescriptions, test results, dementia assessment tests...
Need to verify symptoms symptoms of acute, subacute, or gradual onset. If symptoms are acute in onset, it is more likely that the patient has delirium rather than dementia. Perform differential diagnoses with infectious, vascular, traumatic, psychiatric, or other causes. If the onset of symptoms is subacute, it is common in infectious or cancerous causes. If symptoms are gradual, they are common in dementia.
1.3 General examination, including neurological examination Perform general examination, neurological examination to look for signs of cerebrovascular disease, Parkinson's disease...
1.4 Take psychological tests Perform Dementia assessment tests to distinguish between different forms of dementia and to monitor disease progression.

2.1 Use of drugs to slow the progression of the disease Use of acetylcholinesterase inhibitors to improve cognitive ability in people with Alzheimer's disease. Drugs include: donepezil in 1997, galantamine in 2001, rivastigmin in 2000.
All of these drugs have anticholinesterase effects in Alzheimer's disease, as well as increase executive function, memory.
2.2 Treatment of behavioral disorders in patients Change of living environment:
It is necessary to find out the factors that trigger the disease. Manage the patient's behavior while respecting the patient's need for control Increase exercise, participate in social activities Reduce the patient's pain and burden for caregivers. Patient needs to be safe Implement treatment for depression:
Need to recognize symptoms of depression Patient has choice and control Learn about patient's favorite activities Needs to increase awareness Insomnia treatment:
Do not use stimulants such as alcohol, beer, tobacco, coffee... Mental disorders need to be treated Antidepressants can make mood severe memory impairment Treatment of agitation and violence in the patient:
Need to find the triggering factor Choose the appropriate method of communication Change the patient's living environment Can use medication if Need Treatment of psychotic condition in the patient
Identify the patient's paranoid symptoms Use of old or new generation antipsychotic drugs 2.3 Use of neuroprotective drugs There are Nutritional Strategies Estrogen Use: Has an Unequivocal Effect in Slowing the onset of Alzheimer's Disease. n early treatment for good results. Use of Statins: They work to prevent amyloid deposition in the brain through cholesterol formation, not all statins are created equal and the evidence for efficacy remains controversial. argue. 2.4 Enhance social and physical activities Help patients integrate into society, not narrow and isolate themselves. Regular exercise, participating in social activities will have a positive effect on the prevention of dementia.
To care for someone with dementia, caregivers need to have certain knowledge, and most importantly, the patient needs to be examined and treated promptly by medical professionals.