University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

298

Pages:

2
Author:

Mariam A.

Dementia Diagnosis and Causes      From Latin: “without mind”. The gradual onset and continuing decline of cognitive function from a previously higher level, resulting in impairment in social or occupational function. Impairment of recent memory (ability to learn new information) and disturbance of language, praxis, visual processing or executive function. The cognitive deficits are not due to other psychiatric, neurological or systemic diseases. Deficits do not exclusively occur in setting of delirium. DSM IV criteria  Memory impairment.  At least one of the following: o Aphasia: loss of comprehension and formulation of language. o Agnosia: loss of ability to recognise objects, persons, sounds, shapes or smells while the specific sense is not defective, nor is there any significant memory loss. o Apraxia: loss of ability to executive or carry out learned purposeful movements. o Disturbance in executive functioning.  Sufficient to cause social or occupational dysfunction.  Must represent a decline from a previous level of function.  Must not occur exclusively in the context of delirium. Epidemiology  Limitations to data retrieval: o Most epidemiological studies based on clinical diagnosis without pathologic validation. o Clinical diagnosis of the type of dementia may be unreliable, particularly outside specialist centres. o Hospital based series are biased towards severe dementia and may not reflect pattern of disease in community. o Different pathologic criteria for the diagnosis of degenerative diseases used in different studies.  Prevalence (number of cases in a population at any one time) is largely influenced by age. o Rate of dementia rises exponentially with age, at least up to 95 years old. o Roughly doubles with each subsequent 5 year increment.     Incidence (number of newly diagnosed cases in certain time interval) rises dramatically with advancing age. Given the ageing Australian population, prediction that without some forms of prevention: o Dementia prevalence estimated to increase from 172, 000 in 2000 to 588, 000 in 2050. o Over the same period, dementia incidence estimated to increase from 43, 000 to 143, 000 new cases per year. o Reduction in the ratio of number of working-age people per person with dementia from 75 to 26. With preventative means; delaying the onset by: o 5 years – projected dementia prevalence in 2050 reduced by 44%. o 6 months – projected dementia prevalence in 2050 reduced by 5.6%. Projection: o Ageing of the Australian population will lead to a rapid increase in dementia. o An increasing burden for the working-age population. o Health, social and economic impact. o Even modest prevention efforts could lessen the impact. o A significant issue now and more so in the future. Aetiology