What Is Psychosis in Dementia?

Dementia (English Dementia, Demenz), the English word Dementia comes from Latin (de- means "away" + mens means "mental"); it is a progressive recognition caused by brain injury or disease It is known that the function is degraded, and the magnitude of this degradation is much higher than the progress of normal aging.

Dementia

Syndrome caused by slow-onset progressive brain disease. It is characterized by a variety of advanced cortical dysfunctions involving memory, thinking, orientation, comprehension, calculation, judgment, speech and learning ability. Clear consciousness, poor emotional self-control, social or motivational decline are often accompanied by cognitive impairment, but can sometimes occur before cognitive impairment.

Introduction to dementia diseases

In particular, it will affect memory, attention, language, and problem solving ability. In severe cases, it is impossible to distinguish personnel, features and features.

Dementia can be reversible or irreversible, depending on the disease. Less than 10% of dementias are reversible. Dementia is an unspecific general term. Also called dementia.

The most common type of dementia is Alzheimer's disease (Alzheimer's disease). Its typical initial symptom is memory impairment. Patients forget what just happened (poor short-term memory), while older memories (long-term memory) are relatively unaffected in the early stages of onset.

Because most people with dementia may have symptoms of insanity. Although the symptoms of confusion may be alleviated by close care, improved living conditions, and diet; psychiatric drugs can also help stabilize mood, reduce hallucinations, or impulse control. But the drug has not yet slowed brain degradation. Dementia patients are also often accompanied by depression, which is best diagnosed and treated by professional medical personnel.

Age is the most important risk factor for dementia. According to epidemiological studies, 5% of people over the age of 65 have dementia, and it increases to 20% of those over the age of 85.

Basic information on dementia

Dementia: chdi dementia

Dementia Condition Symptoms

slowness; ignorance: a pair of dementia | pretend dementia. Dazed: Demented with anger | Standing with dementia | Dementia look. Overview

The original intelligence is normal. Later, due to the effects of physical and chemical and viral infections, the normal intelligence is impaired, and the intelligent metamorphosis is called dementia.

Dementia is a secondary decrease in intelligence caused by brain lesions after intelligence has developed considerably, and can be caused by a variety of organic factors. Dementia is not diagnosed under the age of 18.

Investigation of dementia symptoms

Medical certificate name. Belonging to psychiatric disorders. "Book of Jingyue · Miscellaneous Essence Mo": "Dementia card, where there is usually no sputum, but with depression, or inconvenience, or thought, or doubt, or fright, and gradually dementia. Reverse the words, do not act Jing, or sweating, or sentimental, its evidence is strange and omnipresent; pulses must be chords or numbers, large or small, change easily, this is the Qi of the heart or liver and gallbladder, and the qi is unclear However, if the body is strong, the diet is not diminished, and there is no other symptom of prostration, it is best to take it, and it is the most stable and most wonderful. However, there are those who can be cured, those who are unhealable, and they also care about the stomach, The strength of the vitality is to be restored after a while, but it can be anxious. For all these evidences, if you are shocked by a panic, you will occasionally break your heart, and you will lose your sense of coma. This should be based on quickening the righteousness. Or Dabuyuan Jianzhu. "Therefore, dementia is included in the epilepsy. See epilepsy, sickness bar.

Dementia etiology and pathology

1. Cerebral degeneration: Certain cortical and subcortical diseases can cause dementia. Common causes are Alzheimer's disease, Pick's disease, Huntington's disease, Parkinson's disease, hepatolenticular degeneration, and cortico-striatum-spinal cord combination. Denaturation, etc.

2. Cerebrovascular disease: Cerebrovascular diseases in different parts can cause dementia, such as multiple infarct dementia, carotid artery occlusion, subcortical arteriosclerotic encephalopathy, thrombotic vasculitis and so on.

3. Metabolic diseases: Some metabolic diseases affect brain function and cause dementia, such as myxedema, hyperparathyroidism or hypothyroidism, hyperadrenal cortex function, hepatolenticular degeneration, uremia, chronic liver insufficiency, etc.

4. Intracranial infection: Intracranial infection leads to changes in brain parenchyma and brain function, leading to dementia, such as various encephalitis, neurosyphilis, various meningitis, Kuru disease and so on.

5. Intracranial space-occupying lesions: Tumors and subdural hematomas can cause structural and brain function changes and cause dementia.

6. Hypoxia and hypoxemia: including ischemic (cardiac arrest, severe anemia, and bleeding), hypoxic (respiratory failure, asthma, asphyxia, anesthesia), and stasis (heart failure, excessive red blood cells) And tissue toxicity and other types of hypoxemia.

7. Nutritional deficient encephalopathy: Thiamine deficient encephalopathy, pellagra, vitamin B12 and folic acid deficiency.

8. Toxic diseases: common in carbon monoxide poisoning, lead, mercury and other poisoning, organic poisoning and so on.

9. Craniocerebral trauma: open or closed trauma to the head, boxer dementia, etc.

10. Others: normal pressure hydrocephalus, sarcomatoid disease, etc.

Mechanistic dementia is related to organic diseases of the brain. The location of the disease is different, and its clinical manifestations are also different. However, it is easy to lose intelligence when the parts of the frontal lobe, temporal lobe, limbic system, and third ventricle that combine fiber accumulation are damaged. Cerebral degeneration can cause brain atrophy, decrease, loss, degeneration, and necrosis of nerve cells, some nerve cells shrink, special astrocytes hypertrophy, proliferation and degeneration, and neurofibrillary tangles and granular vacuole degeneration in some nerve cells The changes are more significant in the hippocampus, almond region, and striatum, which are directly related to memory and mood. Certain physical diseases can cause electrolyte disturbances, acid-base balance imbalances, large accumulation of intermediate metabolites, cerebral blood flow disorders, and long-term hypoxia in brain tissue, causing degeneration, softening, necrosis, or punctate bleeding of brain cells. Causes brain dysfunction.

Infiltration of certain microbial toxins into brain cells can also cause changes in brain function. Vitamin deficiency can cause brain cell carbohydrate metabolism disorder, brain trauma can change brain structure, brain tumor can directly stimulate and destroy brain tissue, brain trauma can change brain structure, brain tumor can directly stimulate brain tissue And destruction, can also cause functional compression and displacement of adjacent and distant brain tissue, can also cause cerebral blood and cerebrospinal fluid circulation disorders, degeneration, necrosis of brain cells. Some toxic diseases can cause softening and necrosis of gray matter and pale globules in the cerebral cortex, resulting in brain dysfunction and loss of intelligence. In addition to the changes mentioned above, some diseases can also cause changes in some neurotransmitters, leading to a reduction in catecholamines, acetylcholine, -aminobutyric acid, and brain peptides, which are directly related to memory, mood, thinking, behavior, etc. The reduction of these substances can lead to emotional, thinking, behavioral, memory and other obstacles, and dementia occurs.

Clinical manifestations of dementia

Near-memory defects are often the earliest clinical manifestations, mainly because of impaired function. Patients cannot remember a good appointment or task, and they cannot remember recent events. However, patients have a self-knowledge about this, and strive to cover up and make up for it. They often take a series of auxiliary measures, such as meticulous written records or unusual reminders, so as to reduce or avoid memory defects on work, society and life. The adverse effects of this also mask the memory loss as a symptom manifestation.

Another early symptom of dementia is a decline in the ability to learn new knowledge and new skills, and it is easy to feel tired, frustrated and irritated when encountering unfamiliar homework. Its abstract thinking, generalization, comprehensive analysis and judgment ability progressively diminish. The full involvement of memory and the lack of understanding and judgment can cause delusions, which are short-lived, changeable, and unsystematic. Their content is usually theft, loss, suspicion, victimization, or jealousy of spouse. Impaired memory and judgment can cause dysfunction, and patients lose time, place, people, and even their ability to recognize. Therefore, it is often day and night without knowing the way home or roaming for no purpose.

In terms of emotions, it showed emotional instability in the early stage, and gradually became indifferent and dull in the evolution of the disease. Sometimes emotions lose control and become superficial and changeable. Anxiety, depression, or indifference, or outrage, easy to cry and laugh, unable to control oneself. High-level emotional activities such as shame, moral responsibility, and glorious feelings are the earliest.

Personality disorders can sometimes appear in the early stages of the disease. Patients become less energetic, easily fatigued, lose enthusiasm for work, lose interest in activities that they usually enjoy, and appear careless about people and things. Clothing and appearance are not as careful as before, and they can become untidy and trimmed. Sometimes indecent acts against young children or violations of social ethics, such as exposing the genitals. Someone becomes suspicious, stubborn and careless.

When comprehensive intelligence declines to severe dementia later, patients cannot even take care of their daily lives, diet needs daily care, incontinence, loss of language answering ability, and some patients do nt even recognize their spouse and children. The directional force is almost completely lost, and often lost when going out. Eventually the patient died of infection, visceral disease or failure.

9 Dementia 9 drugs can cause dementia in the elderly

1. Antipsychotic drugs. Antipsychotic drugs such as methisobutrazine. Haloperidol, etc., can cause disorientation and decreased computing power. Antidepressants plus sulpiride and imipramine. Chlorpromazine hydrochloride, etc., can cause memory loss and localization.

2. Anxiolytic drugs. Anxiolytics, such as diazepam, are commonly used in the elderly to ensure sleep, and frequent use can lead to severe memory loss.

3. Antiepileptic drugs. Excessive amounts of phenytoin and carbamazepine or prolonged medication can reduce intelligence.

4. Antitremor paralysis drugs. It has been reported that the anticholinergic effect of Antan can cause central anticholinergic syndrome. If the medication is taken for too long, the patient's memory of his name and articles is not very clear, and sometimes he has poor orientation ability.

5. Antihypertensive drugs. Hypertension is a common disease that seriously endangers the health of the elderly. Reserpine, methyldopa, and clonidine are commonly used in the treatment of this disease, and they may cause neurological deficits.

6. Cardiotonic drugs. Digitalis is prone to the symptoms of accumulation poisoning, and visual impairment can also occur. Illusion of positioning. Central nervous system dysfunction such as mental decline. Lidocaine can cause drowsiness, abnormal behavior, and disorientation.

7. Digestive system drugs. Cimetidine can block brain histamine, causing delirium, intellectual damage, and lethargy. Aluminum and barium are neurotoxic.

8. Respiratory drugs. The central antitussive agent aminophylline can cause memory disorders that are difficult to recover, and the dosage should be reduced as appropriate in elderly patients.

9. Hypoglycemic drugs. Insulin treatment of diabetes is also prone to "overcorrection", leading to hypotension. Symptoms such as insanity, lethargy, and even coma can occur.

Chinese treatment

Cerebral emptiness is the basic pathological change of senile dementia, and deficiency of kidney qi and kidney essence is its basic pathogenesis.

A large number of experimental and clinical studies have shown that most of the elderly with kidney deficiency have reduced brain function, reduced brain nerve cells, decreased transmitter content and transmitter receptor numbers, endocrine disorders, decreased immune function, increased autoimmunity and allergies, and freedom in the body The capacity of radicals and peroxides accumulate with age, while the content of free radical-resistant substances such as SOD decreases. These changes indicate that kidney deficiency is an important cause of senile dementia. Taking kidney deficiency as the main pathogenesis and replenishing kidney and replenishing the essence and marrow to treat Dafa prescriptions to delay aging and prevent senile dementia can be said to be a traditional consensus. But no matter how the condition changes, kidney deficiency always runs through the entire course of senile dementia, which is its most essential feature. Clinically, as long as nourishing the kidney and filling the essence and marrow cubes to prevent senile dementia, better results can be achieved. Tibetan Medicine Compound Hand Ginseng Puzzle Capsule Chinese Medicine Standard Z20026454 nourishes liver and kidney, nourishes and strengthens the brain. Main treatment of liver and kidney yin deficiency type Indications: nourishing liver and kidney, Yijing Jiannao. For liver and kidney deficiency, Qi and blood deficiency caused by forgetfulness, dizziness, palpitations, insomnia, fatigue and fatigue. Director of History, Physical and Mental Care, Center for Brain Atrophy Treatment Center of Beijing Institute of Traditional Chinese Medicine Difficulties believes that this medicine is suitable for use: loss of intelligence, forgetfulness, insomnia, loss of love, disregard of loved ones, language reversal, aphasia, drooling, dull expression, hallucination fantasy, limb numbness , Lost home, lost incontinence, tremor of hands and feet, etc.

Kidney deficiency is an important pathological basis for senile dementia, and sputum and blood stasis are important factors for senile dementia. Phlegm stasis is both a pathological product and a causative factor. Phlegm coagulation and stasis promotes the development of senile dementia. The normal aging process itself has the potential for blood stasis syndrome. Therefore, stasis and blood stasis are also an important cause of dementia, and stasis of the heart and brain can be disturbed, palpitations, insomnia, forgetful dementia, and faint slang. "Blood Syndrome · Blood Stasis" also says: "Blood stasis attacks the heart, heartache, dizziness, and coma ..."

The clinical symptoms of senile dementia are dull, dull, dumb, crying, smirking, faint or pale tongue, white greasy fur and so on, which belong to the category of sputum coagulation and blood stasis. The traditional Chinese medicine Huanzhi Jiannao capsule Z61020986 can relieve stasis and clear collaterals, warm phlegm, refresh the brain, open the qi, and strengthen the brain. The director of the history, body and mind of the Center for Brain Atrophy of Beijing Research Center for TCM Research believes that kidney deficiency and sputum coagulation and blood stasis are the most important pathogenesis of senile dementia. By grasping this pathogenesis, the nature of senile dementia and the general law of development have been grasped, and clinical treatment can achieve better results. Tonic the kidney, promote blood circulation, remove phlegm, and prevent and treat senile dementia can be a good method. To improve memory, solve cerebral dementia, and fight aging, the country's only pure Chinese medicine is the first choice for treating dementia.

In summary, kidney deficiency is the main cause and basis of senile dementia, and sputum coagulation and stasis are the direct cause of the disease. Kidney deficiency-based, sputum coagulation and blood stasis as the standard, this deficiency standard is the basic pathogenesis of senile dementia. Zhengxu can produce sputum and stasis, and phlegm and stasis can aggravate Zhengxu, both of which cause and cause each other, leading to the development of the disease.

Diagnosis of dementia

First determine if you have dementia, then determine the cause of dementia.

Dementia Cognitive Function Test and Intelligence Test

Dementia screening tests include the Mini Mental State Test (MMSE) created by Folstein (1975), the Hasegawa Dementia Scale (HDS) created by Kasuga Kazuo (1974), and the Cognitive Scale (CAS) created by Pattie et al. (1979) )Wait. The common feature of these tests is that they are simple in content and can be completed in a short period of time. Generally, they are set as demarcation points for dementia, so they are quite practical. Taking MMSE as an example, if the score is <15 points for dementia, 15 to 24 points may be dementia. The Wechsler Adult Intelligence Test can only be used by patients who have been done before the illness, otherwise it will be more difficult.

Comprehensive history of dementia

First understand the age of onset, the age of dementia are relatively older, and then understand the onset form and course of disease, trauma and cerebrovascular disease are often acute, and most of the other causes are chronic. Dementia symptoms caused by cerebrovascular disease can fluctuate and can be automatically relieved. Dementia caused by heart disease, hypothyroidism and vitamin deficiency can be relieved with the relief of physical symptoms, atrophy caused by senile and other degeneration, and the symptoms of dementia are persistent Ongoing and worsening.

Physical examination of dementia

Dementia itself has no fixed signs, but some signs can often appear in the primary disease. Patients with paralytic dementia may have irregular pupils, two of which are not the same size, and Ai Luo's pupils. Patients with senile psychosis often have corneal rings, gray hair and skin wrinkles. Lead lines can be seen in the gums of patients with lead poisoning. Certain primary diseases are often accompanied by certain signs of the nervous system.

Dementia laboratory test

Patients with suspected organic dementia should undergo selective lumbar puncture, blood biochemical tests, electroencephalography, brain ultrasound, isotope brain scans, plain radiographs of the brain, pneumoencephalography, cerebral angiography, or CT.

Differential diagnosis of dementia

(1) Alzheimer's disease (Alzheimer's disease) is early manifested as memory impairment and is getting worse. At the beginning, there are only near memory disorders, poor orientation, reduced work efficiency, fictional or fictional, on the basis of which dementia is getting worse, computing power is reduced, judgment is low, reactions are slow, understanding is difficult, speech disorders and symptoms later appear. Aphasia, apraxia, confession, etc. Behavioral disorders, stereotyped animals, occasional fragments of hallucinations and delusions, the age of onset is 40 to 60 years old.

(2) Pick's disease is mostly between 40 and 60 years old, and there are more women than men. The initial prominent symptom is behavior disorder, and the patient is less active and lazy. It is important for others' daily life such as diet, sleep, and clothing. If you don't pay attention, you can have personality changes and memory impairment at an early stage. Patients lose their previous tact, carelessness in their work, and focal symptoms such as apraxia, aphasia, dyslexia, or confession can occur early. Intellectual disorders are mainly abstract thinking difficulties and memory loss. Its dementia develops rapidly, its course is short, and it usually dies due to subsequent infection or failure within one to several years.

(3) Huntington's disease (Huntington's disease) is usually very insidious. The first symptom is a decrease in work efficiency and it cannot handle daily affairs well. Cognitive slowness, impaired intelligence, and memory impairment become apparent immediately after the onset of choreographic symptoms, without aphasia and frustration. The concentration and judgment are progressively impaired, the problem-solving initiative is poor, the ability to calculate, near memory, and hand-eye coordination are poor. Symptoms of depression are very common, and personality disorders are also common. Neurological symptoms are dance-like movements, and muscle rigidity is also common in a few patients.

(4) Parkinson's disease is characterized clinically by tremor, muscle rigidity, decreased movement, and abnormal posture, and can be accompanied by personality changes, mental retardation, and mental illness. The mental retardation is characterized by reduced memory, comprehension, judgment, and computing power, poor mobility, and it is difficult to perform an intelligence test. On the one hand, it is related to the performance difficulties. In addition, because of the physical and mental retardation of patients, it is easy to cause judgment mistake.

(5) Hepatolenticular degeneration often has some psychiatric symptoms, such as mood disorders, mental retardation, personality changes, and hallucinations such as hallucinations. The appearance of mental retardation can be early or late, mainly due to inattention, reduced computing, memory, understanding, judgment ability, and later the disease gradually worsened, resulting in severe dementia.