1. Understand the neurology of dementia.
1. Describe a range of causes of dementia syndrome.
a) Alzheimer’s Disease
Scientists know that during Alzheimer’s two abnormal proteins build in the brain. They form clumps called either ‘plaques’ or ‘tangles’. These plaques and tangles interfere with how brain cells work and communicate with each other. The plaques are usually first seen in the area of the brain that makes new memories. A lot of research is focused on finding ways to stop these proteins in their tracks and protect brain cells from harm. There are three genes that have been identified which play a role in the development of early- onset of Alzheimer’s, these are called: • Amyloid precursor protein (APP)
• Presenilin 1 (PSN1)
• Presenilin 2 (PSN2)
All three genes are involved in the production of a protein called amyloid, which is known to build up into toxic plaques in the brain during Alzheimer’s. b)Vascular Dementia
Is caused when the blood flow the brain is reduced as blood carries essential oxygen and nourishment to the brain and without it, brain cells die. So the network of blood cells that carry blood throughout the body is called the vascular system. Stroke- related dementia happens after a stroke. A stroke occurs when the blood supply to a part of the brain is suddenly cut off. This can cause difficulties in moving, speech impairment, problems with co-ordination and sight. If a stroke causes memory loss or problems with attention, then a person may be diagnosed as Post-Stroke Dementia. Multi-infarct dementia is caused by a series of small strokes in the brain, which the person might not notice.
Subcortical vascular dementia or vascular cognitive impairment is caused by a series of small injuries to blood vessels deep inside the brain. A person usually does not notice these injuries and their cause is not yet known. Over time many of these injuries gradually damage parts of the brain that are important for attention, memory and language.
c) Dementia Lewy Bodies (DLB)
This type of dementia is caused by small clumps of protein that build up inside nerve cells in the brain, which inhibits communication between cells in parts of your brain. These are named Lewy bodies after Dr Frederich Lewy, who first identified them. The nerve cells affected by Lewy bodies control thinking and movement, research is underway to find out what causes the protein build up and how to prevent or stop it.
d) Frontotemporal Dementia
Frontotemporal dementia (FTD) is caused by a variety of abnormal proteins building up in the brain. The nerve cells affected are in areas of the brain called the frontal and temporal lobes. The frontal lobes are involved in regulating our personality, emotions and behaviour, as well as reasoning, planning and decision-making. The temporal lobes are involved in memory and the understanding and production of language. As the disease progresses, other parts of the brain become affected.
1.2 Describe the types of memory impairment commonly experienced by individuals with dementia. Mild forgetfulness, confusion and loss of focus that can easily be mistaken as part of ageing at first, but as the disease progresses it becomes more evident that the person experiences far than ‘normal’ changes. It could start by forgetting names and places that you would know, you can go on to finding it hard to find the words that you would normally use to describe something (i.e) replacing the word ‘chair’ for ‘that thing that I sit on’, it could even be recent conversations or events that took place. Significant dates to you, belongings or places, you may find yourself stumped by everyday activities like washing your hair or brushing your teeth. Put household items in unusual places like a book in the fridge, forget where you live or who your relatives are or how to do things around your own home the way you would normally do them. Sudden...
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