Dementia

Dementia is an umbrella term for various cognitive disorders affecting memory, thinking, and social abilities. It is not a disease but a symptom of different diseases. Some people with dementia cannot control their emotions, and thus their personalities may change. Dementia ranges in severity from mild to severe. Dementia generally involves memory loss, loss of attention, mood swing, etc. 

The person suffering from dementia may show the symptoms listed below:

 

• Recent memory loss,
• Difficulty completing tasks like making tea or cooking a meal,
• Communicating problems like language difficulty, forgetting words, or using wrong words,
• Disorientation
• Misplacing things  like forgetting the location of items such as keys, or wallets,
• Mood changes,
• Personality changes like irritable, suspicious or fearful,
• Loss of initiative like showing less interest in starting something,
• Cognitive impairments.

 

Dementia can be caused due to neurodegenerative diseases, other reasons may be:

 

• Brain cell death, progressive brain cell death that happens over time,
• Head injury,
• Stroke, 
• Brain tumor,
• Repetitive traumatic brain injuries such as those received by sports players,
• Prion diseases like Creutzfeldt-Jakob disease,
• HIV infection.

 

Pathology:

 

Dementia is a symptom of a variety of structural brain diseases and several system degenerations. Alzheimer's disease is the most common cause, it results in a cortical-subcortical degeneration of ascending cholinergic neurons and large pyramidal cells in the cerebral cortex.

Physical Examination:

Physical Examination is done to check the symptoms along with the medical history.

 

Cognitive and neuropsychological tests:

Evaluation of cognitive functions like thinking skills, language skills, memory, orientation, judgment, reasoning, and attention is done.

 

Neurological evaluation:

Evaluation of memory, visual perception, language, attention, movement, problem-solving, senses, reflexes, balance, and other areas are also done.

 

Brain scans:

Magnetic resonance imaging and computed tomography are used to rule out stroke, tumor, bleeding, or hydrocephalus.

 

Laboratory tests:

Laboratory tests are used to detect vitamin B-12 deficiency or an underactive thyroid gland that can affect brain function. Examination of the spinal fluid is done for infection, inflammation, or degenerative diseases.

 

Psychiatric evaluation:

Mental health professionals help to determine depression or any other mental health condition.

Medication: Anti-anxiety medications, antidepressants, etc.

Note: Medication should not be taken without the doctor's prescription.

 

The physiotherapist performs the assessment and designs a treatment plan.

 

Fall prevention:

A fall prevention program is created and completed between treatment sessions. The home assessment done along with the fall prevention program increases safety at home and reduces the risk of falls.

 

Stretching exercises:

Stretching exercises help a person to move and assist in muscle tightening.

 

Strengthening exercises:

Water therapy exercises are done to promote strengthening and mobility these exercises decrease the risk of osteoporosis and increase bone strength.

 

Balance exercises:

Group exercises are conducted to improve balance and mobility.

 

Postural Management:

For posture management, it is important for a person to regularly change the position. A physiotherapist helps to increase comfort levels as well as decreases joint movement.

 

Other exercises:

Exercises like walking, running, and dancing can also be incorporated to improve the mood of the patient.

 

Social interaction:

Social interaction is encouraged to reduce the need for medication and recover better and faster. As it has a positive impact on psychological and behavioral symptoms.

 

Modification of the environment:

Reduce clutter, noise and hide objects that can threaten safety, such as knives.

 

Task simplifying:

Tasks can be broken up into easier steps, which helps to reduce confusion in people with dementia.

The physiotherapist provides advice on aids and adaptations to maximize the Patient's Independence. Family members are educated about home safety ideas, strategies to prevent falls and injuries, and communication techniques to improve everyone's quality of life.