Dementia is a broad

term used to describe a

Dementia decline in cognitive
function severe enough
to interfere with daily
Definition: Dementia is a
syndrome characterized by
life. It is not a specific
a decline in cognitive disease but a syndrome
function, affecting caused by various brain
memory, thinking, and the disorders. Dementia
ability to perform daily primarily affects
activities. It is not a memory, thinking,
specific disease but rather problem-solving,
a term that describes a language, and behavior.
range of symptoms 2. Causes and Risk
associated with cognitive
Factors
impairment.
Incidence: Over 55 million
Dementia is caused by
people worldwide have damage to brain cells,
dementia, with nearly 10 leading to impaired
million new cases each communication between
year. It is more common in them. Several diseases
older adults, particularly and conditions can lead
those over 65. Dementia is to dementia, including:
currently the seventh A. Neurodegenerative
leading cause of death and Diseases
one of the major causes of These are progressive
disability and dependency disorders that damage
among older people brain cells over time:
globally1.
 Alzheimer’s disease
Clinical Features:
Symptoms of dementia
(AD) – The most
can vary depending on the common cause,
type and stage of the characterized by
condition. Common amyloid plaques and
symptoms include: tau tangles in the
 Memory loss, brain.
especially recent  Vascular dementia –
events Caused by reduced
 Confusion and
blood flow to the
disorientation
brain due to strokes
 Difficulty solving

problems and making

or small vessel
decisions disease.
 Lewy body
 Changes in mood and

behavior, such as dementia (LBD) –

depression, anxiety, Associated with
and agitation abnormal protein
 Difficulty with deposits called Lewy
language, such as bodies in the brain.
finding the right  Frontotemporal
 words or following dementia (FTD) –
conversations Results from
 Difficulty performing
degeneration of the
familiar tasks frontal and temporal
 Misplacing items and
lobes, affecting
getting lost in familiar
places
behavior and
Risk Factors: Several language.
factors can increase the B. Secondary Causes
risk of developing Other conditions that
dementia, including: may lead to dementia
 Age (more common in include:
those 65 or older)  Parkinson’s disease
 High blood pressure
(with dementia)
(hypertension)  Huntington’s
 High blood sugar
disease
(diabetes)
 Traumatic brain
 Being overweight or

obese injury (TBI)

 Chronic alcohol use
 Smoking

 Drinking too much (Wernicke-Korsakoff

alcohol syndrome)
 Physical inactivity  Vitamin B12

 Social isolation deficiency

 Depression
 Infections
Types: There are several (HIV/AIDS, syphilis,
types of dementia, each Creutzfeldt-Jakob
with its own causes and disease)
characteristics. The most C. Risk Factors
common types include:  Age: Most common
 Alzheimer's Disease:
in individuals over
The most common
form of dementia,
65.
 Genetics: Family
accounting for 60-70%
of cases. history increases
 Vascular Dementia: susceptibility.
Caused by reduced  Lifestyle: Poor diet,

blood flow to the lack of exercise,

brain, often due to smoking, and alcohol
strokes or other abuse contribute to
vascular conditions. dementia.
 Dementia with Lewy
 Medical conditions:
Bodies: Characterized
by abnormal protein
Hypertension,
deposits called Lewy diabetes, and high
bodies in the brain. cholesterol can
 Frontotemporal increase risk.
Dementia: Affects the 3. Symptoms of
frontal and temporal Dementia
lobes of the brain, Symptoms vary based on
leading to changes in the cause and stage of
personality, behavior, the disease but generally
 and language. include:
 Mixed Dementia: A A. Early Symptoms (Mild
combination of two or Dementia)
more types of  Short-term memory
dementia, such as
loss
Alzheimer's disease
 Difficulty finding
and vascular
dementia. words
 Mood changes
Management: While there
is no cure for dementia, (depression,
various treatments and irritability)
interventions can help  Reduced ability to

manage symptoms and plan or organize

improve quality of life. tasks
Management strategies  Confusion in familiar
include:
places
 Medical

Management:
B. Middle-Stage
Medications can help Symptoms (Moderate
manage symptoms Dementia)
and slow cognitive  Increased

decline. Commonly forgetfulness,

prescribed including personal
medications include history
cholinesterase  Difficulty recognizing
inhibitors (e.g., friends and family
 donepezil,  Hallucinations and
rivastigmine) and delusions
memantine.  Difficulty managing
 Nursing finances and
Management:
personal care
Providing support and
 Wandering and
assistance with daily
activities, creating a getting lost
safe and structured C. Late-Stage Symptoms
environment, and (Severe Dementia)
offering emotional  Complete

support to both dependence on

patients and caregivers
caregivers.  Inability to
Techniques such as communicate
reorientation,
effectively
validation therapy,
 Loss of mobility and
and reminiscence
therapy can be incontinence
 Difficulty swallowing
beneficial.
 Lifestyle  Increased risk of

Modifications: infections
Encouraging physical 4. Diagnosis of
activity, social Dementia
engagement, and There is no single test
cognitive stimulation for diagnosing dementia.
 can help maintain A thorough evaluation
cognitive function and includes:
overall well-being.  Medical history and

physical
examination
A. Cognitive Enhancing
Medications
 Cognitive and
These medications aim to neuropsychological
improve memory, tests (e.g., Mini-
thinking, and behavior by Mental State
increasing Examination
neurotransmitter activity (MMSE), Montreal
in the brain. Cognitive
1. Cholinesterase Assessment (MoCA))
Inhibitors  Brain imaging (MRI,
These drugs increase the
CT scans to detect
levels of acetylcholine, a
neurotransmitter involved
strokes, tumors, or
in memory and learning, atrophy)
by preventing its  Blood tests (to rule
breakdown. out vitamin
 Donepezil (Aricept) – deficiencies, thyroid
Approved for all dysfunction)
stages of Alzheimer's  Spinal fluid analysis
disease. (in suspected cases
 Rivastigmine (Exelon)
of Alzheimer's
 – Available as a patch disease)
or oral capsule; used 5. Treatment and
for Alzheimer's and Management
Parkinson's disease Currently, there is no
dementia.
cure for dementia, but
 Galantamine

(Razadyne) – Used for

treatments aim to
mild to moderate manage symptoms and
Alzheimer’s disease. slow progression.
🡆 Side effects: Nausea, A. Medications
vomiting, diarrhea, loss of  Cholinesterase

appetite, dizziness. inhibitors

2. NMDA Receptor (Donepezil,
Antagonists Rivastigmine,
 Memantine
Galantamine) –
(Namenda) –
Improve memory
Regulates glutamate
activity to protect
and cognitive
brain cells from function in
excessive stimulation. Alzheimer's.
 Used for: Moderate to  NMDA receptor

severe Alzheimer's antagonists

disease. (Memantine) – Used
 Side effects: Dizziness, in moderate to
headache, confusion, severe dementia.
constipation.  Antipsychotics and
3. Combination Therapy mood stabilizers –
 Donepezil + Used for behavioral
Memantine issues but must be
(Namzaric) – Used for used cautiously.
moderate to severe
B. Non-Pharmacological
Alzheimer's disease.
 Provides better
Approaches
symptom control than  Cognitive
either drug alone. stimulation therapy
(puzzles, games,
B. Symptomatic
music therapy)
Management
 Occupational
Since dementia affects
mood, behavior, and daily therapy (to improve
functioning, other daily functioning)
medications are often  Physical activity

required. (reduces cognitive

1. Antipsychotic decline)
Medications  Healthy diet

Used for severe behavioral (Mediterranean diet,

symptoms like aggression, rich in omega-3 fatty
hallucinations, and
acids and
delusions.
antioxidants)
 Examples:

Risperidone, C. Caregiver Support

Olanzapine, and Palliative Care
 Educating caregivers
 Quetiapine. on dementia
 Used cautiously due progression
to increased risk of  Providing support
stroke and mortality groups and respite
in elderly dementia
care
patients.
 Ensuring a safe
 Side effects: Sedation,

weight gain, environment for

extrapyramidal dementia patients
symptoms.  End-of-life care

2. Antidepressants planning in
Depression is common in advanced stages
dementia patients. 6. Prevention of
 Examples: Selective
Dementia
serotonin reuptake Though some risk factors
inhibitors (SSRIs) like
like age and genetics are
Sertraline, Citalopram.
 Benefits: Improve
uncontrollable, lifestyle
mood, anxiety, and changes can reduce the
sleep patterns. risk:
 Side effects: Nausea,  Regular physical

dry mouth, dizziness. exercise

3. Anxiolytics  Healthy diet (rich in

Used for anxiety, agitation, fruits, vegetables,

and restlessness. and lean proteins)
 Examples: Lorazepam,
 Mental stimulation
 Diazepam. (learning new skills,
 Caution: reading)
Benzodiazepines can  Controlling chronic
cause sedation and diseases (diabetes,
increased fall risk.
hypertension)
4. Sleep Medications
Dementia patients often
 Social engagement
have disturbed sleep-wake and stress
cycles. management
 Examples: Melatonin,

Trazodone.
 Preferred over

benzodiazepines due
to fewer side effects.
2. Non-Pharmacological
Management
While medications are
useful, they work best
when combined with non-
drug therapies.
A. Cognitive and
Behavioral Interventions
 Cognitive stimulation

therapy (CST):
Activities like puzzles,
 games, and memory
exercises.
 Reality orientation

therapy: Helps
reorient the patient
using reminders and
structured routines.
 Reminiscence

therapy: Encourages
recalling past events
using photos and
music.
B. Physical and
Occupational Therapy
 Exercise programs:

Improve mobility,
balance, and brain
health.
 Occupational therapy:

Helps with activities of

daily living (ADLs).
C. Nutritional Support
 Dementia patients

often have poor

appetite or difficulty
swallowing.
  High-protein, high-
calorie diet helps
prevent weight loss.
 Vitamin B12 and

folate supplements
may help cognitive
function.
D. Caregiver Support
 Educating caregivers

about disease
progression.
 Teaching stress

management
techniques.
 Support groups and

respite care services.

3. Future and
Experimental Treatments
Ongoing research focuses
on disease-modifying
therapies:
 Anti-amyloid

therapies: New drugs

like Lecanemab and
Aducanumab target
 amyloid plaques in
Alzheimer's.
 Tau protein
inhibitors: Being
investigated for
slowing
neurodegeneration.
 Gene therapy and
stem cell therapy:
Potential future
treatments