Dementia care management was provided at the homes of patients with dementia. Dementia care management is a model of collaborative care, defined as a complex intervention aiming to provide optimal treatment and care for patients with dementia and support caregivers using a computer-assisted assessment determining a personalized array of intervention modules and subsequent success monitoring. Dementia care management was targeted at the individual patient level and was conducted by nurses with dementia care-specific qualifications.
Vascular dementia is a general term describing problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to your brain.
You can develop vascular dementia after a stroke blocks an artery in your brain, but strokes don't always cause vascular dementia. Whether a stroke affects your thinking and reasoning depends on your stroke's severity and location. Vascular dementia can also result from other conditions that damage blood vessels and reduce circulation, depriving your brain of vital oxygen and nutrients.
Factors that increase your risk of heart disease and stroke — including diabetes, high blood pressure, high cholesterol and smoking — also raise your vascular dementia risk. Controlling these factors may help lower your chances of developing vascular dementia.
Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with mild cognitive impairment seem to remain stable or return to normal over time, but more than half progress to dementia within 5 years. Mild cognitive impairment can thus be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension. The amnestic subtype of mild cognitive impairment has a high risk of progression to Alzheimer's disease, and it could constitute a prodromal stage of this disorder. Other definitions and subtypes of mild cognitive impairment need to be studied as potential prodromes of Alzheimer's disease and other types of dementia.
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia in older people, accounting for 10% to 15% of all cases, it occupies part of a spectrum that includes Parkinson's disease and primary autonomic failure. All these diseases share a neuritic pathology based upon abnormal aggregation of the synaptic protein α-synuciein. It is important to identify DLB patients accurately because they have specific symptoms, impairments, and functional disabilities thai differ from other common dementia syndromes such as Alzheimer's disease, vascular cognitive impairment, and frontotemporal dementia. Clinical diagnostic criteria for DLB have been validated against autopsy, but fail to detect a substantial minority of cases with atypical presentations that are often due to the presence of mixed pathology. DLB patients frequently have severe neuroleptic sensitivity reactions, which are associated with significantly increased morbidity and mortality. Cholinesterase inhibitor treatment is usually well tolerated and substantially improves cognitive and neuropsychiatrie symptoms. Although virtually unrecognized 20 years ago, DLB could within this decade become one of the most treatable neurodegenerative disorders of late life.
Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities usually during their prime working years and has no cure. HD is known as the quintessential family disease because every child of a parent with HD has a 50/50 chance of inheriting the faulty gene. Today, there are approximately 41,000 symptomatic Americans and more than 200,000 at-risk of inheriting the disease.
The symptoms of HD are described as having ALS, Parkinson’s and Alzheimer’s – simultaneously.
Symptoms usually appear between the ages of 30 to 50, and worsen over a 10 to 25-year period. Ultimately, the weakened individual succumbs to pneumonia, heart failure or other complications. Everyone has the gene that causes HD, but only those that inherit the expansion of the gene will develop HD and perhaps pass it on to each of their children. Every person who inherits the expanded HD gene will eventually develop the disease. Over time, HD affects the individual’s ability to reason, walk and speak.
Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease—those with the late-onset type—symptoms first appear in their mid-60s. Early-onset Alzheimer’s occurs between a person’s 30s and mid-60s and is very rare. Alzheimer’s disease is the most common cause of dementia among older adults.
The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).
These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.
This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.
Parkinson's disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination.
Parkinson's symptoms usually begin gradually and get worse over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
Both men and women can have Parkinson’s disease. However, the disease affects about 50 percent more men than women.
One clear risk factor for Parkinson's is age. Although most people with Parkinson’s first develop the disease at about age 60, about 5 to 10 percent of people with Parkinson's have "early-onset" disease, which begins before the age of 50. Early-onset forms of Parkinson's are often, but not always, inherited, and some forms have been linked to specific gene mutations.
Semantic dementia (SD) is the fluent type of progressive aphasia and is primarily associated with temporal lobe involvement. As in PNA, the onset of semantic dementia is insidious and the course of the impairment is progressive. SD is characterized by effortless, fluent, grammatical speech. Repetition and writing skills are basically intact. By contrast, word production (e.g., in picture naming) and word comprehension are impaired. As in fluent aphasia (see Language Disorders: Aphasia), speech often appears empty, due to the increased use of vague terms. Word substitutions (semantic paraphasias) are common, especially as the dementia progresses. Researchers have pointed out that the lexical deficit in SD can indicate loss of semantic knowledge. Evidence for this can be found in the semantically based word production errors and in word and object recognition errors produced by individuals with SD
Individuals with semantic dementia have difficulty producing irregular past tense forms (e.g., break–broke) but perform at near-normal levels with regular verbs (e.g., visit–visited). This is consistent with research findings suggesting that irregular verb forms are represented as words in the lexicon, whereas regular verb forms are produced by the grammar. Similarly, irregular verb production (but not regular verb production) correlates with the ability to judge verb synonyms (i.e., whether two given verbs have roughly the same meaning), suggesting semantic, rather than syntactic, impairment. Furthermore, more individuals with SD show greater impairment on naming tests than those with PNA or other subtypes of FTDs. People with SD also show a significant correlation between naming and performance deficits on semantic memory tests as well as impaired performance on word list generation tasks, consistent with a memory deficit basis for the naming impairment.
Frontotemporal dementia is an umbrella term for a group of uncommon brain disorders that primarily affect the frontal and temporal lobes of the brain. These areas of the brain are generally associated with personality, behavior and language.
In frontotemporal dementia, portions of these lobes shrink (atrophy). Signs and symptoms vary, depending on which part of the brain is affected. Some people with frontotemporal dementia have dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language properly.
Frontotemporal dementia is often misdiagnosed as a psychiatric problem or as Alzheimer's disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer's disease. Frontotemporal dementia often begins between the ages of 40 and 65.
NPs who specialize in adult and geriatric care need a specific skill set to carry out their duties. AGNPs need to show a high level of compassion and understanding. In addition to this, they must demonstrate patience because their charges are usually trying to adapt to a changing style of life, which may leave them feeling vulnerable and likely to lash out. AGNPs also need to demonstrate extreme emotional stability to be there for their patients in their time of need. Strong decision-making skills are crucial to ensuring that plans are set in motion and followed. Finally, AGNPs must have expert communication skills because their patients may have trouble with making their needs known, and it’s up to the NP to help them get their message across.
In some cases, treating the condition that causes dementia may help. Conditions most likely to respond to treatment include dementia due to:
In most cases, dementia isn’t reversible. However, many forms are treatable. The right medication can help manage dementia. Treatments for dementia will depend on the cause.
For example, doctors often treat dementia caused by Parkinson’s disease and LBD with cholinesterase inhibitors that they also often use to treat Alzheimer’s.
Treatment for vascular dementia will focus on preventing further damage to the brain’s blood vessels and preventing stroke
People with dementia can also benefit from supportive services from home health aides and other caregivers. An assisted living facility or nursing home may be necessary as the disease progresses.
Bioinformatics advent can be used to regulate and evaluate data from the current high-throughput research technologies and render means for novel discoveries in the field of neurodegenerative diseases. It is reported that there is very little published data on Epigenomics. It is said that the data are obtained from high throughput technologies in the screening of the human brain. These data intend the upcoming researchers to know and design their experiments. Data Mining plays an important role in the prediction of the disorder, where the actual data is compared with the real data and the results are interpreted. The Transcriptomics and Proteomics studies have also been carried out providing necessary solutions for the problems.