| Introduction | | | | The person may develop self care apraxias like: |
| Alzheimer's disease is the most common cause of | | | | dressing, shaving, bathing, combing hair.o Visual |
| dementia in the elderly. More than 60% of the cases | | | | agnosia is followed by auditory, tactile agnosias.o In |
| of dementia are due to this. Its prevalence is age | | | | these advanced stages, even the musculature is |
| related is as high as 47% in persons of 85 years | | | | affected. The patient walks in a shuffling manner |
| above. | | | | with short steps. Stiffness of all the muscles leads to |
| Definition: It is a degenerative disorder of the | | | | slowness and awkwardness of all the movements. |
| cerebral cortex resulting in progressive senile | | | | The entire course of the illness is 5-8 years |
| dementia. | | | | approximately. During the course of the illness, any |
| Causes | | | | coexistent illness worsens the condition of the |
| The persons in whom the onset of the disease is | | | | patient acutely. |
| before 65 years of age, the genetic factors are | | | | Diagnosis: |
| considered to be one of the important causes. | | | | It is basically done by ruling out any other causes of |
| The main cause of this functional debility is the | | | | cognitive disorders. |
| irreversible death of the brain cells due to deposition | | | | Progressive worsening of memory and at least two |
| of protein plaques. | | | | areas of cognitive impairment. |
| Environmental agents like viruses are also considered | | | | Onset between 40 years 90 years of age (mostly, |
| to be one of the causes, but, enough evidence has | | | | after 65 years) the person should be in a state of |
| not been found in this respect. | | | | normal arousal i.e. he should not be drowsy, or |
| Risk factorso Advancing age is a risk factor, though; | | | | comatose or delirious. |
| all elderly persons do not invariably show these | | | | Diagnosis is based on the order of the appearance of |
| features.o Having as family history of the disease.o | | | | the symptoms can be supported by imaging |
| Alcohol toxicity, previous head trauma and some | | | | techniques like: MRI, CT scan ; which show |
| immunological factors may also add to the risk of | | | | enlargement of the ventricular space along with brain |
| developing the disease. | | | | atrophy. But, this is not confirmatory of Alzheimer's |
| Screening diagnosis | | | | as such changes are also seen in most of the other |
| The disease has a very insidious onset and it | | | | people of this age group. |
| progresses very gradually. It basically affects the | | | | Homoeopathic treatment: |
| emotion, intellect and memory of the person. It | | | | The homoeopathic medicines cannot provide cure to |
| develops through 3 stages: | | | | the patients, but will help in recovery of the memory |
| Stage 1o The memory of the person is affected in | | | | loss of the patient. |
| the initial stages. First, impairment of memory for | | | | Our medicines will also help by altering the rate of |
| recent happenings can be noticed which is later | | | | progress of the disease. Also, the other psychiatric |
| followed by impairment of long term memory also.o | | | | disturbances which the patient develops in the course |
| Patients themselves complain of the difficulty in the | | | | of the disease like anxiety, depression, delusions, |
| initial stages.o The person also has disorientation of | | | | disturbed sleep etc can also be safely relieved by |
| time and place; he misidentifies things and people.o He | | | | homoeopathic medicines. |
| repeats his words again and again. | | | | If the patient is brought to us in the early stages, we |
| Stage 2o Here, the patient denies that anything is | | | | have a lot to help for relieving the patient's |
| wrong with him says that he is alright.o Gradually, the | | | | complaints without any other side effects. |
| person shows deterioration of his intellectual functions | | | | Environmental structuring: This means providing a |
| and certain personality changes occur. He may also | | | | safe, non stimulating, environment to the patient |
| develop problems pertaining to speech language.o He | | | | which provides him with consistency comfort. |
| may later develop aphasic syndrome (Lack of right | | | | Patient careo For stage 1 patients, reality orientation |
| word at the right time compels the patient to | | | | is very helpful.o For stage 2 patients, reality |
| compensate by speaking around the subject- | | | | orientation is not possible; hence validation therapy is |
| àparaphasia-àimpoverished | | | | the best choice. Here, we should value support the |
| vocabulary- also that the patient can't convey his | | | | patient's feelings thoughts.o The patient should be |
| feelings due to fragmented words sentences -a | | | | encouraged to do self care, exercise his other |
| mutism results.)o Constructional apraxia (Inability to | | | | activities. His mental and emotional states, his other |
| draw two or three dimensional figures.) follows.o The | | | | vital signs body functions should be assessed for any |
| person finds it difficult to wave his h to someone, | | | | deterioration.o We should keep in mind the patient's |
| greet someone or even to use a pen for writing.o | | | | capabilities our expectations should not exceed his |
| Visual agnosia develops (inability to comprehend what | | | | abilities to perform any tasks.o We should speak to |
| he sees).Due to these functional deficits, the person | | | | the patient calmly allow him sufficient time to reply as |
| develops some psychiatric disturbances like: | | | | we understands that the thinking process of the |
| depression, aggression, anxiety, delusions, | | | | patient has slowed down. He should also be referred |
| sleeplessness etc. | | | | to appropriate support groups, counseling groups etc. |
| Stage 3o Finally, the person reaches a stage when he | | | | Dr. |
| has to depend on others for his daily living activities.o | | | | |