WHAT IS
DEMENTIA?
• Syndrome of brain disorders
• Slowly ↓ memory &
reasoning
• Erodes independence
• Impairment in
cognition that
impairs ability to function on
a daily basis
Rising Tide of Dementia
• 1 in 4 require assistance with ADLs
• 1 in 4 exhibit
behaviors
• 1 in 4 experience symptoms of depression
• 1 in
4 hospitalized over 3 months
• 1 in 5 visit emergency over 3 month
• Results in great personal strain for
those with dementia
& their
caregivers
• 55% Canadians with dementia live
at
home
• Causes > disability than other diseases
•
Severe financial burden for family &
caregivers ($10.4
billion out of pocket
expenses)
• Caregiver stress → ↓ health
Reducing the
Risk
• Diet
• Physical activity
• Assess & manage hearing
loss
• Sleep
• Manage sleep apnea
• Avoid sleep
deprivation
• Good sleep hygiene
• Increase or maintain
engagement in cognitively
stimulating exercises
•
Social engagement
• Minimize exposure to
anticholinergic
medications
• Annual influenza vaccination
MILD
COGNITIVE
IMPAIRMENT
or COGNITIVE
IMPAIRMENT
NOT
DEMENTIA
• ↓ cognition
• Usually memory
• Executive function
preserved
• Maintains ability
to carry out IADLs
Types of
Dementia
dementia=umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life
-alzheimers
-lewy body
-vascular
-frontal temporal
-others(parkinsons, huntingtons)
-mixed dementias
Pathobiology Hypotheses of dementia
-cholinergic hypothesis
-beta-amyloid hypothesis
-tau hypothesis
Additional Hypotheses
• Inflammatory
• Oxidative
stress
• Serotonergic
• others
-cholinergic hypothesis
suggests that a dysfunction of acetylcholine containing neurons in the brain contributes substantially to the cognitive decline observed in those with advanced age and Alzheimer's disease (AD)
-beta-amyloid hypothesis
beta amyloids come together to form Plaques (waste prodt
accumulation)
• Block neurotransmission
• Promote
inflammation → neuron death
• Weaken blood vessels
•
Initiates phosphorylation of tau proteins
tau -hypothesis
abnormal agregation of tau proteins which leads to formation of tangles with nerve cells in the brain, in a normal brain tau proteins help to lengthen and support microtubule structure-wic transport nutrients and information molecules throughout the nueron.