Dementia Types and Symptoms

• Dementia is an acquired neurological syndrome.
• It is associated with a persistent or progressive decline in intellectual functions.
• These functions include cognition, visuospatial skills, language, memory, emotion, and personality.
• Wernicke-Korsakoff syndrome is related to dementia and alcohol abuse.

DAT (Dementia of the Alzheimer Type)

• It forms cortical dementia.
• The ratio of occurrence is higher in females than males (F>M), affecting 70% of individuals.
• Key features include neurofibrillary tangles, neuritic plaques, neuronal loss (leading to shrunken brains) and neurochemical changes involving depletion of chemicals.

Symptoms of Dementia

• Subtle memory problems
• Self-neglect
• Poor reasoning and judgment in social situations
• Behavior changes, self-neglect, and avoidance of routine tasks like cooking
• Depression with intellectual deterioration
• Hyperactivity or problems with arithmetic
• Difficulty managing daily routines
• Loss of initiative and possible hallucinations
• Inappropriate humor, laughter, or seizures
• Pragmatic language problems
• Naming difficulties, verbal paraphasia, and circumlocution
• Difficulty comprehending abstract meanings
• Impaired picture description
• Logoclonia (repeating the final syllable of words)
• Empty speech characterized by jargon, rapid delivery, and being slurred

Frontotemporal Dementia (Inc. Pick Disease)

• It represents a heterogeneous group of diseases related to Parkinson's Disease (PD).
• FTD accounts for 12% of all dementia cases, with occurrence rates between 12% and 65%.
• There is degeneration of nerve cells with Pick bodies.
• These bodies are dense intracellular formations in the neuronal cytoplasm, and Pick cells (balloon-inflated neurons) are present.
• Symptoms include right-sided atrophy, emotional disturbances like being moody, degeneration, excessive eating, anorexia, parafasias, circumlocution, and impaired comprehension.

Dementia Associated with Parkinson's Disease

• Affects 33-55% of individuals.
• Parkinson's disease is characterized as a single disease entity resulting in hypokinesia.
• It involves neuropathology and brainstem degeneration.
• Lewy bodies are present as small pathological spots in the substantia nigra.
• Frontal lobe atrophy (wide sulci) occurs.
• Reduced dopamine levels.
• Neurofibrillary tangles and plaques are present.
• Slowed voluntary movements (bradykinesia).
• Tremors occur during resting muscles and stress.
• Muscle rigidity leads to a mask-like face.
• Swallowing disorders and sleep disturbances can occur.

Speech and Language Problems

• Reduced speech volume, resulting in dysarthric speech.
• Monotone pitch and loudness.
• Difficulty with word list generation.
• Dysarthric speech.
• Memory and visuospatial perception deficits.
• Micrographia (small handwriting).
• Confusion, hallucinations, and delirium may occur.

Dementia Ass. I Huntington's Disease (subcortical)

• Occurs in 35-40% of cases.
• Mutation on the short arm of chromosome.
• Malformed protein called huntingtin affects brain cells, which control movement.
• Involves loss in basal ganglia, specifically the caudate nucleus, putamen, and substantia nigra.
• Atrophy is present in the prefrontal and parietal lobes.
• There is an "inhibit" of neurotransmitters, particularly GABA.
• Chorea (jerky, spasmodic, involuntary movements of the neck, head, and face) may occur.
• Gait disturbances, muteness, and dysarthria may manifest.
• Deterioration in intellectual functioning, naming, and speech.

Infectious Dementia (subcortical)

• HIV encephalopathy leads to forgetfulness and impaired thinking.
• Motor skills are affected.
• Dementia due to Creutzfeldt-Jakob disease, a form of infectious dementia.
• PRION (protein infectious particle).
• Involves widespread spongiform.
• Fatigue, sleep disturbances, ataxia, tremors, rigidity, chorea, visual problems, and stupor.
• Assess using the ABCD assessment tool.

Arizona Battery for Communication Disorders of Dementia

• Assesses changes in household and dressing habits.
• Global Deterioration Scale checks the level of cognitive function.
• No awareness to severe cognitive daily functioning.

Management Strategies

• Implement simple and structured routines and concrete instructions.
• Use reminders and writing lists as memory aids.
• Keep numbers visible and point out topics.
• Use card names as association aids.
• Use gestures, postures, and visual cues.
• Involve family using infra-bracelets.
• Employ a slow, touch approach.
• Minimize demands and reduce emotional outbursts.