hereditary diseases, depression (pseudo-dementia), intake of the medicinal drugs (anti-psychotics, tranquilizers,hypnotics, anticholinergic and antispileptics), alcoholism and other intoxications, metabolic disturbances(hypoglycaemia, hypothyroidism, deficiency of vitamins B, and B
, hypoparathyroidism, liver disease).Practically, it is very importantly that in circumstance that 10-15% of dementia recovers completely or partially.these dementia, which developed as a result of medicine-induced intoxication, depressions, metabolicdisturbance, caused by the somatic disorders and sometimes by other reason (for example, by brain tumor orchronic subdural hematoma, which can be removed surgically). Earliest diagnostics of dementia is extremely desirable.In reversible form of dementia, makes it is possible begin timely treatment, in the case of the irreversible form, largereffectiveness if pathogenetic and symptomatic therapy are carried out, and to organize medical and social aid.In Alzheimer's disease, anticholinesterases (rivastigmine, galantamine and others), acatinol and memantin areused. In vascular dementia, besides the use of these drugs, treatment is directed toward the prevention of progression of cerebrovascular disease, (reaching the optimum level of arterial pressure, anti-aggregant, if indicated - anticoagulants, statins). In case with dysmetabolic disturbances and the intoxications, it is indicated toeliminate them. In the quality of preparations, to increase cognitive functions, at the early stage of dementia it ispossible to use Piracetam (nootropil), vinpocetin (Cavinton), Cerebrolizin, tanakan, pentoxiphillin and other.Improvement of cognitive abilities can be achieved by systematic exercises and training of memory and attention,active participation of patients in the daily life of family, support of the existing daily habits.The reasons for the acute development of amnesia are craniocerebral injury, stroke, encephalitis, hypoglycaemia,metabolic encephalopathy, acute alcoholism, or other intoxication. Transient amnesia can be due to epilepsy,migraine, transitory ischemic attack (transitory global amnesia). Korsakov syndrome most often is caused by chronicalcoholism. Other reasons are stroke, injury, tumor and hypoxic encephalopathy with the lesion of hypocampus.Progressive amnesia more frequently appears in Alzheimer disease or vascular dementia, being combinedusually with the disturbance of speech, and reduction of intellect.The treatment of memory disturbances is directed to basic disease, if it is possible. It is possible to recommendneuropsychological training, to correct of memory disturbances in the daily life of patient, and also drugs, whichimprove the memory: akatinola of memantin, Piracetam (nootropil), vinpotsetin (Cavinton), cerebrolizin,tanakan, pentoxipillin and other
Degenerative disease of the brain causing dementiaAlzheimer s disease
Alzheimer Disease is the most frequent degenerative diseases of brain, which lead to dementia. Disease appearspredominantly in the elderly and old age. Alzheimer's disease is encountered in 5% of people older than 60 year old and in20% people older than 85 years. The disease is encountered more frequently among the women than in men.
The etiology of disease is not known, in 15% of the cases, it is hereditary. In the present time,several genetic versions of Alzheimer disease are established, and they are connected with the anomaly of chromosome 14 or, rarely chromosomes 1, 19 and 21.Atrophic process develops in greatest degree in the associative zones of temporal, occipital and frontal portion. In thepathogenesis of disease, its important role is assigned to reduction in the activity of cholinoacetyltransferase andcontent of acetylcholine in the hippocampus and neocortex. In pathomorphological investigation, besides the loss of neurons, they reveal the deposit of amyloid in the senile plague and in many preserved neurons thinning anddensifying of neurofibrillary structures (neurofibrilary depositon/tangle), which contain that pathologically changedprotein - tau-protein. Deposit of amyloid in the senile plague and neurofibrillary deposits in the neurons of brainare revealed in insignificant quantity in all elderly persons; however, these changes they do not achieve this largeprevalence as with Alzheimer disease.