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Cognitive Decline: Dementia

Cognitive Decline: Dementia

Kara Kiscadden

School of Nursing: James Madison University

NSG 325: Concepts in Aging

Professor: Dr. Powell

November 15, 2020

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Cognitive Decline: Dementia

Abstract

Dementia is a disease that affects normal cognitive function as well as psychological changes. It

is caused by damage to nerve cells in the brain which impair memory, thinking, problem-solving

skills, sensations and motor skills. It is estimated that five million Americans per year suffer

from dementia, and fifty million people worldwide (2018). Although there is no cure for

dementia, there are health promotion activities that can reduce the risk of the disease including

smoking cessation, healthy diet, exercise and lowering both blood pressure and cholesterol

levels. Patients suspected of dementia will undergo different laboratory tests and scans to rule

out other potential diagnoses. Healthcare professionals will also review medical history,

complete a physical exam and sometimes speak to loved ones regarding recent behavioral

changes of the patient. Treatment methods for dementia focus on symptom management and

include medications, therapies and lifestyle changes.

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Cognitive Decline: Dementia

Cognitive Decline: Dementia

Effect of Aging on the Neurological System

The central nervous system is composed of the brain and spinal cord. It is responsible for

controlling body movements, sensations, and thoughts and memories. Aging causes the loss of

nerve cells as well as nerve cell mass leading to atrophy of the brain and spinal cord (Eliopoulos,

2018). When this occurs, nerve cells send messages slower and senses are reduced which can

lead to safety or mobility issues (2020). It is normal for geriatric patients to have some form of

memory loss as they age, but it is important to be able to differentiate between normal memory

loss and dementia.

What is Dementia?

Dementia is “an irreversible, progressive impairment in cognitive function affecting

memory, orientation, judgement, reasoning, attention, language, and problem-solving”

(Eliopoulos, 2018). It is caused by damage to brain cells which leads to the brain cells not being

able to interact as normal. There is not a specific test to conclude that a person has dementia, but

doctors will assess medical history, complete a physical exam, perform lab tests and get

information on changes in a person’s behavior or thinking, sometimes from someone close to the

patient. Some of the tests involved are CT scans or MRIs and PET scans. These will rule out

other potential issues and can show if the amyloid protein is present in the brain as this is present

with Alzheimer’s disease (2019).

Treatment Methods and Interventions

Although there is not a cure for dementia, healthcare professionals focus on symptom

management. Some medications that are commonly prescribed to these patients include

cholinesterase inhibitors, memantine, antidepressants and medications to help with sleep

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Cognitive Decline: Dementia

(Hoffman et al., 2020). Cholinesterase inhibitors work by “boosting levels of a chemical

messenger involved in memory and judgement” (2019). Memantine also involves regulating

chemical messengers in the brain (2019). Another way to manage symptoms of dementia include

therapy. Patients with dementia often work with occupational therapy to prevent injuries in their

homes and to help them cope with the disease. Some other therapies used to encourage relaxation

include music therapy, pet therapy, aromatherapy, massage therapy and art therapy.

Nursing interventions for patients with dementia include education on enhancing

communication, encouraging exercise and activities, and utilizing calendars (2019). Education

for communication is geared toward caregivers and it should consist of encouraging patience,

slow, simple sentences and gestures to simplify things for these patients. Exercise benefits

include better strength and cardiovascular health. It is also though to slow the progression of the

disease (2020). Encouraging patients with dementia to engage in social activities helps to

continue stimulating the mind and it helps to lift their spirits and reduce depression. Using a

calendar can help these patients to remember days and events.

Risk Factors and Preventative Measure

There are multiple risk factors associated with dementia. Genetics plays a part in

dementia as well as modifiable risk factors including smoking, high blood pressure, high

cholesterol, obesity, lack of exercise and an unhealthy diet. Smoking increases the risk for

cardiovascular issues as well as increasing oxidative stress and inflammation that can lead to

dementia (Kivipelto et al., 2018). Educating patients on the MIND diet (Mediterranean DASH

intervention and Neurodegenerative Delay) can be beneficial as it has been associated with

reducing the risk of dementia. The MIND diet includes leafy green vegetables, berries, whole

grains, fish, poultry, beans, nuts and olive oil. It limits the amount of red meat, sweets and
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Cognitive Decline: Dementia

cheeses in the diet (2019). It is important for nurses to teach the geriatric community about these

risk factors and to help them implement healthy lifestyle choices.

Conclusion

In conclusion, it is important that healthcare professionals understand dementia and are

able to differentiate it from normal memory loss or other potential diagnoses. It is important that

nurses focus on health promotion topics in the geriatric community such as specific lifestyle

factors in order to slow the progression of nerve cells breaking down, which in turn will decrease

the risk of dementia. Some of the lifestyle factors that need to be discussed include smoking

cessation, exercise, diet and limiting alcohol use as these can all contribute to dementia. This

information will help to maintain healthy cognitive function as people age and will hopefully

reduce the risk of dementia diagnoses.

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Cognitive Decline: Dementia

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