Confusion – a sign of dementia in the elderly

Alzheimer’s and stroke are the two main causes of dementia in the elderly, making them confused and unable to care for themselves.

Doctor Nguyen Ba Thang, Head of the Center for Neuroscience, Head of the Stroke Unit, Ho Chi Minh City University of Medicine and Pharmacy Hospital, said recently the hospital received a 65-year-old female patient who often forgot her way home. . The family member said that a few months ago, she used to repeat the same question many times. About a week before she was admitted to the hospital, she had several outings on the same day but could not remember the way home. She has a history of diabetes and has been on medication for more than 4 years.

Neurological and psychological evaluation tests showed that the woman had intermediate stage dementia, requiring hospitalization to monitor the progress of the disease, and guide care and exercise to improve function.

According to Dr. Thang, dementia is a disease that occurs when brain cells, or the connections between brain cells, are damaged, causing loss of normal functioning. These are advanced human functions, such as memory, organizing work, calculating, thinking, planning, taking care of yourself, caring for others… This neurological disorder does not not only directly affects the quality of life of patients and relatives, but also creates economic burdens for families and society.

With the same opinion, Dr. Tong Mai Trang, Department of Neurology, said that dementia is a common disease in the elderly and is classified as a “red flag” disease worldwide. According to the 2015 statistics of the World Health Organization (WHO), there is a new case of this disease every three seconds in the world. As the disease progresses, the patient is unable to take care of himself, unable to function normally without the support of loved ones. Patients may not be able to recognize their loved ones, have symptoms of psychosis, such as irritability, suspicion, and agitation, leading to non-cooperation during treatment.

Dr Trang cited WHO research showing that the rate of people with dementia doubles every 10 years. In 2018, the world had 50 million people with dementia, it is estimated that in 2030 this number will be about 82 million people, in 2050 about 152 million people. In which, the new incidence of dementia in developed countries is under stable control, due to the stable aging of the population. As for developing countries like Vietnam, the rate of sick people is higher, because in developing countries, population aging is happening faster than in other countries.

In Vietnam, the Association of Alzheimer’s Disease and Cognitive Neuropsychiatric Disorders statistics in 2018 that there were 500,000 people over 60 years old with dementia, accounting for about 5% of this age group.

Doctor Trang examines and tests neuropsychiatry with questions to survey memory, language ability, and situation handling for patients with suspected dementia. Image: Hospital provides

According to experts, there are many causes of dementia. Most of them are related to neurodegenerative conditions, most notably Alzheimer’s disease. The second is pathology related to blood vessels, specifically stroke sequelae. Traumatic brain injury, Parkinson… also cause this disease. Some other groups of diseases such as neurological infections, micronutrient deficiencies also bring similar manifestations of dementia.

Every year in Vietnam, about 200,000 people have a stroke, according to the Ministry of Health. The world recorded the rate of dementia after stroke about 30-60% depending on the study. However, Dr. Thang analyzed, not all stroke patients have this condition. People who have had multiple, multifocal strokes (multifocal cerebral infarction) and strokes in the hippocampus (where responsible for memory maintenance, advanced functions such as thinking, calculating, planning) …) will have a higher risk of dementia. The same depends on the area of ​​​​the damage and the extent of the damage after the stroke that determines whether the patient has dementia or not.

The risk of disease onset widens with age. In adolescents, a low level of education is a prerequisite for future dementia. People in the middle-aged group (40-60 years old) have an increased risk of dementia if they fall into cases of hearing loss, head injury, high blood pressure, obesity, drinking a lot of alcohol. In the elderly, diseases related to blood vessels such as diabetes, stroke, depression or long-term smoking habits, a sedentary lifestyle, less social contact, and communication will increase the risk. cognitive decline.

“Even so, about 40% of the factors affecting the brain that cause dementia can be prevented early by building a healthy lifestyle, limiting bad habits such as smoking, drinking alcohol. , prolonged stress …”, Doctor Thang said.

Besides, dementia is not a natural aging phenomenon, the manifestations of this syndrome are pathological in nature, Dr. Trang said. Patients and relatives can rely on the following 10 warning signs to recognize early signs of the disease. Including memory loss; difficulty performing familiar tasks; difficulty in using language to express ideas; disorientation in time and place; reduced ability to assess situations; changes in attitudes and behavior; difficulty understanding visual and spatial information; withdraw from work and social activities.

Early detection and treatment of dementia helps patients manage the condition and maintain a better quality of life in its early stages. It also takes time to plan, choose the right treatment and care. In addition, relatives and caregivers will have time to gradually adapt to the patient’s changes in cognition and behavior.

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