Pathophysiology/Discussion Prompt 8


Using the video from Episode 8 on Rowena, answer the following prompt:    Prompt 1: Explain in detail the different types of dementia.  Also, note that content in this case scenario incorporates topics from Chapter 44 and 45.    Requirements: 1-2 references to support your responses.  1-2 full paragraph responses Sample for Discussion prompt : Prompt 1: Explain in detail the different types of dementia.  Multiple causes and types of dementia exist. Dementia a syndrome associated with many pathologic processes. All potential causes of cognitive change when dealing with patients with mental status change (Banasik & Copstead, 2019). Dementia is a decline in reasoning, memory, judgment, and other cognitive functions. Although common in elderly persons, dementia is not a normal part of aging. It can be reversible and irreversible causes. Dementia is more than age-related forgetfulness. It is a serious illness. Individuals with dementia lose the ability to reason, cannot solve problems, and cannot think abstractly. They are disoriented to time and place, and eventually, they cannot identify persons. The causes of dementia can vary, depending on the types of brain changes that may be taking place. The two main causes of dementia are Alzheimer’s disease and multi-infarct dementia, a vascular disease. Alzheimer’s disease is the most common cause of dementia in older adults. Other dementias include Lewy body dementia, frontotemporal disorders. It is common for people to have mixed dementia—a combination of two or more types of dementia. For example, some people have both Alzheimer’s disease and vascular dementia. (Banasik & Copstead, 2019). Alzheimer’s Disease is an accumulation of neurofibrillary tangles. Senile plaques also called beta-amyloid plaques, and cerebrocortical atrophy of the brain. A special kind of protein, tau, makes the neuron structures healthy, but in Alzheimer’s disease, these proteins change and become unstable (Capriotti & Frizzell, 2016). Vascular dementia refers to progressive loss of memory and other cognitive functions caused by vascular injury or disease within the brain. Symptoms of vascular dementia may sometimes be difficult to distinguish from Alzheimer’s disease. Problems with organization, attention, slowed thinking, and problem-solving are all more prominent in VCID, while memory loss is more prominent in Alzheimer’s (Vascular Contributions to Cognitive Impairment and Dementia 2017).  Vascular cognitive impairment involves changes in language, attention, and the ability to think, reason, and remember that are noticeable but are not significant enough to impact daily life greatly. These changes, caused by vascular injury or disease within the brain, progress slowly over time. (Vascular Contributions to Cognitive Impairment and Dementia 2017). Post-stroke dementia can develop months after a major stroke. Not everyone who has had a major stroke will develop vascular dementia, but the risk for dementia is significantly higher in someone who has had a stroke. Multi-infarct dementia is the result of many small strokes (infarcts) and mini-strokes. Language or other functions may be impaired, depending on the region of the brain that is affected. The risk for dementia is significantly higher in someone who has had a stroke. Dementia is more likely when strokes affect both sides of the brain. Even strokes that don’t show any noticeable symptoms can increase the risk of dementia (Vascular Contributions to Cognitive Impairment and Dementia 2017). Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an extremely rare inherited disorder caused by a thickening of the walls of small- and medium-sized blood vessels, which reduces the flow of blood to the brain. CADASIL is associated with multi-infarct dementia, stroke, and other disorders. The first symptoms can appear in people between ages 20 and 40. CADASIL may have symptoms that can be confused with multiple sclerosis. Many people with CADASIL are undiagnosed (Vascular Contributions to Cognitive Impairment and Dementia 2017). Subcortical vascular dementia, previously called Binswanger’s disease, involves extensive microscopic damage to the small blood vessels and nerve fibers that make up white matter in the brain. Cognitive changes include problems with short-term memory, organization, attention, decision making, and behavior. Symptoms tend to begin after age 60, and they progress in a stepwise manner. People with the subcortical vascular disease often have high blood pressure, a history of stroke, or evidence of disease of the large blood vessels in the neck or heart valves (Vascular Contributions to Cognitive Impairment and Dementia 2017). Cerebral amyloid angiopathy is a buildup of amyloid plaques in the walls of blood vessels in the brain. It is generally diagnosed when multiple tiny bleeds in the brain are discovered using magnetic resonance imaging (Vascular Contributions to Cognitive Impairment and Dementia 2017). Rowena’s case on episode 8 video: Rowena was diagnosed with vascular dementia five years ago, so sometimes she does not recognize Toni. She has the typical sign and symptoms of this vascular dementia, such as short-term memory issues in the past weeks.    Reference Banasik, J. L., & Copstead, L.-E. C. (2019). Pathophysiology (6th ed.). Elsevier. Capriotti, T., & Frizzell, J. P. (2016). Pathophysiology: introductory concepts and clinical perspectives. F.A. Davis Company U.S. Department of Health and Human Services. (2017). Vascular Contributions to Cognitive Impairment and Dementia. National Institute on Aging.

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