Dementia

Organic Brain Syndrome, Organic Mental Syndrome, Senile Organic Psychosis, Degenerative Dementia

What is Dementia?

Dementia signs and symptoms

  • Forgetfulness, especially of recent events.
  • Unpredictable, sometimes violent, behavior.
  • Confusion.
  • Loss of interest in normal activities.
  • Disorientation, especially at night.
  • Poor personal hygiene and appearance.
  • Depression; sleep disturbances.
  • Poor judgment.
  • Incontinence (late stage).

This diagnosis refers to a wide group of psychological and behavioral abnormalities, the cause of which is unknown. They are considered to be abnormalities in brain function and may be temporary or permanent. An organic cause is suspected when there is no indication of an "inorganic" cause, such as a mood disorder; however, the distinction between organic and inorganic processes has become increasingly unclear.

The syndrome can appear as delirium and dementia, with major impairment of intellectual functions such as disorientation, memory impairment, and disorganized thinking and speech. Or there may be amnesia, hallucinations, delusions, or mood and personality changes. Judgment and impulse control are altered. There could also be restlessness and groping, unproductive movements, or sluggishness.

Fearfulness is a common emotional disturbance and can lead to running away or aggressive behavior. Sleep is usually disturbed, with insomnia, drowsiness, or stupor. In all cases, impairment of social and occupational functioning is severe. Organic brain syndromes can occur at any age.

How is it diagnosed?

History is of a major disturbance in thinking, emotions, behavior, and/or level of consciousness. Observation of the individual's orientation, dress, mannerisms, behavior and content of speech provide essential signs to diagnose the illness.

Physical exam may reveal a tremor.

Tests are not diagnostic.

How is Dementia treated?

Treatment is directed at maintaining safety for the person and others. It can involve antipsychotic medication and confinement.

Medications

  • Medications used to treat other conditions may cause confusion or sedation; ask if they may be changed or discontinued.
  • Medication appropriate to treat the underlying condition.

Aricept (Donepezil)

Activity

  • Encourage as much activity as possible.
  • Accident-proof the home.
  • Take precautions against the patients wandering.

Diet

Provide a well-balanced diet.

What might complicate it?

The individual may become injured falling out of bed, may wander, and get lost. The person may be unable to take care of basic nutritional and hygienic needs. There is a susceptibility to infections. Severe depression and suicide can occur. The person may injure another individual.

Predicted outcome

The course and outcome are extremely variable. There can be lucid intervals between disturbances. If the cause is transient, such as unsuspected drug overdose or withdrawal, the disorder will totally clear within a few days. If due to a progressive condition such as Alzheimer's disease, the individual will never recover.

Preventive measures

  • Obtain early medical treatment for underlying causes.
  • Protect yourself from head injury. Wear seat belts in vehicles. Wear protective head gear for riding bicycles, motorcycles and participating in contact sports.
  • To prevent atherosclerosis, don't smoke, eat a diet low in fat, exercise regularly and reduce stress whenever possible.
  • Ask your doctor about preventive steps to take.

Alternatives

Other possibilities are schizophrenia, dementia of the Alzheimer's type, major depression, manic episode, or malingering.

Appropriate specialists

Psychiatrist and psychologist.

Last updated 7 August 2011


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