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Joe Enright PSY 846

Overview
Introduction
History Description

Impact
Etiology Risk Factors Prevention

What is Dementia?

History
Dementia Literally means without mind Referred to a variety of mental illness Senile/Senility Literally means old age Developed negative connotation due to cognitive decline associated with the elderly

(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Age related cognitive decline first recorded by

Pythagoras in the 7th century, B.C.


Old age (Senium) begins at 63

A long period of physical decline and decay,

and regression of mental capacity


A return to the imbecility of infancy Fortunately, few humans experience it
(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Plato and Aristotle (3rd century B.C.)
Mental failure in old age inevitable Elderly are useless in roles requiring high ability,

due to deterioration of imagination, judgment, reasoning, and memory


Didnt link deterioration to organic causes

(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Cicero (2nd century B.C.)
Senile debility is not characteristic of all elderly The weak minded affected more An active mental life can prevent or postpone

mental failure Should be considered a disease and defended against

(Boller & Forbes, 1998)

History
Galen (150-200, A.D.)
Mental deterioration with age inevitable, and due

to reduced number of animal spirits and from coldness and humidity in the brain

Little progress for more than a millennium Roger Bacon (1214-1294) memory is a function of the brain cognitive decline is due to injury to the brain occurring in old age.
(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Dementia described by Shakespeare in literary

works (14th/15th century , A.D.)


Differentiated between cognitive decline and

madness Commented on both affective and cognitive changes that occur with dementia

Many elderly with symptoms of dementia

victimized during witch hunts (1400-1600s, A.D.)


(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Human dissection becomes popular/acceptable

in the 1700s
Brain atrophy first observed Senile dementia classified as medical condition

(neuroses) resulting from disturbed nervous system function Senile dementia defined as decay of perception and memory in old age Cullen

(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
Suspected causes for senile-dementia in the

early 19th century:


Menstrual disorders Sequelae of delivery Head injuries Progression of age Ataxic fever Hemorrhoids surgery Mania and monomania Paralysis Apoplexy Syphilis Mercury abuse Dietary excesses Wine abuse Masturbation Unhappy love Fears Political upheavals Unfulfilled ambitions Poverty Domestic problems

(Esquirol, 1838)

History
In the 1860s decreased brain weight linked to

senile dementia and eventually brain atrophy


1890s Brain atrophy in dementia attributed to

lesions caused by neurovascular events (strokes), cutting off the blood supply to the brain
1898 senile dementia differentiated from

dementia praecox (later schizophrenia)


(Birchtold & Cottman, 1998; Boller & Forbes, 1998)

History
1907 Alois Alzheimer using advancing cellular

staining techniques discovered neurofibril tangles, and plaques throughout the brain of a deceased 51 year old with pre-senile dementia
Auguste D. is first observed case of Alzheimers

disease
5 cases of Alzheimers Disease discovered by

1910
(Jellinger, 2006)

Current Definition & Description


No universal definition
Considered to be a syndrome, analogous to

unhealthy aging, a diagnostic label


Deterioration in at least three of the following

domains: memory, language, visuospatial skills, personality or behavior, and executive functioning
Common symptoms include forgetfulness,

language deterioration, mood changes, impaired judgment, and loss of initiative


(Mandell & Green, 2011; Cummings & Mega, 2003)

Celebrities w/ Dementia
Charles Bronson

Celebrities w/ Dementia
James Doohan

Celebrities w/ Dementia
Charlton Heston

Celebrities w/ Dementia
Ronald Reagan

Dementia Pandemic
2005 24 million people with dementia globally
A new case every 7 seconds

Alzheimers Disease (AD) accounts for up to

70% of all dementia cases


AD is 5th leading killer in the U.S. of adults over

age 65
Over 100$ billion a year for care (US)
(Mandell & Green, 2011)

Dementia Pandemic

(ASC, 2010)

Dementia Pandemic

(ASC, 2010)

Dementia Pandemic

(Mandell & Green, 2011)

Prognosis
2005 24 million people with dementia
A new case every 7 seconds

Alzheimers Disease (AD) 5th leading killer in

the U.S.

(Mandell & Green, 2011)

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