Dementia

Dementia

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We just don’t cure, we care

According to World Alzheimer Report 2015, 47 million people worldwide are living with dementia. Of these 4.1 million are in India alone. Dementia is a condition that not only impairs a person’s ability to think, recall and reason, its societal impact is also deep. At Meditourz we strive to improve the quality of life for a dementia patient making the condition more manageable.

The Meditourz Outcome

Every dementia patient requires individual care and a tailor-made treatment approach. We attempt to provide customized treatment modules for our patients. Stem cell therapy is a revolutionary method which when coupled with rehabilitation therapy in a friendly and warm environment can work wonders for dementia patients.

Our stem cell therapy combined with extensive Neuro rehabilitation program under the supervision of our experts has helped patients exhibit significant improvements in their condition. The positive changes include improvement in following commands, emotional responses, more cooperation, reduced crying spells, improved sitting tolerance and compliance to therapies. Cognitive functioning with respect to memory, attention, concentration, mathematical abilities and reasoning also shows a marked improvement. These improvements are recorded on the neuropsychological test called MMSE, which stands for Mini Mental Status Examination.

Our patients are now able to maintain a routine and are more independent in performing day to day activities. There are also improvements in fine motor activities, localization of objects, or motor control and swallowing.

Most significantly, following Stem Cell Therapy, the progression of dementia gets halted and patients are able to live a fulfilling life.

Dementia includes a wide range of neurological disorders that lead to progressive loss of memory and ability to think greatly affecting the quality of life of those affected. The symptoms are accompanied by a lack of motivation, mood swings and problems with language. Alzheimer’s disease is the single most common cause of dementia dominating close to 70% of the cases. The occurrence of dementia has become more common with an increase in longevity and is today the most common cause of disability among the old.

Loss of memory alone is not a definitive sign of dementia but coupled with one or more brain attributes such as problem with language, reasoning or judgement in a conscious state the condition may be diagnosed as dementia.

Dementia is classified based on the disease that gives rise to it. The most common causes of dementia are:

Alzheimer's disease

The brain experiences shrinking as cells begin to degenerate because of the presence of an abnormal protein. Hippocampus is the most severely affected area of the brain in this case. Most common symptoms associated with Alzheimer’s are short-term memory loss, problem with spatial orientation, getting lost and difficulty finding words.

Vascular dementia

In this case the diminished supply of oxygen to the brain causes cells to degenerate and die. The reduced supply of oxygen could be due to blockage of blood vessels, thus the name vascular dementia. It usually starts with one large stroke or a series of small strokes implying damage to blood vessels. Early symptoms include difficulty with problem-solving, concentration and bouts of confusion.

Mixed Dementia

In many cases, an individual suffers from more than one type of dementia at the same time. Often, symptoms of both types of dementia are exhibited. Alzheimer's disease and vascular dementia commonly occur together.

Dementia with Lewy Bodies

This type of dementia is caused by the growth of small abnormal structures inside brain cells. This dementia is linked with Parkinson’s disease as both show similar symptoms such as problem in movement, intermittent bouts of alertness, problem with figuring distance and hallucination.

Frontotemporal dementia

This dementia is caused by damage sustained to the front and side of the brain due to formation of abnormal proteins inside cells. This type of dementia is characterized by personality and behavioural changes. Difficulty in speaking fluently and differentiating between words are other accompanying symptoms.

Dementia can also be categorized on the basis of common features:

Cortical dementia: Affects only the outer layer (cortex) of the brain

Sub cortical dementia: Affects the lower layer of the cortex

Progressive dementia: A gradual decrease in mental faculties over time affecting more cognitive abilities in the process. Alzheimer’s Disease is a form of progressive dementia.

Primary dementia: Does not result from any other disease

Secondary dementia: Occurs due to a physical disease or injury

Conditions such as Huntington's disorder, Traumatic Brain Injury, Multiple sclerosis and Parkinson's disease can also lead to dementia. Dementia due to immune disorders, metabolic disorders, nutritional deficiency and reaction to medication is reversible./p>

Those suffering from dementia often exhibit problems with visual-spatial orientation, balance, speech and language, eating and swallowing; suffer from warped memories, tremors and restlessness.

In most cases, when symptoms begin to show much of the damage to the brain has already taken place. Frequently, people suffer from more than one type of dementia simultaneously; a condition that is known as mixed dementia.

Apart from neurological symptoms, dementia is accompanied by behavioral and psychological symptoms like agitation, anxiety, depression, mood swings, impulsive behavior, delusional bouts, disturbance in sleep cycle and apathy.

Some of the typical symptoms of dementia include:

  • Memory loss
  • Difficulty in communication
  • Difficulty with complex tasks
  • Difficulty in planning out things or being organized.
  • Difficulty in coordinating and other motor functions.
  • Problems with disorientation, such as getting lost
  • Personality changes
  • Inability to reason/li>
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

Except for reversible dementia caused due to hypothyroidism, vitamin B12 deficiency, Lyme disease and neurosyphillis, all other forms of dementia are permanent. However, various therapies have been known to support and assist those with this condition.

Most types of progressive dementia such as Alzheimer's disease are not curable. However, certain medicines may help relieve symptoms like improving or stabilizing memory and thinking skills. These drugs known as cholinesterase inhibitors slow the breakdown of the neurotransmitter acetylcholine, which is present in lesser quantities in the brains of people with Alzheimer’s. At present, four cholinesterase inhibitors are approved for use in the US: tacrine (Cognex) ,rivastigmine (Exelon),galantamine (Reminyl) and ), donepezil (Aricept),

Psychological therapies

Music therapy has been known to have some effect. For specialized care of dementia patients, there are adult day-care centers that provide supervision, entertainment, food, and to some extent health care. Many nursing homes also provide this facility.

The aggression of dementia patients can be addressed by analyzing the causes of such behavior and providing appropriate care.

Medication

While there is no known medication that cures dementia, some antipsychotic medicines may be given to ease accompanying symptoms such as sleep disturbance, aggression, anxiety, depression etc. However, before prescribing any medication, it is very important to analyze the patient’s behavior.

Stem Cell Therapy

Dementia is primarily caused by the loss of brain cells. Through stem cell therapy new cells are created to repair and replace damaged and dead brain cells. It has been found after a number of clinical trials that mesenchymal stem cells derived from bone marrow, once in the brain, release chemicals that trigger creation of new nerve cells and promote an environment where these cells can survive. Apart from this, they also support several other metabolic reactions that may contribute towards improving the abilities of those suffering from dementia.

Stem cells are known to secrete neurotrophins, growth factors and other supportive substances that help in more survival chances of neurons.

Autologous Hematopoietic Stem Cell Transplantation in combination with Neuro-rehabilitation can help delay the progression of dementia.

Dr. Alok Sharma

Consultant Neurosurgeon

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