Senile dementia/Alzheimer's type
Alternative names:
Alzheimer's disease; diffuse brain atrophy; primary degenerative dementia
Symptoms:
- awareness of intellectual decline, initially
- apraxia: inability to perform purposeful movements (not caused by motor or sensory impairment); inability to use objects properly
- difficulty with any previously learned, skilled sequential movement
- trouble naming objects (anomia)
- "word-finding" deficits in conversation
- dementia, slowly progressive (progressive loss of many brain functions) including
- gradual onset of intellectual decline
- disrupted or wandering attention
- inability to maintain goal directed, purposeful thinking or behavior
- inability to concentrate
- disorientation
- confusion
- memory losses, primarily short-term memory (at first)
- withdrawal from social interaction
- progressive difficulty interacting in social or personal situations
- decreased ability to function in self care and daily living activities
- lack of spontaneity
- behavior that is inappropriate relative to the environment
- judgment impairment
- agitation or other affect/mood changes that appear or worsen as the disorder progresses
+ sleep pattern changes (sleep apnea is fairly common)
Signs and tests:
The disorder is tentatively and/or provisionally diagnosed by the health care provider based in part on the history and progression of symptoms, and by ruling out other causes of dementia, including dementia due to metabolic causes. The history may show progressive decline in memory, judgment, and orientation, with changes in mood and behavior.
A neuromuscular examination shows inability to reproduce movements or perform skilled, coordinated movements. There may be a loss of ability to perform simple daily living activities such as eating, dressing, or toileting. Language and calculation abilities may be altered. Inappropriate reflexes, or increased or decreased action of normal reflexes, may be present. Psychologic studies and tests of sensation, cognitive function, and motor function may be abnormal.
Atrophy (shrinking) of the frontal or temporal lobes of the brain, generalized atrophy, and/or other "signal" changes in the white matter may appear on: An EEG (electroencephalography) may show nonspecific changes. A lumbar puncture and cerebrospinal fluid (CSF) examination is normal.
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