DEMENTIA AND DELIRIUM

I want to start this post defining three concepts:

  

The concept of  "ALTERING / MILD COGNITIVE IMPAIRMENT" refers to a clinically apparent intellectual decline, functional disability but carries NO apparent functional disability.

Dementia is a slow, insidioud process that results in progressive loss of cognitive function Acute confusion, often called delirium, is characterized by disturbances in cognition, attention, memory ans perception. This type of confusion is usually caused by a physiologic process that affects the I give you one classification table of dementias:

IRREVERSIBLE	REVERSIBLE
Vascular Dementia Posttraumatic Dementia Alcoholic Dementia Degenerative Diseases: Alzheimer Pick Parkinson Huntington Infectious Diseases: AIDS Creutzfeldt-Jacob Other: Multiple sclerosis Dialitic Dementia	Metabolic Disturbances Diseases: Thyroid Adrenal Pellagra B12 and float deficit B1 deficit Uremia Wilson Porphyria Hepatic encephalopathy Calcium upset Inflammatory and infectious diseases Syphilis Meningitis Encephalitis Vasculitis Intracraneal Procesess: Neoplasya Subdural Hematoma Hydrocephalus Depression

On the other hand I think that is important to know some nursing intervention for delirium and dementia:

DELIRIUM:

• designded to treat underlying pathologic condition and mantain physiologic integrity.
• includes administration of fluids, nutrition, oxygen, antianxiety medications, and so on.
• designed to control enviromental stressors, to protect safety and to promote comfort.

DEMENTIA

• designed to maintain or maximize level of function
• includes enviroment modification, activity-based therapies, and communication strategies.

I want to pay attention on one of the primary cortical degenerative dementias, alzheimer's disease: this is a progressive brain disorder, characterized by degenerative changes of cortical nerve cells and brain nerve endings. This causes an irreversible deterioration of memory and destruction of intellectual functions.

I didn´t know the relation between level of education and dementia. I look information about this point and I want to summary two article that I found.

First of all, it is important to know the therm of cognitive reserve. Cognitive reserve could be defined like brain's ability to tolerate dementia pathology's effects may be the result of an innate ability or the effects of their experiences, such as education or occupation. Low education could be a risk factor for dementia.

The level of cognitive reserve attained by an individual is influenced by both genetic and life experience factors such as educational attainment and occupational history. I would talk about an information that I found in one article that I think that is interesting, The Tasmanian Healthy Brain Project (THBP) is a world-first prospective study examining the capacity of university-level education to enhance cognitive reserve in older adults and subsequently reduce age-related cognitive decline and risk for neurodegenerative disease.

Do you know about this?

In other article I found two types of reseve: cerebral reserve, this term be based on characteristics individual such as brain size, the number of neurons or synaptic densitythat help offset possible degenerative Central Nervous System diseases; and cognitive reserve that I explained before.

I think that it is very important because the cognitive reserve explain the possibility that two patient may have the same amount of AD pathology, but one of they may appear much demented than the other.

I didn´t know nothing about the cognitive reserve, for this reason I have tried to explain some information about this. I hope that you were interesting in this topic.

I include a trailer about a documental of the process of the alzheimer disease in a public personage such as Pascual Maragall. I saw all documental and I think that it very interesting for our profession to watch this.

If you would know more about thats point,I leave you some interesting articles:  

Conde J.L.Personalidad premórbida y factores de riesgo en la enfermedad de alzheimer. 1999.  Revista Española Geriatria Ferontología.  Vol 34 núm 3. 
Summers MJ, Saunders NL, Valenzuela MJ, Summers JJ, Ritchie K, Robinson A, Vickers JC. The Tasmanian Healthy Brain Project (THBP): a prospective longitudinal examination of the effect of university-level education in older adults in preventing age-related cognitive decline and reducing the risk of dementia. Int Psychogeriatr. 2013 Mar