Psychological behavioral management of patients with senile dementia
Introduction
Dementia is a disorder that can have multiple etiologies and that is with progressive and diffuse cerebral dysfunction. The different dementia subtypes are characterized by a clinical picture with common symptoms that differ in their etiology, age, form of presentation, clinical course and associated disorders. It is estimated that between 4 and 5 % of the population old.
Classification
Dementias have been classified as primary and secondary depending on whether the process originates inside or outside the central nervous system. There is talk of Alzheimer’s disease when the clinical picture is associated with anatomopathological evidence (neurofibrillary networks, senile plates, granulovacuolar changes and gliosis). When there is no anatomopathological study, but the clinical picture is presented is called senile or presenile dementia. Pre-senile dementia and senile dementia are defined as cognitive impairment according to the age of presentation of symptoms; Thus, the presenil dementia or inmence of early onset, manifests itself before 65 years of age; While senile dementia or late start dementia, it is presented in 65 -year -old individuals.
Diagnosis
Due to the fact that there is no specific diagnostic marker, much of the diagnosis depends on family information. The information that the family pours is the most important instrument for the detection and evaluation of dementia. For this reason the professional builds much of the diagnosis from the information he obtains from the word of family informants. The visibility of dementia, for the clinician, becomes the “incoherent” behavior of the subject that suffers it. The diagnostic interview with relatives is the authentic field where the institutional appropriation mechanisms with which the symptom into a sign are intended; the subjective in objective; The intimate in public.
Source
It has been discovered that some genes are important in the pathogenesis of some cases of senile dementia. This gene produces an autosomal dominant senile dementia of early onset. Vascular origin is the second most frequent cause of dementias, which is originated by the rupture of a glass or a heart attack. Cerebral arteriosclerosis is the most frequent cause of vascular dementia.
Behavior management in dental consultation
The dental management of the geriatric patient requires special considerations; Therefore, if this condition is added to this condition, these needs demand greater understanding and effort on the part of the treating personnel. Refers to the care provided to the patient, and that will be different, to the extent of the progression of the disease. In this aspect the dentist aims to help maintain oral health in terms of absence of pain, infection and discomfort so that the patient can develop the activities of the stomatognathic system.
To achieve this, he must have knowledge of the individual evolution of senile dementia in the patient and establish a relationship not only with him, but also with his caregivers to whom he must educate and motivate himself to get involved in the common objective of preserving health; In addition, the dentist must establish an adequate relationship with the caregivers, for the fundamental role in the communication that they will have, when the patient cannot do so, since they will be, as connoisseurs of the patient, who most easily identify the changes in behavior, which can Indicate symptoms of pain or discomfort that the patient is not in the ability to tell. Involve the caregiver from the beginning is fundamental, because performing oral hygiene will become more difficult, as the disease progresses and that the person maintains a greater number of natural teeth present in the oral cavity.
Dentists face the challenge of promoting good oral health and a better quality of life of people as they age; guarantee in this group of people the best mouth conditions that provide physical well -being, including good eating habits; as well as the social and emotional well-being that allow the elderly person to relate themselves and with other people; Understand the interrelation of oral health and general health due to the close relationship of oral health with systemic conditions as evidenced by the growing related scientific literature. Given this panorama, dentists face several challenges:
- Prevention from an early age that lead to a greater number of teeth in old age.
- Adequate diagnostic and therapeutic management that guarantees oral health conditions during the aging course.
- Understand the limitations of the changes suffered by the stomatognathic system with old age, to address them in the most appropriate way, in the planning of geriatric patients care.
- Be part of multidisciplinary teams oriented to understand the management of patients with special situations, such as dementia and different types of disability, to adapt the approaches that dentists have to the needs of each individual and their living conditions, so that Have the ability to adapt the knowledge of the proposals to individual needs, with the specificities of each case and that fit the reality in which the elderly live.
Bibliography
- Garre Oj. Dementia diagnostic criteria: at the doors of paradigm shift. Unitat de Recerca. Santa Caterina Hospital. Salt (Girona). Alzheimer’s. Real Invest Demenc. 2007; 35: 4-11. Available at: https: // www.Researchgate.NET/PUBLICATION/268433581_Criterios_diagnosticos_deMe-Cia_a_las_puertas_del_Cambio_de_paradigma?ENRICHID = RGREQ- B45D77BD9D27FA4F33D773F41A3C1EFE-XXX & ENRICHSOURCE = Y292ZXJQYWD- LOZI2ODQZMZU4MTTBUZOYMJM1NJOTGZNZKWMD- LAMTQZMDMMJJU1MTQWMWM
- Rodríguez J, Samper J, Pérez Z. Alzheimer -type senile dementia treatment with magnetic field and ozone. Cuban Magazine of Military Medicine, July-December. Posted by scientific dissemination. October 7, 2016. Available at: https: // www.Exponenial health.com/treatment-of-dementia-senil-tipo-alzheimer-with-field-and-and-ozone/
- Cornejo W, Lopera F, Uribe M, Salinas M. DESCRIPTION OF A FAMILY WITH DEMENCY PRESENIL TYPE ALZHEIMER. Colombian Medical Act Vol. 12 no. 2 (March-April) 1987. Available at: http: // actamedicacolombiana.com/annex/articles/02-1987-03.PDF
- Custodio N, Montesinos R, Alva C, Mejía-Rojas K, Becerra and, Lira D. New clinical terms, prevention and treatment of vascular cognitive disorder: evidence-based literature review. Rev Neuropsychiatr [Internet]. 2016 Jul [cited 2019 Oct 21]; 79 (3): 152-165. Available at: http: // www.Scielo.org.pe/scielo.PHP?script = sci_arttext & pid = S0034- 85972016000300004 & lng = is.
- Cañabate p. Analysis on biomedical representation and popular representation of senile dealence and Alzheimer’s. Notebooks-e of the Catalan Institute of Anthropology [online], 2003 No. two. Available at: https: // www.Raco.Cat/Index.PHP/Quadernseica/Artici/View/51411/131241
- Aquino J, Apaza J, Huaynoca N. Senile dementia. Rev. Act. Clin. Med [magazine on the Internet]. [Cited 2019 Oct 21]. Available at: http: // www.Magazines Boils.org.Bo/Scielo.PHP?script = sci_arttext & pid = s2304-376820120002007 & lng = is.
- Mejia N, Arbelaez D, Munera M. A look at the dental management of the geriatric patient with dementia . Internet magazine. Cited 2019 Oct 21. http: // www.Scielo.org.CO/PDF/CESO/V30N1/V30N1A06.PDF
- Crespo M, Hornillos C, Bernaldo M, Gómez M. The evaluation of the quality of life in people with dementia. Rev. Elsevier.2011.46,319-24 cited 2019 Oct 21. https: // www.Elsevier.It is/es- Revista-Espanola-Geriatria-Gerontologia-124-LinkResolver-La-Evaluation-Vaidad-Vida- People-S021139x11001740
- Fernandez H, Garrido B, Pastor C. The dental care of the geriatric patient with cognitive detention. AV ODONTOMATOL VOL.31 no.3 Madrid May./jun. 2015. http: // scielo.is- cii.It is/scielo.PHP?script = sci_arttext & pid = s0213-128520150003002
- Foltyn p. Ageing, Dementia and Oral Health. Australian Dental Journal Volume 60, ISSUE S1. March 2015. https: // OnlineLibary.Wiley.com/doi/full/10.1111/adj.12287
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