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CHAPTER II
BASIC CONCEPTS
A. Defnition
Behavioural and Psycholoical Sy!"to!s o# De!entia $ De!entia %or in
Enlish is said to de!entia& is a condition 'here a "erson e("eriences a
decline in !e!ory and thin)in and the a*ility )e!a!"un inter#ere 'ith the
#unction o# everyday li#e.
De!entia is a syndro!e due to disease or *rain disorders are usually chronic+
"roressive+ 'here there ,annuan no*le #unction o# cortical includin-
!e!ory+ thin)in+ orientation+ co!"rehension %co!"rehension&+ arith!etic+
)e!a!"un learnin+ lanuae and "o'er value ud!ent+ enerally
acco!"anied+ and so!eti!es "receded *y deeneration %deterioration& in
e!otional control+ social *ehavior+ or !otivation to live.
De!entia is a syndro!e that indicates deterioration o# intellience.
De!entia is a disorder o# intellectual #unctions 'ithout interru"tion veetative
#unctions or a'a)e. /e!ory+ eneral )no'lede+ a*stract thin)in+ ud!ent+
and inter"retation o# 'ritten and oral co!!unication can *e interru"ted.
%Eli0a*eth 1. Cor'in+ 2334&
B. Cause
De!entia is caused *y-
a. Acute condition untreated or not cura*le+ i# an acute condition that causes
deliriu! or can not *e treated+ there is a "ossi*ility that this condition 'ill
*eco!e chronic and can there#ore *e considered as de!entia.
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*. 5ascular disease+ such as hy"ertension+ arteriosclerosis+ and atherosclerosis
can cause a stro)e.
c. Par)inson6s disease- de!entia attac)ed 738 o# these "atients.
d. Prion diseases %"rotein contained in the in#ection "rocess Creut0#eldt91a)o*
disease&.
e. In#ection o# hu!an i!!uno defciency virus %HI5& can attac) the central
nervous syste!+ causin ence"halo"athy )o!le) HI5 or AIDS de!entia.
#. Disru"tion o# *rain tissue structure+ such as nor!al "ressure hydroce"halus
and inuries #ro! head trau!a.
C. Rane Res"onse
D. Process o# Pro*le!s
There are so!e ty"ical *ioche!ical chanes and neuro"atholoy are co!!on
in de!entia. :i*ers neuron tanles %tanles "eriod neuron are not #unctionin&
and senile "la;ues or neuritis %"ritein *eta9a!yloid de"osits+ "art o# a lare
"rotein+ "recusor a!yloid "rotein %APP&&. Da!ae occurred in "ri!ary neurons
o# the cere*ral corte( and cause da!ae to *rain si0e. Si!ilar chanes are
also seen in nor!al *rain tissue o# s!all *u!"s elderly. The !ain cells a<ected
*y the disease is usin the neurotrans!itter acetylcholine. In *ioche!ical+
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asetil)olion a<ectin "roduction decreased activity. Acetylcholine is !ainly
enaed in the "rocess o# !e!ory.
Cere*ral Da!ae occurs 'hen the *lood su""ly )eota) disru"ted. In#arction+
*rain tissue death+ occurs at an incredi*le s"eed. Cere*ral in#arction s!all
!ulti"le9in#arction.
Di00iness+ headache and decreased "hysical and !ental strenth are the early
sins o# the disease. In !ore than hal# the cases+ the disease a""ears as a
sudden con#usion. Then dii)uuti sudden !e!ory loss. Then #ollo'ed a radual
!e!ory loss. Patients !ay e("erience hallucinations and sho'ed sins o#
deliriu!+ s"eech disorders can occur.
E. Sins and Sy!"to!s
a. =oss o# !e!ory %the early staes o# a ne' !e!ory loss li)e #orettin 'as
coo)in #ood on the stove+ the ne(t stae o# !e!ory loss to #oret the "ast as
children6s na!es+ 'or)&.
*. The decline in the #unction o# lanuae %#oret the na!e co!!on o*ects
such as chairs or ta*les+ "alilalia >re"eatin sound?+ and re"eat the 'ords
heard >echolalia?&.
c. =oss o# the a*ility to thin) a*stractly and to "lan+ initiate+ se;uence+ !onitor
and sto" co!"le( *ehavior %loss o# e(ecutive #unction&- the client loses the
a*ility to "er#or! sel#9care activities.
:. Ty"e $ 5arious @inds o# De!entia
. By ae-
a& Senile de!entia is de!entia that occurs in those aed years.
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*& De!entia "rasenilis na!ely de!entia that occurs at ae years.
2. Accordin to the course o# the disease-
a& Reversi*le %i!"roved&
*& Irreversi*le %nor!al "ressure hydroce"halus+ su*dural he!ato!a+ vita!in B
defciency+ hy"othyroidis!+ into(ication PB&. In this ty"e de!entia there is an
enlare!ent vertri)el 'ith increased cere*ros"inal Fuid+ it led to-
G Distur*ance o# ait %unsta*le+ drain&.
G rinary incontinence.
. Accordin to the structure o# the *rain da!ae-
a& De!entia Al0hei!er6s ty"e
Al0hei!er6s is a decrease in the concentration o# acetylcholine and choline
acetyl trans#erase in the *rain and is a deenerative disease due to the death
o# *rain cells and enerally cause a deterioration o# intellectual or conitive
#unctions+ 'hich include deterioration o# re!e!*erin and thin)in "rocess.
*ehavior e("erienced *y de!entia are #oret#ulness or de!entia. Althouh
"ennye*a* de!entia Al0hei!er6s ty"e is not )no'n #or sure+ so!e studies
have suested that as !any as 738 o# "atients have a #a!ily history o#
de!entia Al0hei!er6s ty"e so hihly rearded enetic #actors "lay a role in the
develo"!ent o# disorders in at least so!e cases.
*& 5ascular de!entia
The "ri!ary cause o# vascular de!entia is the cere*ral vascular disease that
causes a "attern o# !ulti"le sy!"to!s o# de!entia+ 'hich usually also called
!ulti9in#arct de!entia. 5ascular de!entia is co!!on in !en+ es"ecially in
those 'ith "re9e(istin hy"ertension or other cardiovascular ris) #actors.
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,. Phase $ Stae
Phases $ staes o# de!entia are-
. Early Staes- In the initial condition+ de!entia has an insidious onset o#
sy!"to!s+ the condition is vascular de!entia occurs 'ith chanes in conition
that sudden. At this stae+ the client can sho' the "attern o# "oor ud!ent+
es"ecially i# it is in a ne' situation or cause stress+ "ersonality chanes occur.
Clients started to sho' an e("losion o# e!otion and *eco!e an(ious and
aitated+ there 'as con#usion *et'een the orientation o# ti!e and distance.
The s"ecifc sy!"to!s-
a. Chanes in !ood or "ersonality.
*. I!"aired ud!ent and "ro*le! resolution.
c. Con#usion a*out ti!e and "lace.
d. DiJculties 'ith nu!*ers+ !oney and *ills.
e. Kithdra' or de"ression.
2. /iddle Staes- In this condition+ the !e!ory o# the client at this ti!e and
the "ast deteriorated and the lac) o# ud!ent led to concerns a*out sa#ety is
reduced. This stae is the stae that reatly a<ect the daily li#e o# the client.
The s"ecifc sy!"to!s sho'n at this stae-
a. /e!ory i!"air!ent "resent and "ast.
*. I!"aired ud!ent and "ro*le! solvin severe.
c. Perce"tual disorders.
d. =oss o# i!"ulse control.
e. An(iety+ restlessness.
. :inal Staes- In the fnal staes o# de!entia+ the client *eco!es !uscle
riidity+ and reFe(es "ri!iti#e also a""eared. The sy!"to!s are-
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a. Severe disru"tion on all conitive a*ilities.
*. The ina*ility to reconi0e #a!ily and #riends.
c. Severe co!!unication disorders %!ay ru!*le+ co!"lain or !u!*le&.
d. At least sel#9care ca"acity.
e. Pro*a*le hi"eroral and have an active hand.
#. Decreased a""etite+ dis"asia+ and the ris) o# as"iration.
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