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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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