Dementia

• Dementia


  Chronic deterioration of memory, personality, language skills, perception, reasoning or judgment - with no LOC

  • Changes may happen over weeks or years & can be subtle
• Wernicke encephalopathy presents with dementia

  • Caused by vitamin B deficiency - occurs in pt who are chronically malnourished (ex. chronic alcoholism)
  • Presentation: Atacia, confusion, agitation, nystagmus, generalized weakness, foot drop, peripheral neuropathy
• Alzheimer disease


  Most common form of dementia

  • Progressive, organic condition in which neurons die
  • Cause: gradual buildup of plaques within brain, eventual dec. in brain mass - process begins 10-20 yrs before signs apprear
  • Presentation: memory loss
  • Moderate: dec. in attention, judgement, language function
  • Severe: cannot recognize ppl or communicate
• Management

  • Check BGL, O2
  • Be compassionate
  • If pt is suspected to be malnourished - thiamine 100-200mg IVP before glucose is given
  • If pt is Vitamin B deficient & glucose is given, condition may worsen
  • Monitor ECG
  • Pt may have hypokalemia, hypomagnesemia, & hyponatremia