Dementia

ABSTRACTAlzheimer's disease is one of the most devastating brain disorders of elderly humans. It is a decade has witnessed a steadily increasing effort directed at discovering the etiology of the disease and developing pharmacological treatment. Recent developments include improved clinical diagnostic guidelines and improved treatment of both cognitive disturbance and behavioral problems. Symptomatic treatment mainly focusing on cholinergic therapy has been clinically evaluated by randomized, double-blind, placebo-controlled, parallel-group studies measuring performance-based tests of cognitive function, activities of daily living, and behavior. The role of estrogen replacement, anti-inflammatory agents, and antioxidants is controversial and needs further study. Antidepressants, antipsychotics, mood stabilizers, anxiolytics, and hypnotics are used for the treatment of behavioral disturbance. Future directions in the research and treatment of patients with Alzheimer's disease include: applying functional brain imaging techniques in early diagnosis and evaluation of treatment efficacy; development of new classes of medications working on different neurotransmitter systems (cholinergic, glutamatergic, etc.) Keywords: Dementia, Symptoms and Stages of disease, Etiology, Pathology, Neurophysiology, Risk factors, Causes, Diagnosis, Treatment, Prevalence, 

ABSTRACTVascular dementia and cognitive impairment are major problems in stroke which must be diagnosed properly and very less effort is put into management of cognitive decline after stroke. This study is a prospective; questionnaire based observational study conducted for 6 months among stroke patients admitted into in patient setting of a tertiary care teaching hospital done to estimate the prevalence of stroke based on age, sex and educational status and to estimate the prevalence of dementia and cognitive impairment among stroke patients using neuropsychological testing. Data was collected from a total of 181 stroke patients of the age distribution 20 to 85 y with a mean age of 57.68±12.34 y and 75.6% patients were diagnosed with ischemic stroke and 24.3% with hemorrhagic stroke. Majority (76.79%) of patients were from rural population. Diagnostic and Statistical Manual of Mental Disorders-IV, Revised text criteria were used to assess dementia. Mini-mental state examination and short portable mental state questionnaire were used to know the extent of cognitive impairment. Various comorbid conditions like hypertension, diabetes mellitus, coronary artery disease and epilepsy were observed in 69.06% patients. The percentage (45.83%) of people with mild cognitive impairment is high with short portable mental state questionnaire and the percentage (77.69%) of people with moderate dementia is high using mini-mental state examination. 92.81% patients out of 181 were prescribed with neuroprotective drugs. The tools used for screening dementia are not perfect in case of uneducated patients and patients with low education. Current hypotheses and methodologies for the management of post-stroke dementia must be re-evaluated, and new strategies need to be explored. Keywords: Stroke, Dementia, Cognitive impairment, MMSE, SPMSQ