Pathology: Presence of cerebral neuronalcell loss, senile plaques, neurofibrillary tangles and beta-amyloid deposition
Aetiology: Most common cause ofdementia predominantly affecting memory. The age of onset is usually from 6thdecade onwards
Symptoms: Short Term Memory Loss:Progresses gradually to involve other cognitive domains
Progressive Personality Changes: Apathy,wandering and emotional lability.
Language Deficits: wordfinding difficulty, problems with reading and writing
Advanced Stages: Mobility, speech,swallow and memory are severely affected.
Signs: Rigidity,myoclonus and seizures in the late stages.
Investigations: Bloods: B12, TSH, Syphilis, HIVto screen for reversible causes of dementia
Imaging: MRI or CT brain may show atrophy in the medialtemporal lobe
Treatment: Medical: Central cholinesteraseinhibitors such as donepezil, galantamine and
rivastigmine mayslow disease progression.
Symptomatictreatment with antidepressants or neuroleptics
MDT Approach: Physiotherapy, occupationaltherapy, SALT and family input
Complications: Agitation,incontinence, depression, falls, wandering, self-neglect
Prognosis: The average life expectancyfrom the time of diagnosis is around 6-7 years, Death is usually due to sepsis.
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