Dementia- A living bereavement  

Dementia is a condition characterized by progressive loss of cognitive functions without change in consciousness. 

The cognitive functions affected are: 

1. Praxis- motor functions like ability to perform tasks
2. Gnosis- ability to recognize things
3. Memory
4. Speech 

The resultant effects of changes in these functions are: 

1. Apraxia- inability to perform activities of daily life that individual used to perform normally.Ex: inability to button and unbutton clothes, inability to brush teeth, comb hair and shave beard, inability to work in kitchen, garden. 
2. Agnosia- inability to recognize things/ items used in daily life. 
3. Amnesia- forgetfullness, initially  past memories are preserved but later individual has no memory of either past or present. He is unable to learn new things. 
4. Aphasia- some people experience change in speech with inability to understand and respond to questions or inability  to name things/people and inability to put up words together. 

Besides cognitive other symptom domains of dementia are: 

1. Executive- inability to plan, organise and maintain attention.
2. Behavioral and psychosocial symptoms- hyperorality (mouthing everything), hyperphagia (increased food intake), apathy (dulled emotions), psychotic and affective symptoms. 
3. Activity- agitation, aggressiveness, wandering

Prevalence

• 5% in population more than 65 years
• 20-40% in more than 85 years

Most common dementia is Alzheimers. 

Phases of Alzheimers dementia

• 1st- failing/ poor memory, muddled tasks, spatial disorientation
• 2nd- rapid progression of intellectual and personality deterioration
• 3rd- profound apathetic dementia, bed ridden and double incontinence

Other types of dementia: 

• Vascular dementia
• Fronto- temporal dementia
• Lewy body dementia
• Huntington disease
• HIV associated dementia
• Head trauma associated dementia
• Substance induced dementia

Treatment

1. Behavior oriented therapy
2. Cognition oriented therapy
3. Emotion oriented therapy