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