Online Counselling for Dementia and Delirium
Online Counselling for Dementia and Delirium
May 17 2023 TalktoAngel 0 comments 418 Views
Mental health issues frequently manifest in aging typically are shown in the form of delirium, dementia, and depression. The 2 Ds, Delirium and Dementia are the most frequently encountered in the clinical setting. The majority of the time terms are interchangeably used and thus are not acknowledged at the time of initial evaluation. It is vital to recognize that delirium and dementia are distinct disorders with distinct prognoses and treatments. Although an acute state of confusion that changes and progresses in a matter of days or weeks could be delirium, a longer-lasting and continuous progression of symptoms suggests dementia. The distinction between the two is unclear in cases of persistent delirium, and irreversible dementia. Cognitive ability is measured across six areas that include memory and learning, executive functioning, language complex attention, and perceptual-motor and social cognition. Connect with the best clinical psychologist in India to know more about areas that are affected by dementia and delirium.
Delirium is defined as a state of impaired awareness that most commonly impacts brain attention, while dementia is defined as a cognitive decline that affects one or more areas of the brain and impacts brain health. Delirium is an abrupt appearance of a loss of orientation or awareness of the surrounding environment, in contrast to dementia, which can be a slow process that leads to disruption of the central part of the brain, and attention is impaired later in the course of the disease.
The majority of the time, dementia is a neurodegenerative condition that occurs in the later years of life and is different in its subtypes, in terms of age of onset dependent on the type. However, it is an age-dependent condition that is more common in older patients and may be experienced under different conditions. Delirium usually lasts for a period of time, ranging from a few hours to days and dementia is a gradual progression over months or years. The two conditions are often co-existing with the elderly as well as when dementia is rapidly progressing. It is often difficult to differentiate between the two when there is no previous experience with dementia.
Pathophysiology and signs of Delirium and Dementia
The two conditions are often interspersed. The mechanism behind their interaction is not fully understood. Some theories that explain the mechanisms include neuroinflammation and nervous system imbalance along with chronic stress. The pathophysiology that underlies it differs based on the kind of dementia. Beta-amyloid plaques that accumulate, neurofibrillary tangles, and tau protein hyperphosphorylation are hallmarks of Alzheimer's disease. Accumulations of alpha-synuclein can be seen within Lewy body-related dementias, Parkinson's disease, and multiple system atrophy. Corticobasal degeneration. Progressive supranuclear palsy and Frontotemporal Dementia (Pick disease) are known as tauopathies.
The physical examination and the history are the primary tools used to determine the presence of dementia and delirium. The collection of medical history from the patient and their family members is crucial. The first priority is to establish the patient's baseline mental functional state. The second is the acuity of the beginning of symptoms and an outline of the course is required to establish.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 has the following criteria for delirium:
- A lack of attention and awareness is a sign of acuteness and can change in intensity.
- At the very least, disturbance of cognition
- Disorders that cannot be explained by pre-existing cognitive impairment.
- Disturbances that are not experienced within the context of the most reduced levels of stimulation or coma.
- Evidence of organic causes.
DSM-5 established the following criteria for diagnosing dementia:
- A significant decline in cognition from the baseline ability in one of the cognition domains. It could be due to the concerns of the patient, the caregiver, or significant information from an informant or cognitive performance as measured by tests for neuropsychological disorders and neurodegenerative diseases.
- The cognitive impairment that hinders the daily routine activities
- The decline in cognitive function does not only occur in the context of delusion
- Reasons for Cognitive decline other than the presence of any medical or mental disorder.
Difference between Dementia and Delirium
The words delirium and dementia are distinct conditions, yet they are often used interchangeably because of their similar characteristics. Delirium is the sudden appearance of decreased awareness of the surroundings as opposed to dementia, which is a gradual degenerative process that causes a disturbance in the fundamental features and attention loss occurs later in the course of the disease.
There are exceptions to this, such as sudden cognitive decline that is accompanied by vascular disease and the gradual onset of delirium following chronic exposure to aspirin. Dementia can be a trigger in the formation of delirium among elderly patients, and it also is a significant risk factor in the progression of dementia. Delirium is preventable and reversible. However, dementia is not curable, other than in cases of normal pressure hydrocephalus as well as when it is pseudo dementia that results from B12 deficiency, thyroid problems such as syphilis, depression, or thyroid disorders.
Delirium may be a result of dementia due to a myriad of causes. This is why it is necessary to conduct a thorough examination for diagnosis. In contrast to delirium, people with dementia are more likely to be in the state of being awake and the primary deficits tend to be corrected. Delirium may be a sign of a medical issue that is underlying and could cause death in the older population. Early detection and risk stratification may aid in reducing the risk.
The change in cognition is one of the main characteristics that characterize Lewy Body Dementia (LBD) which can resemble a euphoric state. Delirium and LBD have a lot in common. Dysautonomia, Parkinsonian symptoms, and neuroleptic sensitivity as well as other neuroimaging-related features that support it, aid in precise diagnosis.
Treatment, Medication, and Online Counselling for Dementia and Delirium
If an etiology or several possible causes are identified for delirium, the first line of treatment is non-pharmacologic strategies that include removing or reducing psychoactive and anticholinergic drugs as well as reorienting the patient to create an energizing, peaceful environment. Psychotherapy and specific cognitive and relaxation therapy can be helpful. In patients suffering from Alzheimer, and dementia, pharmacotherapies using Cholinesterase inhibitors (e.g. galantamine, donepezil, and rivastigmine) and memantine have been approved for patients with moderate or severe dementia. The remainder is supportive elder care from a caregiver.
Seek online counselling to learn more. Connect with the best online psychiatric consultation or the most experienced clinical psychologist in India on TalktoAngel. Counseling and cognitive stimulation are the treatment plans, used effectively for the treatment of dementia, amnesia, and delirium by the best neuropsychologists in India.
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