Dementia develops rapidly on the basis of stroke, after craniocerebral injuries and in some neurodegenerative diseases. In most cases, it is preceded by a long period of less pronounced cognitive impairments – in medicine they are called predementia. At the same time, at the beginning of the predemental stage, only the person himself notices changes in intelligence, but they are not obvious to relatives or friends. Ekaterina Demyanovskaya, a candidate of medical sciences, a neurologist at the Gemotest Laboratory, told socialbites.ca.
“In the subjective cognitive impairment stage, it is worse when a person is given cognitive loads that did not cause difficulties before. For example, remembering to-do lists becomes difficult – you have to set reminders on your smartphone or write everything down in a notebook. This is often alarming for mental workers, they can even go to the doctor, but at this stage even in-depth tests do not reveal memory impairment, ”said the neurologist.
Over time, the symptoms become more pronounced and understandable to others. Many people go to the doctor with complaints of poor memory, and even then, tests show a decrease in cognitive function.
“The disease progresses and moves to the next stage – mild cognitive impairment, or LCR. People begin to forget complex words, confusing terms that sound similar. Decreased concentration The area of interest can change radically, for example, a patient with technical expertise may hit politics or pedagogy,” said doctor Ekaterina Demyanovskaya.
He noted that with LCR, the brain works worse and worse, and not only memory regions are impaired, but also areas responsible for critical thinking, complex skills and behaviors.
The next stage is moderate cognitive impairment (MCD), when it becomes quite clear that intellectual decline is beyond the age norm. In the RBM stage, the person may not be able to cope with his previous job, but still can move on to work more easily by continuing his professional activity. Usually with a list – he can go shopping himself. Also, a patient with MCD can read books, watch TV shows, and understand their meaning while watching. But if you ask him about the content of the work or transmission, then he cannot reproduce it.
“Recognizing the transition from pre-dementia cognitive impairments to dementia allows for the reality of social, work, and home dissonance. This means that a person can no longer do the usual things in the same capacity and become completely dependent on the care of others, ”said the candidate of science.
According to him, neuropsychological tests help identify cognitive disorders before dementia. They allow you to test five major brain functions: memory, perception and recognition, speech, motor skills, and intelligence. So, a person is asked to memorize a list of several words, name familiar objects, for example, a phone, a pen, a mug, show how to do simple household chores – combing hair, cutting paper with scissors, writing a few words, drawing a clock, from geometric shapes draw a picture. To assess intelligence, they may be asked to say as many words as possible in 1 minute or to describe the common features of tomato and cucumber, hat and cap.
If a person makes too many mistakes and passes the test with great difficulty, this reduces the overall test result, and after scoring the doctor determines the degree of cognitive decline.
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