7^th International Conference on Dementia & Care Practice August 14-16, 2017 Toronto, Canada

Neurodegenerative disease is an allied term for a range of conditions which primarily affect the neurons in the brain and are incurable and attenuate conditions that dynamically result in degeneration or death of nerve cells. Examples of neurodegenerative diseases include Dementia, Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis and Huntington’s disease. The most banal kind of neurodegenerative disorder which people are facing is dementia.

Dementia is a group of conditions characterised by wreckage of at least two brain functions, such as memory loss and judgment. The deficit of brain function is stern enough that an individual cannot do normal activities and leads to such an extent that it interferes with a person’s lifestyle. Additionally, some individuals with dementia cannot manage their emotions. The occurrence of dementia increases emblematically with increasing age. However, it’s not a standard part of aging. Many people live into their 90s beyond with nil signs of dementia.

Amongst the induced and later stages of dementia an individual often involves challenging behavioural problems such as anger, sadness, paranoia, confusion and fear that can further result in oppositional, aggressive and sometimes violent actions.

Although there is currently no cure for dementia and no way to stop the underlying death of brain cells, but dementia research has shown that there is still a leeway to improve the essence of life of people living with dementia by providing a supportive environment to them.  An individual’s centred care is considered important which characterises a clear perceptive of the individual and giving consideration to their cultural background, personal history, social and family networks and preferences for activities in designing their care.

Diagnosing dementia and Alzheimer is generally difficult, particularly in the initial stages. However diagnosis assessment incorporates medical and patient history to rule out different possible causes. Therefore numerous diagnostic procedures are needed which further includes neurological and physical examination related to blood and urine tests, Mental status assessment to work out the level of mental deterioration, Brain scans (CT Scans and MRI), Caregiver interview to see the level of dependency,  Mini Mental State Examination (MMSE) can also be recommended.

Aside from these diagnostics, dementia patient needs reassurance and support from the people closest to them - including their caregivers, friends and family to help the patient to reminisce their sense of existence and feelings of self-worth.

Neurological Nursing is a very provoking nursing specialty which deals with assessment, nursing diagnosis, and management of many neurological disorders for which care practitioners provide patient care regarding neurological disorders such as trauma, brain injuries, dementia, stroke, seizures, tumours, headaches, infections and aneurysms, as well as other neurological intricacies.

Talking about dementia, it encircles many different conditions and is apparent by a loss of cognitive abilities affecting attention, memory, linguistics, reasoning and problem-solving skills that interfere with daily activities. It is caused by brain cell deterioration.

Neurological care practitioners commit to give compassionate care to patients suffering from neurological diseases including dementia and Alzheimer, from diagnosis to treatment and beyond.

Surviving with dementia from conditions such as Alzheimer’s and related disorders can have an ample of emotional, social, psychological and practical impact on a person. Dementia sufferer finds that their mental abilities are declining, for instance, difficulties to remember things, think clearly, communicate with others, or take care of themselves  and often feel vulnerable and need a great deal of reassurance and support.

Neurocognitive disorders accounts a class of mental state disorders that essentially affect learning, memory, judgement, and cognitive behaviour, dementia, and delirium. There's no set age for these disorders to happen but it has been found that age-associated memory impairment and dementia increases typically with increasing age.

Geriatrics  scrutinised and stated that people facing dementia whose symptoms started before the age of 65 are often considered as 'younger people with dementia' or as having young-onset dementia and those before the age of 65 are consider  under   “early onset dementia or “working age dementia” category.

Dementia is the case that people over 60 fear the most.  The most common factors which enhances the risk of developing dementia includes ageing, accumulation of  ApoE, Alcohol use, Genetics,  Down syndrome,  Atherosclerosis, Depression,  stroke,  Diabetes,  Hypertension,  Mental illness, smoking,  Unhealthy diet,  Head injuries and many more.

There is no proper cure for dementia; yet medication (including cholinesterase inhibitors containing Donepezil-Rex) and non-drug treatments could give some comfort. However, dementia is not inexorable as we age and there is a lot we can do to dwindle the chances of mellowing it.

Dementia is not a disease; it’s actually a comprehensive term that portrays a wide range of symptoms related with a drop in memory or thinking skills severe enough to turn down a person's aptitude to perform everyday activities.

No single test can disclose if someone is demented or not however, Doctors or physicians can almost rules out if a person has dementia using medical evaluations which comprises of medical history, mental status testing (Mini-mental state examination, Mini-Cog test) , physical and neurological exams, blood tests and brain imaging (CT Scans and MRI).Though treatment for dementia is entering an energising stage, following many new medications depending upon the pathogenesis of Alzheimer’s illness.

Dementia is a syndrome with eccentric memory loss and impaired ability to recall events from the past often characterized by Alzheimer's disease. Animal models for dementia or Alzheimer is important to think about the human phenotype and what is being modelled in terms of the animal phenotype. Animal models of Alzheimer’s disease or dementia, based on the genetics of the disease and the closely related front temporal dementia, replicate at least some of the pathology.

Researchers have been successful at modelling very specific aspects of  Alzheimer in the mouse for instance plaques, tangles. Multiple approaches have been adopted to create reliable animal models ranging from rodents to non-human primates, where the animals are exposed to a predetermined injury or causing genetic ablation across specific regions of brain suspected to affect learning functions.

Experts believe that biomarkers offer most promising paths to diagnose Alzheimer’s or dementia. A biomarker is something that can reliably indicate the presence of disease.

Certain possible biomarkers are being studied for their strength to indicate initial stages of Dementia or Alzheimer's disease such as including beta-amyloid and tau levels in cerebrospinal fluid (CSF) and brain changes detectable by imaging. However, three biomarkers have been well-established and validated internationally to diagnose AD in CSF with ELISAs: β-amyloid (1–42) [Aβ (1–42)], total tau and phospho-tau-181.

All cells are like minute factories, producing thousands of proteins with precise functions to keep the cells viable. A flaw can occur if a protein is altered, or if excess or too little is formed. Sometimes, the consequences are so severe that a cell dies. Neuron ruination is the chief cause of dementia and is often associated to malfunctions in the connection system that a neuron needs to survive.

Dementia is associated with accumulation of two proteins – amyloid and tau - into plaques and tangles in the brain. Beta-amyloid accumulates as plaques in Alzheimer's disease or dementia and is an endorsement of the disease. Tau compiles into tangles (known as neurofibrillary tangles or NFT). And further disrupts the structure and communication within the nerve cells, leading to cell death.

Dementia is among the most typical neurodegenerative diseases which specifically arise due to neuron death. It is now becoming evident that neurodegenerative diseases have a biochemical basis. Many neurodegenerative diseases are inherited. Their genes are known and DNA-based diagnosis (including prenatal diagnosis) is available. Loss of neurons is accompanied by specific histopathological findings such as Alzheimer's plaques and Lewy bodies. Some neurodegenerative diseases engage specific anatomical systems or adjoining sets of neurons. 

Dementia is a common clinical phenomenon; however, management of the coexisting illnesses remains incomplete. Neuropsychiatric turmoil is one of the clinical characteristics of Dementia. Traditionally, this turmoil has been managed with neuroleptics or benzodiazepines but accounts serious side effects. With the advancement in the neuropharmacology field, many new-fangled medications came into existence. Donepezil is a piper dine based reversible, non-competitive cholinesterase inhibitor and proved beneficial for the management of symptoms of Alzheimer’s disease covering dementia, a disease in which cholinergic pathways in the cerebral cortex and basal forebrain are well known to be compromised.

There are a numerous ways to categorise interventions in dementia care, for instance, by the kind of treatment approach used.  The chief grouping is by the therapeutic goal, with three considerable spheres recommended: the maintenance of function, including cognitive functions, the management of behaviours that challenge and the reduction of comorbid emotional disorders. 

The range of non-pharmacological ‘interventions’ in dementia care is ample and would include the everyday interactions of carers with the person suffering from dementia, the effect of the physical and social conditions and all manner of  ‘therapies’, ranging from art sessions to contact with animals.