Pathophysiology of Dementia Assignment 2022

I have attached the files. Choose Case study 1, References according to APA 6th Style. References within last 10 years. I have also two presentations of the lecture which will be helpful to answer the questions.

Running head: DEMENTIA 1
Dementia
Student’s Name
Institutional Affiliation

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Dementia
Introduction
Dementia refers to a disease that is characterized by the loss of memory, especially
among the elderly. However, the condition may occur as a result of several associated conditions
and not a disease on its own. The disease can materialize in several ways, thus physiologically
affecting the human body. This aspect is what is termed as pathophysiology, and the primary
goal of the ideology is to explain various changes that occur as a result of the presence of a
disease.
Pathophysiology of Dementia
It is clear, as stated, that multiple conditions can cause the onset of the disease. However,
the primary cause of the disease is external or the biological degradation of cells of the brain.
Typical examples of the diseases that can bring about the onset of the disease include
Creutzfeldt-Jakob condition and stroke, which causes the narrowing of the blood vessels in the
brain. Genetic factors originating from infections such as Alzheimer’s disease and Huntington's
disease may cause the occurrence of dementia. Some of the external factors that are linked to the
disease include physical head injury and concussions. Excessive consumption of alcohol may
also lead to the degradation of the brain cells. Even though the causes of dementia take different
directions, the ultimate end of the conditions is the destruction of the cells of the brain. These
section of the paper draws a deeper understanding the pathophysiology related to each and every
cause of the dementia disease.
Alzheimer’s Disease
Alzheimer’s disease is one of the most known causes of dementia, especially among the
elderly (Schmidt et al., 2017). Even though the ultimate cause of Alzheimer’s disease remains

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unexploited, studies link the condition to environmental and genetic factors and lifestyle choices.
The disease is associated with neurofibrillary tangles and collections beta-amyloid protein, which
causes plaques in the brain. The adverse effect associated with the amyloid structure brings about
the death of cells in the brain. As a result of the death of cells, dementia develops.
Vascular Dementia (Stroke)
The adverse effect of stroke on the brain brings about disability among people. Stroke
leads to the block of blood vessels. As a result, individual experiences the inadequate flow of
blood to the brain, thus causing the death of the cells. The lack of blood supply to the brain forms
the pathophysiology of vascular dementia disease. It is essential to acknowledge the fact that as
much as the brain has a great supply of blood vessels, the system is too weak and easily affected
by stroke.
Parkinson’s Disease
The symptoms of Parkinson’s disease include shaking, rigidness and mobility difficulties.
The disease causes the buildup of proteins known as Lewy bodies in the human brain. Lewy
bodies collect at the substantia nigra and basal ganglia as well as the cortex and thalamus, thus
causing the death of brain cells and reduction of the amount of dopamine (Tysnes, & Storstein,
2017). It is significant to acknowledge the role of dopamine as a neurotransmitter. The failure of
the performance of such critical functions is the beginning point of dementia development.
Alcohol-Related Dementia (Wernicke-Korsakoff Syndrome)
Alcohol-related dementia (WKS) is a collection of two diseases. The two diseases
include Korsakoff syndrome and Wernicke’s encephalopathy. The symptoms of Korsakoff
syndrome include memory loss, hallucination and changes in an individual’s personality
(Bowden, & Scalzo, 2017). On the other hand, Wernicke’s disease entails coordination and

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movement pattern issues. Alcoholism is the major cause of WKS. However, the condition may
also result from a deficiency of vitamin B-1. The pathophysiology relating to WKS, as much
dementia is concerned, circumnavigates energy and sugar. The deficiency of thiamine is an
implication of deficiency of fuel for the brain to carry out its tasks effectively. On the same note,
excessive consumption of alcohol can shrink the cells of the brain hence directly causing
dementia.
Risk Factors
The risk factors to dementia are numerous to explore. Typical examples include low
education attainment, cognitive inactivity, social isolation, and depression. Research has also
shown that inactivity, smoking, alcohol consumption, poor diet, high blood pressure, excess
intake of cholesterol, and high blood sugar level are heavy contributors to the prevalence of the
disease. According to the sociological theory of aging, the activity theory suggests that
individuals need to remain active to age. Most importantly, age is the most significant risk factor
for the development of dementia (Mozaffar, Corrada, & Kawas, 2018). According to the
psychological theories of aging, individual’s social and mental wellbeing decreases with age.
This is illustrated within Erikson’s eight stages of life. It is vital to acknowledge the fact that
most of the named risk factors are prevalent among the elderly (Chung, 2018). For instance, most
of the elderly are not aware of the nutritional aspects of eating. Neither do they have the energy
to engage in physical activity. This changes in the normal activity as an individual ages
contradicts the expectations of the nursing theory of successful aging whereby an individual is
expected to maintain the activities and attitudes of middle age (Havighurst, 1963). Furthermore,
most of the elderly are not only a few in population but also neglected in the society hence likely

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to suffer from social isolation. This fact counters the expectations of the age stratification theory
(sociological theory) whereby interdependence is expected between the older adults and society.
Impact of the Disease on the Health of the Elderly Person
Dementia may have fundamental impact on Mrs. Jones. The patient may experience
changes in her emotional responses. Mrs. Jones may lack control over how she feels and how she
expresses her feelings. For instance, she may start overreacting to things; she may undergo rapid
mood changes and become irritable. It is an ethical consideration for the caregivers to
acknowledge that these changes occur as a result of brain damage, and the patient may react in a
manner that is more emotional than expected (Ebert, Kulibert, & McFadden, 2019). This
included crying and becoming agitated. Nursing practitioners have to promote patient centered
care as a legal consideration under the registered nurse standards of practice in Australia. This
standard stipulates that promotion of patient centered care incorporates recognition of the impact
of family and community with respect to religious and cultural diversity (Cashin et al., 2017).
Dementia might make Mrs. Jones feel insecure and lose self-esteem. The patient might
feel that she is not in control and missing confidence in what she is doing. The patient may also
face the effects of social demotion and stigma. The disease may also indirectly cause a loss of
esteem in the patient by affecting the other areas of her life. Such areas include but not limited to
employment status, relationships, financial status and health issues (Zhu et al., 2017). While
caring for such individuals, it is an ethical consideration to engage in conversations that would
build their self-esteem rather than demoralizing them. Belittling statements and criticism must be
avoided and empress support when they make mistakes. According to the code of ethics for
nurses in Australia, nurses are expected to show kindness and respect to each other and patients
(Nursing & Midwifery Board of Australia, 2008).

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Mrs. Jones may also undergo physical effects as a result of the failure to define her own
identity. The loss of memory disrupts the ability to carry out daily activities. It is important to
acknowledge that the patient, in this case, has a history of severe complications such as high
blood pressure, delirium, Osteoarthritis, GORD, COPD and Alzheimer's disease. These diseases
require proper management and engagement in ADL’s to prevent them from recurring. However,
their physical effect on the patient may restart because of her inability to engage in self-
management programs due to the prevalence of dementia disease. While caring for the patient, it
is essential to consider the management of the secondary infection and restoration of personal
identity.
Medications
Lercanidipine
Lercanidipine serves a significant role in lowering high blood pressure. In so doing, they
prevent the damage of high blood pressure to the blood vessels (Rayner, 2019). As a result, the
blood vessels are prevented from narrowing, rupture and leakage. Furthermore, the formation of
clots in the arteries leading to the brain is minimized; hence no blocking of blood flow. As a
result, stroke is minimized, thus reducing the prevalence of dementia.
Side effects of the medication include flushing, palpitation, headache and dizziness. The
drug may also cause swelling of the feet, ankles and lower legs. The drug is also associated with
fatigue and sleepiness, including flushing. Finally, the medication is linked to gastrointestinal
disturbances such as diarrhea, epigastric pain, nausea and heartburn.
Rivastigmine
Rivastigmine is a reversible cholinesterase inhibitor. The drug is used to cure the early
stages of Alzheimer’s disease and dementia (Ray et al., 2020). Rivastigmine's action is

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postulated to exert its therapeutic effect by enhancing cholinergic function. This is enhanced
through an increase in the concentration of acetylcholine via reversible inhibition of its
hydrolysis by cholinesterase.
The side effects of Rivastigmine include anorexia, vomiting, nausea, headache dizziness,
diarrhea and abdominal pain (Kandiah et al., 2017). The medication may also be accompanied by
drowsiness, fatigue and dyspepsia. Further side effects include anxiety, depression, asthenia,
malaise, flatulence and diaphoresis.
Care and Maintenance of the Patient for Quality Life
Helping the patient to take medication is a critical role that will assist her recover from
her illness and live a quality life. The medication needs to be given following the prescription of
the physician, who gives the information that needs to be followed while administering
medication. The administration record usually contains the dosage of the medicines to be
administered and also the time of administration, not forgetting the route of introducing the drug
to the patient (Jin et al. 2015). The medication needs to be administered according to the
medication distribution system. In giving the medication, errors need to be avoided at all costs.
Verification of medical calculations needs to be consulted to the physician in case of an unsafe
prescribed dosage (Handler et al., .2007). Identification of patient allergies and prescribed
medication, which can interfere with the recommended drug therapy of the physicians, is also
essential. The data of the patient’s medical history needs to be compared to Medication
admiration record (MAR) to identify the incompatibility of drug combination or possible allergic
reactions to medication (Jones, & Treiber, 2010). By avoiding the fundamental errors and
following the physician's instructions keenly, the patient will receive the drug in the right way
improving her recovery and life.

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Besides, additional medication can be used to address behavioral illness and mood, which
are comorbid with dementia. The conditions include anxiety, psychosis, and depression.
Therefore the use of antipsychotics, antidepressants, and anxiolytics can help provide relief. A
proper diagnosis from physicians is required so that the medication is achieved appropriately
(Ye, & Fu, 2016). The prerequisite does not, therefore, include conditions such as chronic
traumatic encephalopathy that relies on symptoms since it cannot be diagnosed until one's death.
The appropriate model of care to be used for quality life of the patient is the person
centered care. The care ensures that the dignity of the patient is highly protected. Respecting the
patient’s preferences and rights is also essential. The care is provided to the patient following her
rights and preferences (McCarthy, Ryan, & Klein, 2015). Even in medication the therapeutic
relationship between the patient and care provider should be developed which is on
understanding and mutual trust. The person centered care therefore covers a lot on the patient
and need to be implemented by the care provider for safety and quality services for her to
recover fast and live a wonderful life.
Without direct treatment, it is essential to make a home-dementia friendly for the patient.
A home dementia-friendly can be achieved by organizing the living space and make it safe for
the patient. Loose rugs, furniture, sharp objects, utensils and other obstructions should be shifted
to prevent accidents. Some therapeutic activities, such as playing games and puzzles, exercise,
and sharing stories, does not involve medication (Look & Stone, 2018). The events, therefore,
help to keep her brain active and mood. Social interaction is also encouraged when performing
activities such as exercise. Since she loves music, it is advisable to play her best song and take
part in dancing.

DEMENTIA 9
The patients need to be assisted with ADLs, fixing her hearing aids and frequent
changing of pads. The patient needs to be supported in various daily activities for the smooth
running of her everyday life. Feeding is the necessary activities that need to be done for the well-
being of the patient. The activities ensure good health for the patient. Dressing and grooming
which involves selecting clean clothes and putting them on. Toileting is another activity that
involves getting the patient to and from the toilet and cleaning after use appropriately. Other
necessary assisted activities include bathing, transferring, and walking (Connolly et al. 2017).
Fixing her hearing helps her whenever she wants to hear and feel the surrounding. Frequent
changing of pads day and night is essential due to the incontinence condition she is undergoing.
When the pads are changed, it is, therefore, crucial that her skin is cleaned very well, making her
very comfortable.
It is essential to give the patient advisory services concerning the effect of smoking
following her smoking history. She is therefore recommended not to smoke due to the
medications that she is undergoing. Smoking may increase the risks of breast cancer (Catsburg,
Miller, & Rohan, 2015). The patient can be made happy and relaxed by guiding her through the
garden where she can feel the fresh air, therefore, improving her brain activities and moods.

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