Dementia

Definition

Dementia is a chronic, progressive syndrome of cognitive decline severe enough to interfere with daily function. It involves memory loss, impaired executive function, language disturbances, and behavioral changes.

Major Types

• Alzheimer's disease (most common): Gradual memory loss, beta-amyloid plaques and tau tangles.
• Vascular dementia: Stepwise decline from cerebrovascular disease.
• Lewy body dementia: Visual hallucinations, parkinsonism, fluctuating cognition.
• Frontotemporal dementia: Personality/behavior changes first.

Nursing Interventions

Maintain routine and familiar environment, use simple one-step instructions, reduce stimuli, provide safety measures (locked doors, IDs, bed/chair alarms), validate feelings over reality, use redirection rather than confrontation, provide adequate lighting to reduce sundowning (support caregivers).

Medications

Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) for mild-moderate Alzheimer's. Memantine (NMDA antagonist) for moderate-severe disease. Recent additions include lecanemab (for early AD).

NCLEX Relevance

Safety is priority. Avoid changing routine; use redirection and validation.