Demence je globální porucha intelektu, paměti a osobnosti získaná během života. Je závažným problémem především vyššího věku. Odhaduje se, že poruchami paměti trpí asi 10% osob ve věku nad 70 let, z čehož asi u poloviny jde o Alzheimerovu chorobu.
Alzheimerova choroba
U Alzheimerovy choroby bývají nejprve poruchy paměti především pro čerstvé události, poruchy abstraktního myšlení, rozhodování, zhoršená orientace v prostoru, zpomalené tempo myšlení a jednání, pacient má potíže i při řeči a se psaním. Pro počáteční období bývá typické, že pacient se často opakuje, ztrácí a zapomíná věci jako např. klíče, obtížně hledá slova pro pojmenování zcela běžných předmětů jako jsou hodinky nebo televize. Jindy je demence ještě nápadnější – projeví se jako neschopnost řešit problematickou situaci apod.
Postupně člověk bloudí i na zcela neznámých místech, dochází ke změnám osobnosti – k pasivitě a ztrátě zájmu o činnosti a věci, které mu předtím přinášely radost a uspokojení. Člověk se stává apatickým a nesoběstačným. Jeho city i ke svým nejbližším se také mohou měnit a to bývá příčinou častých rodinných rozepří. Okolí člověka s takovou chorobou to totiž nemá vůbec jednoduché. Nemoc se dosud bohužel nedá léčebně příliš ovlivnit. Používají se neuroprotektivní léky jako je selegilin (Junec, Niar, Sepatrem, Segalin, Cognitiv) a další speciální léky k podpoře kognitivních funkcí – rivastigmin (Excelon) a donepezil (Aricept).
Další příčiny demence
Samostatnou léčbu vyžadují projevy deprese, stavy neklidu, zmatenosti a agitovanosti. Pokud má někdo ve vaší rodině Alzheimerovu chorobu, poraďte se o těchto a dalších možnostech s lékařem.
Ostatními příčinami demence jsou poruchy cévního zásobení mozku (demence po cévních mozkových příhodách vznikají většinou náhle), úrazy (pohmoždění, chronický subdurální hematom), nádory, infekce HIV v pokročilém stádiu, demence po jiných zánětech mozku (např. herpes virus), metabolická a toxická poškození mozku (při rozvinuté cirhóze jater, alkoholismu, chybění vitaminů skupiny B a další), snížená funkce štítné žlázy, hydrocefalus a toxický vliv některých léků, např. psychofarmak (benzodiazepinů a neuroleptik užívaných dlouhodobě) a cytostatik.
Léčba
Léčba demence se řídí podle vyvolávající příčiny, u cévních poruch se podávají vazoaktivní látky zlepšující prokrvení mozku. Podpůrný význam mají nootropika (piracetam – Pyramne, Nootropil, Kalikor, Oikamid, pyritinol – Encephabol, Enerbol a cinarizin – Stugeron).
Diskuze o demenci
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