{"id":195,"date":"2015-06-11T16:38:50","date_gmt":"2015-06-11T16:38:50","guid":{"rendered":"http:\/\/iuliapasarin.ro\/?p=195"},"modified":"2019-10-08T10:17:29","modified_gmt":"2019-10-08T10:17:29","slug":"alzheimer-sau-drumul-spre-necunoscut","status":"publish","type":"post","link":"https:\/\/iuliapasarin.ro\/?p=195","title":{"rendered":"Dementele &#8211; evaluare neuropsihologica si stimulare cognitiva"},"content":{"rendered":"<p><span style=\"color: #000000;\">Dementele intra in categoria afectiunilor neurodegenerative si pot fi de mai multe tipuri, cele mai intalnite fiind dementa in Boala Alzheimer, dementa vasculara, dementa mixta, dementa etilica. Func\u0163iile cognitive afectate \u00een mod obi\u015fnuit \u00een demen\u0163e sunt: memoria, capacitatea de invatare, atentia, orientarea, calculul, limbajul, gandirea si judecata. Aceste tulbur\u0103ri ale func\u0163iilor cognitive sunt uneori precedate \u015fi aproape \u00eentotdeauna \u00eenso\u0163ite de tulburari ale controlului emo\u0163ional, modificari ale personalit\u0103\u0163ii, sau simptome psihiatrice (apatie, depresie, tulbur\u0103ri psihotice) \u015fi tulbur\u0103ri comportamentale.<\/span><\/p>\n<p><span style=\"color: #000000;\">In depistarea dementelor si stabiliea tratamentului este nevoie de:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\"><span style=\"color: #000000;\">Evaluare psihologica <\/span><\/span><\/li>\n<li><span style=\"color: #000000;\">Consult si evaluare psihiatrica \/ neurologica<\/span><\/li>\n<li><span style=\"color: #000000;\">Examen imagistic (tomograf sau RMN cerebral)<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">In functie de gradul de deteriorare a functiilor cognitive si a gradului de autonomie (functiilor executive) pacientul are uneori nevoie de insotitor, de ajutor in activitatile de zi cu zi si cotididiene si poate fi incadrat in grad de handicap.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Dementa vasculara<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">Factori predispozanti: diabetul (care afecteaza toate tesuturile moi, inscusiv invelisul interior al vaselor de sange), tensiunea arteriala, istoric accident vascular cerebral (ischemic sau hemoragic), bolile cardiovasculare, fumatul, consumul de bauturi alcoolice.<\/span><\/p>\n<p><span style=\"color: #000000;\">Specific dementei vasculare este fluctuatia manifesatrilor cognitive, fata de dementa Alzheimer cand manfiestarile sunt relativ constante.<\/span><\/p>\n<p><span style=\"color: #000000;\">Caracteristici care sus\u0163in diagnosticul de <strong>demen\u0163\u0103 vascular\u0103<\/strong> probabil\u0103:<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Apari\u0163ia precoce a unie tulbur\u0103ri de mers (mers cu pa\u015fi mici, magnetic, apraxic-ataxic sau de tip parkinsonian);<\/span><\/li>\n<li><span style=\"color: #000000;\">Istoric de afectare a stabilit\u0103\u0163ii \u015fi posturii, cu apari\u0163ia c\u0103derilor frecvente, neprovocate;<\/span><\/li>\n<li><span style=\"color: #000000;\">Tulbur\u0103ri mic\u0163ionale, cu necesitatea imperioas\u0103 de a urina \u015fi alte simptome neexplicate de o afec\u0163iune urologic\u0103;<\/span><\/li>\n<li><span style=\"color: #000000;\">Modific\u0103ri ale structurii de personalitate \u015fi ale afectului, abulie, depresie, incontinen\u0163\u0103 emo\u0163ional\u0103 \u015fi alte deficite de tip subcortical, inclusiv retard psihomotor \u015fi sindrom disexecutiv.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\">Astazi a uitat ce zi este, in ce an suntem, ce cauta in dulap.<\/span><\/p>\n<p><span style=\"color: #000000;\">Maine uita cateva cuvinte, pune pasta de dinti in frigider, uita sa incuie usa.<\/span><\/p>\n<p><span style=\"color: #000000;\">In zilele urmatoare se exprima tot mai greu, nu isi gaseste cuvintele, nu isi mai aminteste numele unor prieteni dragi. \u201cE normal, are o varsta\u201d.<\/span><\/p>\n<p><span style=\"color: #000000;\">Dar in ziua in care nu te va mai recunoaste pe tine, copilul lui, in ziua in care te va intereba CINE ESTI va fi prea tarziu ca sa mai poti face ceva pentru parintele tau.<\/span><\/p>\n<p><span style=\"color: #000000;\">Daca ai observat ca parintii, bunicii, persoane dragi tie se exprima mai greu, ca au inceput sa uite lucruri familiare, nu sta pe ganduri. Evaluarea medicului psihiatru alaturi de computer tomograf si<a href=\"http:\/\/iuliapasarin.ro\/?page_id=2768\"> evaluarea psihologica<\/a> sunt utile in depistarea deteriorarii cognitive (ex. de tip Alzheimer, vascular, dementa mixta) si prescrierea unui tratament adecvat de catre medicul psihiatru<br \/>\n<\/span><\/p>\n<p><span style=\"color: #000000;\">Deteriorarea neurocognitiva secundara bolii\u00a0Alzheimer (cunoscuta sub denumirea de dementa tip Alzheimer)\u00a0nu se vindeca, dar putem face ca evolutia ei sa fie mai lenta prin medicatie si programe personalizate de stimulare neurocognitiva.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Boala Alzheimer<\/strong> este o afec\u021biune degenerativ\u0103 progresiv\u0103 a creierului care apare mai ales la persoanele de peste 65 de ani, dar poate ap\u0103rea \u015fi \u00eenaintea acestei varste, chiar in jurul varstei de\u00a050 de ani,\u00a0caz in care vorbim despre un debut precoce.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Simptome cognitive ale bolii Alzheimer:<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Tulbur\u0103ri de memorie:<\/strong> pacientul are dificult\u0103\u0163i \u00een a-\u0219i reaminti \u015fi reda informa\u021bii \u00eenv\u0103\u0163ate anterior \u0219i este \u00een imposibilitatea de a asimila informa\u021bii noi. Primele \u201e\u015fterese din memorie\u201d sunt evenimentele recente, \u00een timp ce amintirile vechi pot fi conservate o perioad\u0103 mai mare de timp.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Tulbur\u0103ri de vorbire:<\/strong> pacientul nu \u00ee\u0219i mai g\u0103se\u0219te cuvintele, chiar pentru a denumi obiecte familiare \u2013 pahar, ceas, creion.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Incapacitatea de a efectua diferite activit\u0103\u021bi motorii coordonate:<\/strong> bolnavul &#8220;nu mai \u0219tie&#8221; cum s\u0103 se \u00eembrace adecvat, cum se descuie u\u0219a cu cheia, cum s\u0103 foloseasca lingura etc.<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Imposibilitatea de a recunoa\u0219te, identifica \u0219i denumi obiecte uzuale \u015fi \/ sau de a recunoa\u015fte \u015fi numi<\/strong> persoane familiare \u2013 copii, nepoti<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Tulbur\u0103ri ale func\u021biilor de organizare<\/strong> a activit\u0103\u021bilor zilnice, incapacitatea de a lua decizii.<\/span><\/li>\n<li><span style=\"color: #000000;\">Probleme legate de g\u00e2ndirea abstract\u0103, tulbur\u0103ri de calcul, dezorientare temporal\u0103 \u0219i spa\u021bial\u0103.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Simptome non-cognitive<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Agita\u021bie \u0219i agresivitate fizic\u0103 sau verbal\u0103.<\/span><\/li>\n<li><span style=\"color: #000000;\">Tulbur\u0103ri psihotice: halucina\u021bii, de obicei vizuale, idei delirante (de persecu\u021bie, de gelozie, de abandon etc.).<\/span><\/li>\n<li><span style=\"color: #000000;\">Tulbur\u0103ri ale dispozi\u021biei afective: \u00een principal\u00a0<a style=\"color: #000000;\" href=\"http:\/\/cresterepersonala.wordpress.com\/2014\/07\/13\/povestea-depresiei-manifestari-in-minte-trup-emotii-comportament\/\">depresie<\/a> \u0219i anxietate.<\/span><\/li>\n<li><span style=\"color: #000000;\">Tulbur\u0103ri ale comportamentului alimentar: reducerea sau cre\u0219terea exagerat\u0103 a apetitului, alimenta\u021bie ne\u00eengrijit\u0103, ingerare de substan\u021be non-alimentare.<\/span><\/li>\n<li><span style=\"color: #000000;\">Dezinhibi\u021bie sexual\u0103: comentarii pe teme sexuale, gesturi obscene, mai rar agresivitate sexual\u0103.<\/span><\/li>\n<li><span style=\"color: #000000;\">Incontinen\u021b\u0103 urinar\u0103 \u0219i pentru materii fecale, satisfacerea nevoilor fiziologice \u00een locuri neadecvate sau \u00een prezen\u021ba altor persoane. <\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>Boala Alzheimer nu se vindec\u0103<\/strong>, dar depistarea ei stadiu de debut \u015fi primirea tratamentului adecvat pot duce la \u00eencetinirea evolu\u0163iei. Uneori MAI TARZIU poate fi PREA TARZIU, pentru ca tu iti aminesti cine sunt ei (parinti, bunici), dar ei, mai stiu cine esti tu? <\/span><\/p>\n<p><span style=\"color: #000000;\">\u00a0Doriti o <a href=\"http:\/\/iuliapasarin.ro\/?page_id=2768\">\u00a0evaluare psihologica profesionala<\/a> ? Putei face o programare chiar acum la telefon 0728.967.011. <\/span><\/p>\n<p><span style=\"color: #000000;\">Sunt utilizate teste profesionale, iar la finalul evaluarii se elibereaza Raportul de evaluare psihologica timbrat, necesar atat pentru medicul psihiatru, cat si pentru <strong>Casa de Asigurari de Sanatate si Comisia de Experitza Medicala, Comisia de Pensionare si Handicap<\/strong>.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Programarile<\/strong> se fac la numarul de telefon 0728.967.011<\/span><\/p>\n<p><span style=\"color: #000000;\">Cabinetul se afla in Bucuresti, zona Foisorul de Foc.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dementele intra in categoria afectiunilor neurodegenerative si pot fi de mai multe tipuri, cele mai intalnite fiind dementa in Boala Alzheimer, dementa vasculara, dementa mixta, dementa etilica. Func\u0163iile cognitive afectate \u00een mod obi\u015fnuit \u00een demen\u0163e sunt: memoria, capacitatea de invatare, atentia, orientarea, calculul, limbajul, gandirea si judecata. Aceste tulbur\u0103ri ale func\u0163iilor cognitive sunt uneori precedate &hellip; <\/p>\n","protected":false},"author":1,"featured_media":196,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[163,161,162,43,6,159,122,271,160,7,28,5,23,22,158],"_links":{"self":[{"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/posts\/195"}],"collection":[{"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=195"}],"version-history":[{"count":24,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/posts\/195\/revisions"}],"predecessor-version":[{"id":3030,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/posts\/195\/revisions\/3030"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=\/wp\/v2\/media\/196"}],"wp:attachment":[{"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=195"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/iuliapasarin.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}