Senile depression, senile dementia, vascular psychoses

People over 60 years of age often experience mental disorders with confusion, with symptoms reminiscent of schizophrenia and bipolar disorder. They are often accompanied by delusions, hallucinations, and paranoid manifestations without dementia. In this case, doctors suspect senile psychosis in elderly people. In psychiatry it has a synonym - senile. Relatives of this category of patients have a question: what to do in this case. We recommend contacting the Moscow clinic “Leto”. Our specialists treat mental disorders, including acute/chronic psychotic disorders. Phone number of our medical center: 8(969)060-93-93 . You can call him at any time and get a free consultation.

Senile psychosis, features and causes

The frequency of senile psychotic disorders is in the range of 12-25% of all mental illnesses in old age. The exact causative factors of the disease have not yet been established.

Psychiatrists suggest that the disease develops as a result of age-related changes, character traits and the influence of unfavorable living conditions.

More often, psychosis in an elderly person is characterized by:

• Women.
• Depressed individuals.
• Patients with a hereditary predisposition to this pathology.
• Persons with long-term chronic somatic diseases.

Why are mental disorders more common among older people?

Modern medicine has the ability to optimize the functioning of the nervous system of even a very elderly person. There are people over 80 years of age without any signs of dementia or “senile sclerosis.” Old age is not a disease. Dementia (senile dementia or senile insanity) and age-related depression are diseases with their own clearly defined causes and treatment options.

The nervous system of an elderly person has a number of features.

1. Insufficient blood supply to the brain. With age, blood vessels, including those of the brain, become less elastic, and “plugs” – atherosclerotic plaques – appear inside the vessels. The brain finds itself in a state of lack of blood flow and nutrition. And brain cells are very “gluttonous” and under conditions of nutritional deficiency they work worse and then die. During this period, a kind of senile egoism and insomnia often appear.
2. Slower brain cell renewal . The older we get, the slower the renewal process goes, especially in conditions of reduced blood flow.
3. Changes in biochemical processes in the brain . An electrical impulse is transmitted from one nerve cell to another with the participation of special chemicals - neurotransmitters. These include, for example, serotonin, dopamine, norepinephrine. In older people, the ability to produce and accumulate these substances decreases. Therefore, the conduction of nerve impulses suffers, and, as a result, the overall productivity of the brain weakens, deviations in behavior, emotional, mental and motor spheres arise.

Our task at the examination stage is to unambiguously determine the dominant cause of brain suffering, then our treatment will be exactly as intended.

Two cases of vascular dementia (senile dementia) from our practice. The symptoms are similar, but the treatment required is different.

MRI of the brain. The brain appears gray, the cerebrospinal fluid appears black, and the affected areas of the brain appear white.

• LEFT – normal brain.
• IN THE CENTER – the brain is partially replaced by fluid, arrows indicate areas of reduced blood circulation. The reason is the formation of blood clots due to heart rhythm disturbances + the entry of these blood clots into the brain.
• RIGHT - brain mass is seriously reduced with replacement by fluid, white spots are an area of ​​​​massive death of brain cells. The reason is a narrowing of the carotid arteries by 75% and 80% by cholesterol plaques.

Senile psychosis, types

Doctors at our clinic use the generally accepted classification of the disease.

It includes:

• Affective reactions.
• Paraphrenia.
• States of confusion.
• Mental disorders in severe internal diseases.

Each variant has a dominant syndrome, according to which their differentiation is made.

Diagnostic criteria

In the early stages, it is almost impossible to determine the presence of the disease, since it has a lot of symptoms similar to other pathologies: the cardiovascular system, tumors and other problems.

The reason for the diagnosis is a progressive impoverishment of the psyche, leading over several years to irreversible dementia.

Computed tomography scans also detect hydrocephalus or diffuse brain atrophy.

A visit to the doctor is mandatory if the patient has a number of factors: disorders for more than six months, leading to disturbances in social, professional, and daily activities. At the same time, the person has a completely clear consciousness, there are no mental disorders that could lead to a decrease in intelligence.

Differentiated diagnosis

Differential diagnosis helps to distinguish senile syndrome from diseases with similar symptoms, for example, schizophrenia.

Dementia is often accompanied by depressive disorders (pseudo-dementia), so differentiating the disease is quite difficult.

How does psychosis manifest in the elderly?

Senile psychotic disorders identified by specialists at our health center are divided into several types. They can occur in isolation, with periodic attenuation and new exacerbations. Sometimes one set of symptoms is reduced to another. There are also isolated mental disorders that go into stable remission, which is an indicator of their effective cure. Let's consider the main symptom complexes.

Acute forms of senile psychoses

These are the problems our psychiatrists most often have to deal with.

Their development is caused by somatic ailments:

• Cardiovascular and respiratory failure.
• Hypovitaminosis.
• Diseases of the kidneys and liver.

Patients exhibit characteristic disorders:

• 
  Partial or complete disorientation in space and time with confusion.

• Motor restlessness.
• Anxiety.
• Transient hallucinatory visions.
• Crazy statements.

The duration of symptoms is several days, less often weeks. After the end of the attack, prolonged asthenia and mild lethargy remain. The episode may be repeated.

Chronic senile depression

The severity of clinical manifestations of this form depends on the age of the patients (usually women).

The psychotic reaction consists of:

• Apato-adynamic complex.
• “Silent” depression, in which few people pay attention to the emerging symptoms. And this kind of patient is prone to suicide, which is a complete surprise to others.
• Hypochondriacal complaints with ideas of self-accusation, up to Cotard's delirium.

This senile psychosis lasts a long time - 10 or more years. Thanks to successful therapy in our clinic, it is possible to significantly mitigate its course. Intellect in this form practically does not suffer, only memory problems appear over time.

Chronic paranoid psychoses

The main manifestation of the disorder is the patient’s delusional ideas, with fear of harm from loved ones.

They believe that relatives or neighbors want:

• Bring their death closer.
• Poison.
• Kick out of the home.
• Rob.

Patients turn to various authorities for “protection”, initiate checks, etc. This kind of client retains complete social adaptation, and their nonsense is perceived by department officials as the truth until the circumstances are fully clarified.

Hallucinosis

Characteristic of old age (after 80 years).

Manifest:

• Vivid visual, tactile and auditory hallucinations.
• Severe memory impairment.
• Dermatous delirium. A person is sure that he has parasites and foreign objects on his skin that he cannot get rid of. The patient itches, brushes off non-existent objects, consults dermatologists, and constantly washes clothes and bed linen.

Hallucinatory-paranoid form

This option is characterized by:

• Delirium of damage.
• By adding hallucinations of fantastic content.
• Echo thoughts with hearing voices (schizophrenia-like course).
• False ideas.

This type of disease occurs continuously with slow progression, leading to gradual memory loss.

Senile paraphrenia

Psychotic disorder is manifested by false memories with fantasizing. Patients talk about incredible events, meetings, acquaintances that had no place in their lives. Patients often develop euphoria and delusions of grandeur. The painful episode lasts 3-4 years, then begins to gradually fade.

Symptoms of senile psychosis

As a rule, psychosis occurs acutely, sometimes its development is preceded by a prodromal period lasting one or several days, accompanied by difficulties with self-care, increased fatigue, and disturbances in appetite and sleep.

The main signs of senile psychosis:

• confusion;
• increased fatigue;
• hallucinations;
• rave;
• sleep disorders;
• appetite disorders;
• motor excitement;
• worsening somatic condition.

In chronic senile psychosis, depressive states are observed, more often diagnosed in women. The most favorable course of senile psychoses is characterized by the appearance of subdepressive states, accompanied by lethargy and adynamia; a feeling of emptiness and disgust for life.

In the chronic course of senile psychosis, the appearance of anxious depression, delusions of self-blame, and agitation, reaching Cotard's syndrome, is possible. However, now the number of depressive psychoses has sharply decreased, which is explained by the pathomorphosis of mental disorders.

The following symptoms are characteristic of chronic senile psychosis:

• depressive and paranoid syndromes;
• significant psychopathological disorders;
• prolonged delirium, hallucinations;
• productive diseases with relative preservation of intelligence and memory;
• dysmnestic disorders.

Diagnostics

At the appointment, the doctor at our clinic draws attention to characteristic symptoms that indicate the client has senile psychosis.

During examination and questioning of patients, the following is revealed:

• Preservation of intelligence.
• Stability and limited symptoms.
• Duration of deviations.

It is very important for a psychiatrist to distinguish senile psychosis from schizophrenia, manifestations of vascular pathology. For differential diagnosis, CT and MRI of the brain are used, which can reveal anatomical vascular defects and changes in brain tissue characteristic of other diseases.

Symptoms of age-related depression

The older the age group, the more often depression and dementia (senile insanity) are registered in it. Often elderly patients at our clinic complain of the following symptoms:

1. Negative view of objects and events in life. An elderly man expresses dissatisfaction with youth, authorities, and the weather. Everything that was before is good, and everything that is now is bad.
2. Constant grievances , especially against loved ones, a feeling of “damage done . An elderly family member unreasonably reproaches his loved ones that everyone has abandoned him, they want to take something away from him, they don’t love him, and no one needs him, that they are plotting something against him and want to harm him. This is not behavioral egoism or “harmfulness of character” - but a symptom of vascular disease of the brain (dementia or senile insanity).
3. Impaired ability for integrative brain functions - recall, memorization, thinking. More often, memory for recent events suffers, while events that happened many years ago are remembered well.
4. Cardiovascular attacks due to the slightest stress. A small stimulus is perceived as large, and the released stress hormones “hit” the blood vessels, hence a disruption of the heart rhythm, a hypertensive crisis or a heart attack.
5. Pain in the back, joints, legs, head. Against the background of depression, the pain threshold always decreases and minor pains from arthrosis and osteochondrosis are perceived more clearly.

If you see such symptoms, seek help from a neurologist or psychiatrist. Perhaps brain cells die daily and in large numbers, and it is dangerous to wait. At the same time, if you start treatment in time, its results can be very noticeable. We often see cases of rapid, within 1-2 months, transformation of older people into energetic, positive, active and internally young people. Blood pressure and heart behavior are much calmer.

How to get to our medical center

All you have to do is call 8(969)060-93-93 . The call center manager will provide all the necessary information. From him you will learn the methods and cost of the upcoming treatment. The consultant will help you choose a room. After making an appointment, all you have to do is drive to the clinic. Our hospital is located in a convenient location. Getting to it will not be difficult, either by public transport or by your own. In cases where there are problems with the client, you can order a transfer service from us. Our staff will deliver the patient using convenient transport. All types of diagnostics and therapy are provided anonymously.

Treatment at the Echinacea Clinic

Treating older adults with age-related depression, dementia, and vascular problems is a process that requires patience and a positive attitude. We will be happy to help you.

1. If necessary, we will offer you the help of a neurologist, psychiatrist, psychotherapist, cardiologist, examination of the heart and blood vessels, and the necessary laboratory tests.
2. Visits to the clinic are only when absolutely necessary.
3. We need cooperation between the doctor, the patient and his relatives, you must be prepared for this.

What do we do. First of all, we will find out what led to the brain damage. The reasons may be in different combinations:

1. Atherosclerotic plaques;
2. Increased blood clotting with blockage of small and large cerebral vessels;
3. Stroke;
4. Arrhythmias leading to the formation of microthrombi in the vessels of the brain;
5. High blood pressure accompanied by spasm of cerebral vessels;
6. Alzheimer's disease and other primary dementias.

In all these cases, the treatment will be different and will correspond to the source of the problem. For example, drugs to prevent blood clots will not affect the growth of atherosclerotic plaques and will not normalize blood pressure.

Our clinic has the necessary diagnostic capabilities to assess the condition of cerebral vessels, heart rhythm disturbances, blood clotting and cholesterol levels in an elderly person. If any types of diagnostics have already been performed before, be sure to show their results to the doctor, this will help avoid unnecessary tests.

Treatment will be based on the results of the research. It may include a number of medications, diet, daily routine and exercise, psychotherapy and, if necessary, even therapeutic hypnosis.

Cost of services

This list does not contain all prices for services provided by our clinic. The full price list can be found on the “Prices” , or by calling: 8(969)060-93-93. Initial consultation is FREE!

Where can I invite a psychiatrist to examine a patient in a state of psychosis at home?

There are three types of institutions from which you can call a psychiatrist.

1. Psychoneurological dispensary (PND). This is a government institution, like a clinic, where psychiatrists work. In cities, each psychiatrist is even assigned his own precinct, that is, each city resident has his own local psychiatrist! The responsibilities of such a psychiatrist include home visits to examine seriously ill patients (and psychosis is a serious condition). You, as a relative or loved one, can contact a psychiatrist (in person, through the registry, or by telephone) with a request for an examination at home. An experienced doctor, during a conversation with you (relatives or friends), will draw a conclusion about the patient’s condition and give advice on what to do while you wait for the doctor to arrive.

2. 
   Ambulance. If the patient is agitated, aggressive, poses a danger to himself or others, there is no way to leave him alone and there is no time, then call an ambulance for psychiatric help. For more details on how to do this, see here

3. Private psychiatric clinics. In recent years, their number has been increasing. You can invite a psychiatrist from a private psychiatric clinic to examine the patient. Or call a special team of specialists to provide emergency psychiatric care or hospitalization. The ROSA Clinic is one of the leading private psychiatric clinics in Russia, which operates around the clock and has its own comfortable inpatient department for the treatment of psychosis, and also has a staff of psychiatrists who provide consultations at home.

Treatment of senile psychosis

To relieve the manifestations of psychotic disorders, mandatory medication correction is required. Medicines are selected after examination on an individual basis. The doctor must take into account the characteristics of the patient, age, character, temperament and other aspects of the personality.

Drug therapy is based on:

• 
  Neuroleptics that eliminate delusions and hallucinations.

• Antidepressants that relieve depression and anxiety.
• Sedatives that relieve the patient of fears, agitation, and sleep disturbances.

The treatment complex necessarily includes the following:

• Nootropics.
• Vitamins.
• Drugs for the treatment of somatic pathology.

Against the background of pharmacotherapy, psychologists work with clients, correcting their behavior. Each of our patients is cared for and monitored. Medical staff quickly and effectively provide relief to the sick.

Set of measures

Once the clinical picture has been studied and an accurate diagnosis has been made, treatment of the patient can begin. With the permission of the patient's relatives, he is placed in a medical facility.

The main goal of treatment is to arrest the progression of the disease, symptomatic treatment and alleviation of these characteristic symptoms.

In case of depressive conditions, a specialist may prescribe psychotropic drugs such as Melipramine, Pyrazidol, Azafen. In some cases, drugs can be combined at a certain dose. For all other types of senile psychosis, Propazine, Sonapax, and Haloperidol are prescribed.

In each specific case, the patient is prescribed an individually selected drug and additional medications that correct the accompanying symptoms.

Typically, the acute form of senile psychosis responds more successfully to treatment. A protracted disease can only be suppressed with medications, but it is impossible to completely get rid of it.

What should relatives and friends do?

To maintain the mental state of a patient diagnosed with senile psychosis, the people around him must be understanding of the current situation and understand that this process is inevitable and incurable. This disease is objective and does not depend at all on the patient himself.

In severe cases of senile psychosis, patients require special care, which is best organized in a medical facility. If the patient is inactive, bedsores may appear, which can significantly worsen the health condition.

Patients who are characterized by untidiness require special care. Thus, relatives or medical personnel (depending on the location of the patient) are required to wipe him with camphor alcohol, wash him regularly, change bed linen and prevent sleeping on a wet bed. Cleansing enemas should also be regular.

Forecast and preventive measures

A stay in the hospital of our center with timely assistance provided gives reason to talk about a positive prognosis after treatment of acute conditions. Chronic psychotic forms, unfortunately, have an unfavorable course; doctors can only achieve temporary remission. After discharge, clients, under the supervision of relatives, should follow the recommended regimen, avoid neuropsychic overload, and treat existing pathologies of internal organs. When the first signs of exacerbation appear, simply dial 8(969)060-93-93.

What to expect?

The most favorable prognosis is given to patients with an acute form of the disease, especially if medical help was sought on time and consciousness was not in a state of confusion for long.
The chronic form does not entail anything good and the prognosis in this case is not comforting: the disease develops from one to ten years and the later this process begins, the better, since ultimately the disease ends with cachexia, problems with making movements and even constructing phrases and pronunciation of words.

Experts believe that if you start preventing senile psychosis at the age of 35, then in the future a person will be able to avoid a similar disease:

• the person must be physically active;
• an important factor is the development of mental abilities;
• attention to body weight;
• blood pressure control;
• cholesterol control;
• proper nutrition.