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Tuesday, 29 October 2013

Dementia - Medication Causes of Dementia

About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability that is severe enough to interfere with people's every life and Alzheimer's disease is the most common type of dementia in aging people. American typical diet contains high amount of saturated and trans fat, artificial ingredients with less fruits and vegetable which can lead to dementia and other kind of diseases

I. Causes of Dementia
A. Medication Causes of Dementia
As aging, accumulation of toxins of certain medication used to treat certain diseases, such as antidepressants, sedatives, cardiovascular drugs and anti-anxiety medications may cause increased risk of cognitive dysfunction leading to produced dementia-like symptoms.(1)
1. Antidepressants, selective serotonin reuptake inhibitors, antipsychotics and benzodiazepines
An Antidepressants is a psychiatric medication used to treat mood disorders, such as major depression and dysthymia and anxiety disorders. In a study conducted by Johns Hopkins Bayview Medical Center of total of 230 participants were followed for a mean of 3.7 years. Persistency index (PI) was calculated for all antidepressants, selective serotonin reuptake inhibitors (SSRIs), antipsychotics (atypical and typical), and benzodiazepines as the proportion of observed time of medication exposure, found that Psychotropic medication use was associated with more rapid cognitive and functional decline in AD, and not with improved NPS. Clinicians may tend to prescribe psychotropic medications to AD patients at risk of poorer outcomes, but one cannot rule out the possibility of poorer outcomes being caused by psychotropic medications(2)

2. Anti-inflammatory drugs (NSAIDs)
Lower risks for AD and all-cause dementia were significantly associated with the use of any NSAIDs and the salicylates without barbiturates subgroup in the study sample including subjects with CIND at baseline. There was a weak association between any NSAIDs and the risk of CIND (hazard ratio, 0.87; 95% confidence interval, 0.76-1.00)(3)

3. Cannabis
Cannabis has been  used for the treatment of a number of conditions, including neuropathic pain, treatment of spasticity associated with multiple sclerosis, and chemotherapy-induced nausea, etc,. In the study conducted by University of Western Australia showed that he chronic use of cannabis may impair intellectual abilities but data on this topic remain sparse and difficult to interpret. In conclusion, there is evidence that some drugs contribute to the causal pathway that leads to the development of cognitive impairment but currently available data do not support the introduction of a separate diagnostic category of drug-induced dementia (such as alcohol-related dementia)(4).

4.  Hallucinogens
Hallucinogens are psychedelic drugs, used primary action is to alter cognition and perception, leading to  distortion of sensory perception, and other psychic and somatic effects, including sweating, heart palpitations, blurring of vision, memory loss, trembling, and itching(5)

5. Others
a. Corticosteroids
Corticosteroids are synthetic drugs that closely resemble cortisol, a steroid hormones produced by the adrenal glands to assist the physiologic processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, behavior, etc. but an excess can cause agitation and even actual psychoses.
b. Fluoroquinolone antibiotics 
Fluoroquinolone antibioticsare are medication taken to treat a variety of infections and found to be associated with delirium in elderly patients.
c. H2-receptor antagonists 
H2-receptor antagonists are medicines taken to reduce the amount of acid the stomach by blocking one important producer of histamine2 and are associated with delirium in elderly patients.
d. Anticonvulsants
Anticonvulsants are types of medication used to treat epileptic seizure act on brain through different mechanisms and found to be associated with  drowsiness and difficulty thinking, some more commonly than others.
e. Etc.