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Tuesday, 29 October 2013

Dementia - Substance Abuse Causes of Cognitive Impairment induced 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
J.  Substance Abused Causes of Dementia
Illicit drug used may cause nervous system impairment as a result of direct and indirect effects on the integrity and function of nervous system tissue and, potentially, through immune effects. HIV-1 infection poses an additional risk of impairment, and this risk may be decreased as a result of antiretroviral drug treatment(1). Others researchers suggested that injection drug use represents the primary risk factor for up to 40% of patients with HIV infection.(2)

1. Heroin 
Heroin (diacetylmorphine or morphine diacetate (INN)), also known as diamorphine (BAN), is an opiate drug extracted from the seed pod of the Asian opium poppy plant. Scientist at University of Cambridge, in the study consisted of a neuropsychological test battery which included both conventional tests and also computerised tests of recognition memory, spatial working memory, planning, sequence generation, visual discrimination learning, and attentional set-shifting of groups of subjects whose primary drug of abuse was amphetamine or heroin were compared, indicate that chronic drug use may lead to distinct patterns of cognitive impairment that may be associated with dysfunction of different components of cortico-striatal circuitry(3).

2. Cocaine and Methamphetamine
Cocaine (benzoylmethylecgonine) (INN) is a crystalline tropane alkaloid obtained from the leaves of the coca plant. researchers at reported that report a patient with rapidly accelerating HIV dementia accompanied by seizures and an unusual movement disorder despite highly potent antiretroviral therapy as a result of methamphetamine and cocaine(4).

3. Lysergic acid diethylamide (LSD)
Lysergic acid diethylamide, abbreviated LSD or LSD-25, also known as lysergide and colloquially as acid, is a semisynthetic psychedelic drug of the ergoline family, well known for its psychological effects which can include altered thinking processes, closed and open eye visuals, synaesthesia, an altered sense of time, etc.(5). There are report that LSD may temporarily impair the ability to make sensible judgments and understand common dangers, thus making the user more susceptible to accidents and personal injury. It may cause temporary confusion, difficulty with abstract thinking, or signs of impaired memory and attention span similar to brain damage(5), but in the article, by Dr. Daniel X. Freedman's psychiatric interviews did not reveal clinically significant signs of organic impairment in behavior or life situations. For some, there were characterological and psychological features which were somewhat eccentric; but, over-all, the ability to judge, to acquire competence and new learning, to focus attention and concentrate, to recall and retrieve relevant information, appeared intact. Where unusual personality traits were encountered, they seemed to have been present in the pre-LSD life history, style, and subculture of the subjects.(6)

4. Ecstasy (3,4-methylenedioxymethamphetamine, or MDMA)
Ecstasy, a highly addictive drug, is a powerful CNS stimulant with chemically similar to the stimulant methamphetamine and hallucinogen mescaline and commonly refers to its street pill form. In the article "InfoFacts: MDMA (Ecstasy)" posted in National Institute of Drug abuse wrote that MDMA can produce confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur soon after taking the drug or, sometimes, even days or weeks after taking MDMA. In addition, chronic users of MDMA perform more poorly than nonusers on certain types of cognitive or memory tasks, although some of these effects may be due to the use of other drugs in combination with MDMA. Research in animals indicates that MDMA can be harmful to the brain—one study in nonhuman primates showed that exposure to MDMA for only 4 days caused damage to serotonin nerve terminals that was still evident 6 to 7 years later. Although similar neurotoxicity has not been shown definitively in humans, the wealth of animal research indicating MDMA’s damaging properties strongly suggests that MDMA is not a safe drug for human consumption.(7)

5. Other illicit drugs
Finally, we would like to conclude this article by quoting the study at University of Rostock, Dr. Büttner A. indicated that Drug abuse represents a significant health issue. The major substances abused include cannabis, opiates, cocaine, amphetamine, methamphetamine and 'ecstasy'. Alterations of intracellular messenger pathways, transcription factors and immediate early genes within the brain reward system seem to be fundamentally important for the development of addiction and chronic drug abuse. Genetic risk factors and changes in gene expression associated with drug abuse are still poorly understood. Besides cardiovascular complications, psychiatric and neurologic symptoms are the most common manifestations of drug toxicity. A broad spectrum of changes affecting the central nervous system is seen in drug abusers... Systematic histological, immunohistochemical and morphometric investigations have shown profound morphological alterations in the brains of polydrug abusers. The major findings comprise neuronal loss, neurodegenerative alterations, a reduction of glial fibrillary acidic protein-immunopositive astrocytes, widespread axonal damage with concomitant microglial activation as well as reactive and degenerative changes of the cerebral microvasculature. These observations demonstrate that drugs of abuse initiate a cascade of interacting toxic, vascular and hypoxic factors, which finally result in widespread disturbances within the complex network of central nervous system cell-to-cell interactions.(8)

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