Ake sifunde kabanzi ngesifo sokulahlekelwa yingqondo. Ingabe abathandekayo bakho bangaba nalesi simo?

Ingabe ngezinye izikhathi ukhohlwa izinto ezincane? Njengokuthi izikhiye zakho zikuphi, noma igama lomuntu. Kungaba yinto evamile. Kodwa kwabanye abantu, lokhu kukhohlwa kuba kubi kakhulu kangangokuthi abakwazi ngisho nokwenza imisebenzi yansuku zonke. Yilapho-ke sidinga ukukhuluma ngesimo esibizwa ngokuthi i-dementia.

Kalula nje, i-dementia ayisona isifo esisodwa esithile. Yigama elihlanganisa ukukhubazeka kwengqondo okuhlukahlukene. Sibiza i-dementia lapho ukusebenza kwengqondo komuntu okuhle ngaphambilini kwehla kancane kancane kuze kube yilapho kuba kubi kakhulu kangangokuthi kuphazamisa impilo yansuku zonke. Ukuze umuntu atholakale enesifo se-dementia, kumele okungenani abe nezimo ezimbili ezilandelayo:

• Inkumbulo
• Ukubonisana
• Ulimi
• Ukuxhumanisa
• Isimo sengqondo
• Ukuziphatha

Ingabe i-dementia nesifo i-Alzheimer's ziyinto efanayo? Noma zimbili?

Abantu abaningi bacabanga ukuthi i-dementia nesifo i-Alzheimer's ziyizinto ezimbili ezihlukene. Empeleni, i-dementia iyisambulela esikhulu, njengoba ngishilo ekuqaleni. Isifo i-Alzheimer's siyimbangela eyinhloko ye-dementia ngaphansi kwalesambulela. Okusho ukuthi, akuwona wonke umuntu onesifo i-Alzheimer's onesifo i-dementia, kodwa akuwona wonke umuntu onesifo i-dementia onesifo i-Alzheimer's. Kungase kube nezinye izimbangela.

Ubani othola i-dementia? Ivame kangakanani?

Isifo sengqondo esibi sivame ukukhula njengoba sikhula. Wake wababona ogogo nomkhulu bethu belahlekelwa yinkumbulo yabo? Phakathi kuka-5% no-8% wabantu abangaphezu kweminyaka engu-65 ubudala banohlobo oluthile lwesifo sengqondo esibi. Leli nani liphindeka kabili njalo eminyakeni emihlanu. Cabanga nje, lapho umuntu eneminyaka engu-85, mhlawumbe oyedwa kwababili uzoba nesifo sengqondo esibi.

Ingabe ukulahlekelwa yinkumbulo njalo kusho ukuthi umuntu unesifo sengqondo esibi?

Manje ungase ucabange, 'O, nami ngiyakhohlwa izinto, ngakho-ke nami nginesifo sokuwohloka komqondo?' Ungesabi. Ukuthi nje ulahlekelwe yinkumbulo yakho akusho ukuthi unesifo sokuwohloka komqondo. Kuvamile ukuba nokukhohlwa okuthile njengoba amanye ama-neurons ebuchosheni bethu efa njengoba siguga. Kodwa akuphazamisi imisebenzi yethu yansuku zonke.

I-dementia ayikona ukukhohlwa ukuthi ubekaphi okhiye bakho. Umuntu onesifo sokulahlekelwa yingqondo angakhohlwa nokuthi enzeni ngokhiye. Yilowo umehluko. I-dementia ayiyona into evamile yokuguga.

Ingabe kunezinhlobo ezahlukene ze-dementia?

I-Dementia ingahlukaniswa ngezigaba ezintathu eziyinhloko:

1. I-Primary Dementia: Kulokhu, i-dementia yisifo esiyinhloko.

2. I-Secondary Dementia: I-Dementia ebangelwa esinye isifo.

3. Izimpawu ezifana ne-dementia eziguqukayo: Ezinye izifo noma izimo zingabangela izimpawu ezifana ne-dementia, kodwa lezi zimpawu ziyanyamalala uma zelashwa.

Izinhlobo ze-Dementia Eyinhloko

• Isifo sika-Alzheimer:Lolu uhlobo oluvame kakhulu. Izinhlobo ezimbili zamaprotheni angajwayelekile, amaprotheni e-Tau kanye nama-Amyloid, aqoqana ebuchosheni. Lokhu kuphazamisa ukuxhumana phakathi kwamangqamuzana ezinzwa ebuchosheni, bese amangqamuzana eqala ukufa. Okokuqala, kuba nokulahlekelwa inkumbulo yesikhashana, ukudideka, kanye nezinguquko zokuziphatha. Bese kuba nobunzima bokukhuluma, ukukhohlwa izinto ezindala, kanye nobunzima bokuhamba. Ngokuvamile kwenzeka kubantu abadala. Uma othile emndenini enayo, kungenzeka ukuthi uyithole. Phakathi kuka-60% no-80% wabantu abane-dementia banayo le nkinga.
• I-Vascular dementia: Lesi yisifo sesibili esivame kakhulu. Sibangelwa ukuvaleka noma ukulimala kwemithambo yegazi ethwala igazi liye ebuchosheni (isib. isifo sohlangothi, i-atherosclerosis). Izimpawu zifaka phakathi izinkinga zokukhumbula, ukudideka, ubunzima bokugxilisa ingqondo, kanye nobunzima bokuqeda imisebenzi. Singavela ngokuzumayo (ngemva kwesifo sohlangothi esikhulu) noma kancane kancane (ngemva kwesifo sohlangothi esincane). Abantu abanomfutho wegazi ophezulu, isifo sikashukela, kanye ne-cholesterol ephezulu basengozini enkulu.
• I-Lewy body dementia: Kulokhu, amaqoqo amaprotheni abizwa ngokuthi ama-Lewy bodies aqoqana emaseli ezinzwa zobuchopho. Lokhu kulimaza amangqamuzana ezinzwa. Izimpawu zifaka phakathi izinkinga ngokunyakaza komzimba kanye nokulinganisela, izinguquko emaphethini okulala, ukulahlekelwa yinkumbulo, ubunzima bokuhlela nokuxazulula izinkinga, kanye nokubona izinto ezingekho .
• I-Frontotemporal dementia (FTD): Lokhu kubangelwa ukulimala kwezingxenye zobuchopho zangaphambili nezesikhashana. Kungabangela ukuziphatha komphakathi, izinguquko zobuntu, ukulahlekelwa amakhono olimi (inkulumo, ukuqonda, ukukhohlwa incazelo yamagama avamile), noma izinkinga ngokuxhumana kwemisipha. Lolu uhlobo lwe-dementia oluvame ukuthinta abantu abaneminyaka ephakathi kuka-45 no-64, okusho ukuthi lukhula besebancane.
• I-Mixed dementia: Lokhu kuyinhlanganisela yezinhlobo ezimbili noma ngaphezulu ze-dementia. Uhlobo oluvame kakhulu yi-Alzheimer's disease kanye ne-vascular dementia. Luvame kakhulu kubantu abangaphezu kweminyaka engu-80 ubudala. Kungaba nzima ukuqaphela ngoba uhlobo olulodwa kuphela lwe-dementia olubonakala ngokucacile. Izimpawu zivame ukuthuthuka ngokushesha kulaba bantu kunakubantu abanohlobo olulodwa kuphela.

I-Secondary Dementia (i-Dementia ebangelwa ezinye izifo nezimo)

• Isifo sikaHuntington: Lesi yisifo sobuchopho esibangelwa ukukhubazeka kwezakhi zofuzo. Sibangela izinkinga ngokulawula ukunyakaza komzimba, ukucabanga, ukwenza izinqumo, inkumbulo, kanye nokushintsha kobuntu.
• Isifo sikaParkinson: Abantu abaningi abanesifo sikaParkinson baba nesifo sokuwohloka komqondo ezigabeni zakamuva. Kunezinkinga zokucabanga, inkumbulo, ukubona izinto ezingekho, ukucindezeleka, kanye nobunzima bokukhuluma.
• I-Wernicke-Korsakoff syndrome:Lesi yisifo sobuchopho esenzeka lapho kunokuntuleka okukhulu kwe-thiamine (i-vitamin B1). Ukopha kungenzeka ezindaweni zobuchopho ezihilelekile ekukhumbuleni. Ngokuvamile kubangelwa ukuphuza utshwala ngokweqile.
• Ukulimala kobuchopho okubuhlungu: Lesi simo singabangelwa ukushaywa ikhanda okuphindaphindiwe. Izimpawu ezifana nokulahlekelwa yinkumbulo kanye nezinguquko zokuziphatha zingase zivele eminyakeni eminingi kamuva.

Izimpawu ezifana ne-dementia eziguqukayo

Ngezinye izikhathi kubukeka sengathi yi-dementia, kodwa empeleni kungaba uphawu lwesinye isifo. Ingxenye engcono kakhulu ukuthi, uma seselaphekile, izimpawu ezifana ne-dementia zizophela!

• Imiphumela emibi yemithi ethile: Eminye imithi, njengamaphilisi okulala kanye nama-tranquilizer, ingabangela izinkinga zokukhumbula.
• Ukuntuleka kwamavithamini: Ikakhulukazi uma i-vitamin B12 iphansi.
• Izinkinga ze-thyroid (i-Hypothyroidism).
• Ukutheleleka: Izinto ezifana nokutheleleka komgudu womchamo (UTIs), ikakhulukazi kubantu abadala.
• I-hydrocephalus evamile yokucindezela (NPH): Ukuqongelela koketshezi lomgogodla (CSF). Lokhu kungelashwa nge-shunt yokuhlinzwa.

Ziyini izimpawu ze-dementia?

Ezigabeni zokuqala, ungabona izimpawu ezifana nalezi:

• Ukukhohlwa izenzakalo zakamuva kanye nolwazi.
• Ukuphindaphinda/ukubuza izinto ezishiwo kanye nemibuzo ebuziwe.
• Izinto ezisetshenziswa njalo azikho noma zisezindaweni ezingajwayelekile.
• Ukuntula ukuqonda okufanele inyanga, unyaka nesikhathi.
• Kunzima ukuthola amagama afanele.
• Ushintsho esimweni sengqondo, ekuziphatheni, noma ezintweni ozithandayo.

Njengoba isimo siba sibi kakhulu, izimpawu ezifana nalezi:

• Inkumbulo kanye nekhono lokwenza izinqumo liyehla kakhulu.
• Kuya kuba nzima ukukhuluma, ukuthola amagama afanele.
• Ngisho nemisebenzi elula yansuku zonke njengokuxubha amazinyo akho, ukwenza ikhofi, ukusebenzisa i-remote ye-TV, kanye nokukhokha izikweletu kuba nzima.
• Ukucabanga okunengqondo, ukuziphatha, kanye namakhono okuxazulula izinkinga ayancipha.
• Izindlela zokulala ziyashintsha.
• Ukukhathazeka, ukukhungatheka, ukudideka, ukungahlaliseki, ukungabaza, ukudabuka, kanye nokucindezeleka kuyanda.
• Udinga usizo ngemisebenzi yansuku zonke (ukugqoka, ukugeza, ukudla)
• Ucabanga izinto ezingekho ngempela.

Yiziphi izimbangela ze-dementia?

Kalula nje, i-dementia ibangelwa ukulimala kobuchopho bakho. Lo monakalo uvimbela amangqamuzana ezinzwa ebuchosheni bakho ukuthi axhumane. Ngezinye izikhathi, ukugeleza kwegazi kuya ebuchosheni kuyancishiswa, kubangele ukungatholi umoya-mpilo nezakhamzimba, futhi izicubu zobuchopho zingafa.

Ihlolwa kanjani i-dementia?

Ukuxilonga i-dementia kungaba nzima kancane ngoba izimpawu zifana nezinye izifo eziningi. Udokotela wakho uzokwenza okulandelayo:

• Ngibuza ngezimpawu zakho.
• Ngibuza ngesifo sakho sakudala.
• Ngizobheka imithi oyithathayo njengamanje.
• Ngiyazibuza ukuthi ukhona yini emndenini oke waba nesifo sokulahlekelwa yingqondo.

Ngaphezu kwalokho, ukuhlolwa kwegazi, ukuskena kobuchopho (ukuhlolwa kwezithombe) okufana `(i-computed tomography - CT)`, `(i-magnetic resonance imaging - MRI)`, kanye `(i-FDG-PET scan)`, kanye nokuhlolwa kwe-neurocognitive okulinganisa ikhono lakho lokucabanga kungenziwa. Ungase udinge nosizo lukadokotela wezifo zengqondo.

Ingabe ikhona indlela yokwelapha i-dementia?

Lapha, sidinga ukuqonda amagama athi 'okwelaphayo', 'okuguqulwayo', kanye 'okwelaphayo ngokuphelele'.

Izinhlobo eziningi ze-dementia zinemithi yokusiza ukulawula izimpawu. Kodwa-ke, izinhlobo eziningi ze-dementia azikwazi ukwelapheka ngokuphelele noma ziguqulwe. Ukwelashwa kunikeza impumuzo ethile kuphela.

Kodwa-ke, njengoba kushiwo ngaphambili, ezinye izimo ezifana nokuwohloka komqondo (isib. ukuntuleka kwamavithamini, imiphumela emibi yemithi ethile, izinkinga ze-thyroid) zingelashwa futhi zelapheke ngokuphelele.

Ngezinhlobo ezingelapheki ze-dementia (isib. Isifo i-Alzheimer's, i-vascular dementia), kunemithi yokulawula ukulahlekelwa yinkumbulo nezinkinga zokuziphatha. Isibonelo, kusetshenziswa ama-cholinesterase inhibitors (njenge-donepezil (Aricept®) kanye ne-rivastigmine (Exelon®)) kanye ne-NMDA receptor antagonist memantine (Namenda®). Imithi emisha efana ne-anti-amyloid antibody aducanumab (Aduhelm®) nayo iyatholakala. Nakuba le mithi ingenakuyimisa ngokuphelele lesi sifo, inganciphisa izinga esiba sibi ngalo.

Izinkinga ezibangelwa yi-dementia

Ezinye zezinkinga ezingase zivele ngenxa yesifo sengqondo yilezi:

• Ukuntuleka kwamanzi kanye nokungondleki kahle.
• Izilonda zombhede (izilonda zokucindezeleka).
• Ukulimala kanye nokuphuka ngenxa yokuwa.
• Ukushaya kwenhliziyo.
• I-pneumonia kanye ne-aspiration pneumonia.
• I-Sepsis (ukusabalala kokutheleleka emzimbeni wonke).

Impilo injani ngesifo sokulahlekelwa yingqondo?

Ukutholwa unesifo sokulahlekelwa yingqondo kuyinto edabukisayo kakhulu. Kodwa-ke, ukuthi ungaphila isikhathi esingakanani nalesi simo kuyahlukahluka kuye ngomuntu nomuntu. Abanye abantu baphila iminyaka engaba ngu-8 benohlobo oluvamile lwesifo sokulahlekelwa yingqondo, njengesifo i-Alzheimer's, kanti abanye baphila iminyaka engaba ngu-20. Into ebaluleke kakhulu ukugcina ikhwalithi yokuphila kwesiguli. Abacwaningi basacwaninga ngalesi sifo kanye nezindlela zokusilawula.

Ingabe i-dementia ingavinjelwa?

Nakuba i-dementia ingenakuvinjelwa ngokuphelele, indlela yokuphila enempilo inganciphisa ingozi yokuthola izinhlobo ezithile ze-dementia.

• Yeka ukubhema.
• Landela ukudla okuhle (isib. ukudla kwaseMedithera - imifino eminingi, izithelo, inhlanzi, okusanhlamvu, amafutha omnqumo, inyama ebomvu encane).
• Ukuzivocavoca. Okungenani imizuzu engama-30 cishe izinsuku eziningi zesonto.
• Gcina ubuchopho bakho busebenza. Xazulula amaphazili, dlala imidlalo yamagama. Lokhu kungalibazisa ukuqala kwesifo sokulahlekelwa yingqondo.
• Khuluma futhi uxoxe nabanye.

Izici ezandisa ingozi yokuthola i-dementia

• Ubudala: Isici esiyinhloko. Ingozi iyanda ngokuguga. Ithinta kakhulu abantu abangaphezu kweminyaka engama-65 ubudala.
• Umlando womndeni: Uma abazali bakho noma abafowenu benawo, nawe usengozini enkulu yokuba nawo.
• I-Down syndrome: Abantu abane-Down syndrome basengozini yokuthola isifo i-Alzheimer's besebancane.
• Impilo yenhliziyo embi: Amazinga aphezulu e-cholesterol, umfutho wegazi ophakeme, i-atherosclerosis, noma ukubhema kwandisa ingozi yakho yokuba nesifo sengqondo. Lezi zinkinga zempilo, njengesifo sikashukela, zithinta imithambo yegazi yakho. Imithambo yegazi eyonakele inganciphisa ukugeleza kwegazi futhi iholele ekushayweni yisifo sohlangothi.
• Ukulimala ekhanda okukhulu (Ukulimala kobuchopho): Uma uke walimala ekhanda kakhulu, usengozini enkulu yokuba ne-dementia.

Kunini lapho udinga ukubonana nodokotela?

Bonana nodokotela uma wena noma othile emndenini wakho ebona noma yiluphi lwalezi zinguquko:

• Izinguquko kwimemori yakho.
• Izinguquko ekusebenzeni kwengqondo yakho.
• Izinguquko ekhonweni lakho lokwenza imisebenzi yansuku zonke.
• Izinguquko ekuziphatheni kwakho.
• Izinguquko ebuntwini bakho.

Kwenzekani uma i-dementia iba yimbi kakhulu?

Ngeshwa, izinhlobo eziningi ze-dementia ziba zimbi kakhulu ngokuhamba kwesikhathi. Lapho ubuchopho bungatholi izakhamzimba nomoya-mpilo obuwudingayo, noma lapho "imfucuza" efana namaprotheni angavamile ivimba ukuxhumana phakathi kwamangqamuzana ezinzwa ebuchosheni, izicubu zobuchopho ziqala ukufa.

Isifo i-Alzheimer's kanye nezinye izinhlobo ze-dementia ngokuvamile ziqala ngokulahlekelwa yinkumbulo kanye nokwehluleka okuncane kokuthatha izinqumo - into ongaphila nayo isikhashana. Njengoba ukusebenza kobuchopho kuya ngokuya kuwohloka, imisebenzi ebalulekile iqala ukuthinteka. Lokhu kufaka phakathi ukuphefumula, ukugaya ukudla, ukushaya kwenhliziyo, kanye nokulala.

Ezigabeni zokugcina ze-dementia, umzimba awukwazi ukwenza imisebenzi edingekayo ukuze uzigcine uphila. Ngenxa yokulimala kobuchopho kanye nobuthakathaka bemisipha, ngisho nokunyakaza okulula nokudingekile akunakwenzeka. Ngaphandle kosizo, abantu abakwazi ukukhuluma, ukuhamba, ukulawula isinyi sabo kanye namathumbu, ukudla, ukuhlafuna, noma ukugwinya ukudla.

Uma ungakwazi ukuzinakekela, ukuhambahamba, ukuthola amanzi nokudla okwanele, futhi uzizwa ucindezelekile, kungenzeka kakhulu ukuthi uthole ezinye izifo. I-pneumonia iyisifo esivamile kubantu abanesifo sengqondo. Umzimba obuthakathaka ungase ungakwazi ukulwa nezifo noma ukuzuza emithini. Ubuhlungu nokungakhululeki kwesiguli kungaba kukhulu kunezindlela zokwelapha ezinganikeza impumuzo yesikhashana kuphela.

Ngalesi sikhathi, imindeni eminingi ikhetha ukunakekelwa kwe-hospice kuze kube sekupheleni kokuphila. Ukunakekelwa kwe-hospice kunikeza induduzo futhi kugxile kwikhwalithi yokuphila kunokwandisa impilo. Abantu abaningi abashona ngenxa yezimo ezihlobene ne-dementia abanalo lolu lwazi ezitifiketini zabo zokufa. Lokhu kungenxa yokuthi inkinga abashona ngayo - isibonelo, i-pneumonia - ifakiwe esikhundleni salokho. Esinye isizathu kungaba ukuthi abantu abaningi abatholakali ngokusemthethweni ukuthi bane-dementia ngaphambi kokuba bafe.

Ingabe zikhona izigaba ze-dementia?

Nakuba kungekho ukuhlukaniswa okuqondile kwesifo sokulahlekelwa yingqondo, kunezigaba ezintathu zohlobo oluvame kakhulu, isifo i-Alzheimer's. Lezi zici zivamile ezinhlotsheni eziningi zesifo sokulahlekelwa yingqondo.

Isigaba Sokuqala (Isigaba Esincane)

Phakathi nalesi sikhathi, basengakwazi ukwenza izinto bodwa. Bangase bashayele, baye emsebenzini, futhi baxoxe nabantu. Ezinye izinguquko zenzeka ezingase zingabonakali kumuntu onesifo i-Alzheimer's, kodwa abangane abaseduze nomndeni bangase baqaphele.

Ubunzima bungaba kanje:

• Ngemva kokwethula othile, bayakhohlwa igama lakhe.
• Izinto eziningana azikho noma azikho endaweni yazo.
• Kuhlala kunzima ukuthola amagama afanele.
• Ubunzima bokuhlela, ukuhlela, ukuphatha, noma ukuqeda imisebenzi.
• Ngihlala ngikhohlwa engikufundayo.

Isigaba Esimaphakathi

Abantu abasesigabeni esiphakathi sesifo i-Alzheimer's bangahlala kulesi sigaba iminyaka eminingi. Bangahlanganyela emisebenzini yansuku zonke ngosizo. Izimpawu sezicacile manje.

Ubunzima bungaba kanje:

• Ngididekile ngokuthi ikuphi unyaka/isikhathi nokuthi ikuphi.
• Ukukhohlwa imicimbi, ukungakwazi ukukhumbula imininingwane yomuntu siqu (inombolo yocingo, ikheli, isikole ofunde kuso).
• Izinguquko ebuntwini, emizweni, nasekuziphatheni, isibonelo, ukusola, ukubona imibono engekho, nokuphindaphinda izinto ezifanayo ngokuphindaphindiwe.
• Izindlela zokulala zasemini/ebusuku ziyashintsha.
• Ubunzima bokulawula umchamo kanye/noma indle.
• Ukugqoka izingubo ezingafanele isikhathi noma isenzakalo.
• Ukuhambahamba bese ulahleka.

Isigaba Esinzima

Abantu abasesigabeni sokugcina sesifo i-Alzheimer abakwazi ukukhuluma, abazi ukuthi kwenzekani eduze kwabo, futhi abakwazi ukulawula ukunyakaza kwemizimba yabo.

Ubunzima bungaba kanje:

• Kunzima ukukhuluma, mhlawumbe amagama noma imishwana embalwa kuphela.
• Kunzima ukuhamba.
• Kunzima ukugwinya.
• Kulula ukungenwa yizifo, ikakhulukazi i-pneumonia.
• Badinga ukunakekelwa amahora angama-24 ngosuku.

Ukuxilongwa kusenesikhathi kwesifo sokulahlekelwa yingqondo kungakusiza wena nomndeni wakho ukuba nihlangane ukuze nenze izinhlelo zokuphila okunenjongo. Kungakusiza futhi ukuthi uhlele izinhlelo zakho zomthetho, zezimali, kanye nezempilo kanye nezifiso zakho. Ithimba lakho lezokwelapha, odokotela, izisebenzi zezenhlalakahle, izisebenzi ze-hospice, kanye nabaholi benkolo bakulungele ukukunikeza imfundo, ukwesekwa, kanye nokunakekela wena noma othandekayo wakho. Futhi, buza ithimba lakho ngamaqembu okusekela i-dementia endaweni yakini. Amaqembu okusekela angaba yindawo enhle yokwabelana ngamathiphu okunakekela, ukuthola induduzo, nokwazi ukuthi awuwedwa.

Okokugcina, izinto okudingeka uzikhumbule

I-Dementia iyisimo esibucayi. Kodwa-ke, kubalulekile ukuqaphela kusenesikhathi. Lokhu kuzokusiza wena nomndeni wakho ukuthi nenze izinhlelo ezidingekayo, futhi ninakekele izindaba zomthetho, zezimali kanye nezempilo. Ithimba lakho lezokwelapha, izisebenzi zezenhlalakahle nabanye bonke bakulungele ukukusiza. Ukunakekela umuntu onesifo se-dementia akulula, ngakho-ke ungalokothi unqikaze ukucela usizo nokusekelwa. Khumbula, awuwedwa.

I- Dementia, i-Alzheimer's, ukulahlekelwa yinkumbulo, impilo yobuchopho, ukuguga, ukwehla kwengqondo, ukukhohlwa