Page 35 - Handbook of Electronic Assistive Technology

22 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Progressive problems in walking, balance, eye movements, speech, swallowing and
emotional lability are seen at variable rates. It is often misdiagnosed as a Parkinson’s dis-
order, and indeed treatment options are very similar in terms of medicines to reduce stiff-
ness and discomfort, and therapy input to manage signs and symptoms, helping mobility,
care and function.
As there is no cure, life expectancy is usually around 6–7 years after the initial presenta-
tion of signs and symptoms, normally due to respiratory failure or aspiration-related chest
infections.
Dementia
• Prevalence 1 in 100 – aged 60–64.
• Prevalence 1 in 3 – aged over 85.
• Alzheimer’s dementia 40%–50%.
• Multiinfarct vascular dementia 15%.

The definition of dementia is a progressive, acquired loss of cognition and memory,
often associated with personality change and motor deficit. Sleep problems, psychiatric
problems (particularly depression) and agitation are frequently seen.

Alzheimer’s
• The is what society commonly thinks of when talking about dementia.
• There are both genetic and environmental factors in relative causation.
• There is generalised neuronal loss in the cerebral cortex.
• Memory, word finding and orientation difficulties progress to increasing depression,
confusion and apathy with loss of independence and a life expectancy of around 8 years
after onset.
Spinal Problems
Infective, inflammatory, traumatic and degenerative conditions are also seen in the spinal
cord and the vertebral column. This can lead to disordered nerve transmission to and from
the brain and from and to the body.
• Injury – the spine is susceptible to shearing forces, direct trauma and compression
from blood clots or displaced or fractured vertebrae. This can lead to rapid onset of
sensory and motor problems distal to the site with initial floppiness progressing to
stiffness.
• Disorders – if slow progression is seen, then a tumour has to be ruled out. Cavities
within the cord (syrinx) or narrowing of the passages through which it passes
(spondylosis) are also other reasons for slowly progressive spinal disorders. The latter is
often seen in elderly patients with spongy bones (osteoporosis).

The spine is also susceptible to infection and inflammatory disorders – myelitis. A
range of causes is usually not too different from the brain and treatment depends on find-
ing out what’s causing the inflammation.