bimbingan coass 2016 demensia

8/18/2019 Bimbingan Coass 2016 Demensia

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GANGGUAN FUNGSI KOGNITIF

1BIMBINGAN COASS DEMENSIA


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1. Atensi

2. Bahasa

3. Memori4. Visuospasial

5. Fungsi eksekutif

DOMAIN FUNGSI KOGNITIF



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COGNITIVE CONTINUUM

3

BIMBINGAN COASS DEMENSIA


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MILD COGNITIVE IMPAIRMENT

(MCI) :

Criteria for the clinical and cognitie!"ndro#e Ada $el%han &er%'ahan f%ng!i $ognitif

Ada gangg%an !at% ata% le'ih do#ain

f%ng!i $ognitif ecara $e#a#&%an f%ng!ional #a!ih

inde&enden

Tida$ de#en!ia

Alzheimers Dement. 2011 May ; 73!" 270#27$

%BIMBINGAN COASS DEMENSIA


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&BIMBINGAN COASS DEMENSIA


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PENGERTIAN

Demensia a'alah sin'r(m )en*r*nan+*n,si intele-t*al 'ian'in,seel*mnya yan, /*-*) eratsehin,,a men,,an,,* a-tiitas s(sial'an )r(+esi(nal yan, ter/ermin 'alama-tiitas hi'*) -eseharian iasanya

'item*-an *,a )er*ahan )erila-*'an ti'a- 'isea-an (leh 'eliri*mma*)*n ,an,,*an )si-iatri may(r.

BIMBINGAN COASS DEMENSIA


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ETIOLOGI

Penyakit Alzheimer Demensia Vaskuler

Penyakit Lewy Body De,enerasi 4(ar 5r(nt(tem)(ral In+e-si 6I 8enya-it 8ri(n Creutzfeld-Jacob Disease! 8enya-it 8ar-ins(n 8enya-it 6*ntin,t(n 9ra*ma -e)ala 8en,,*naan (at : s*stansi tertent* (n'isi me'i- lain Eti(l(,i m*lti)el



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PatofsologiPatofsologi Alzheimer's diseases Alzheimer's diseases

DepositDeposit zatzat--zatzat racunracunpadapadaotak otak

sepertiseperti yang yangnamanyanamanya::

Amyloid Amyloid Beta Peptides Beta Peptides(( A A ßß)) NeurofbrillaryNeurofbrillarytangletangle

Mikroskopik:


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Amyloid plaque in Alheimer disease

beta-amyloid protein :

! too much ‘sticky’amyloid

! forms plaques on the

outside of brain cells

immune-system cells

attack, killing innocent

nerve cells


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Paired helical structure of neurofibrillatory

tangles

tau molecules :! assembles microtubules that

support the structure of the

nerve cell! chemical changes in the nerve

cells cause the tau molecules to

change shape so they no longer

hold the microtubules in place.

The ‘railroad ties’ begin to twist and tange. ell shrinks and

dies.


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A.el*han -(,nisi "

Gangguan memori ter*tama-emam)*an elaar materi ar* yan,

serin, mer*)a-an -el*han )alin, 'ini.Mem(ri lama isa ter,an,,* )a'a'emensia taha) lan*t.

Disorientasi 'i se-itar r*mah ata*

lin,-*n,an yan, relati+ ar*.Gan,,*an -emam)*an mem*at-e)*t*san judgement! 'an)en,ertian 'iri tentan, )enya-it.

GEJALA KLINIS



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GEJALA KLINIS

B. el*han n(n


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C.Geala =si- "

gangguan motorik -el*m)*han

an,,(ta ,era- -es*litan eralani/ara /a'el 'an ,an,,*an ,era-lainnya.

Kejang 'a)at 'item*-an ses*ai'en,an eti(l(,inya.

GEJALA KLINIS

1%BIMBINGAN COASS DEMENSIA


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Pemeriksaan neuropsikologi.

Tes penapisan sederhana"Minimental State Examination MMSE > 2%!

Clock Drawing Test CD9 >%!

Montreal Congitive ssessment


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TATA LAKSANA

A !nter"ensi #armakologi$ 9era)i 5arma-(l(,i *nt*- 5*n,si (,nisi

8enye-at (linesterase !rade " #evel $" good!

D(ne)ezil

?iasti,min

Galantamin

E+e- sam)in, " m*al m*ntah 'iare 'an ra'i-ar'i

2. 9era)i 5arma-(l(,i Behai(ral an' 8sy/h(l(,i/alSym)t(ms (+ Dementia B8SD!

B !nter"ensi %onarmakologi

BIMBINGAN COASS DEMENSIA 1


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IS

C4OC D?AING 9ES9

nt*- menilai " 5*n,si e-se-*ti+ l(*s +r(ntalis! is*(s)asial l(*s )arietalis!

Met('e " Minta )asien *nt*- men,,amar se*ah am

4eta--an an,-a


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IS 2011


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IS 2011


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TERIMA KASIH



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B. In+(rmant *esti(nnaire (n C(,nitieDe/line in

El'erly ICODE!

C. 8emeri-saan -linis terstr*-t*r" Clini/alDementia ?atin, CD?!

D. riteria 'ia,n(sis"

riteria DSM


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Pemeriksaan la'oratorium :

8emeri-saan stan'ar" hemat(l(,i r*tin ,*la 'arah sea-t* +*n,si ,inal

*re*m -reatinin! +*n,si hati SGO9 'an SG89! +*n,si tir(i' -a'arser*m itamin B12 'an asam +(lat.

9es ser(l(,is Si=lis ersi+at sele-ti+ 'an hanya 'ila-*-an ses*ai in'i-asisaa

Pemeriksaan ((G :

6anya 'ila-*-an )a'a -as*s 'emensia 'en,an -ean, Creutzfeldt-Jakobdisease ata* 'eliri*m

Tindakan LP dan pemeriksaan likuor sere'rospinal "hanya atas in'i-asi a'anya '*,aan in+e-si.

Pemeriksaan marka genetik) dan AP*("

ti'a- 'ire-(mmen'asi-an *nt*- -e)erl*an -linis.

2%BIMBINGAN COASS DEMENSIA


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Penentuan derajat keparahandemensia

MMSE

rin,an s-(r 21


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Kriteria Diagnostik DSM-V ntkGanggan Nerokognisi Ma!or

"#e$ensia% A'anya *-ti si,ni=-an )en*r*nan -(,nisi 'ari seel*mnya

)a'a sat* ata* leih '(main -(,nisi atensi -(m)le-s +*n,si

e-se-*ti+ -emam)*an elaar 'an mem(ri ahasa )erse)si<

m(t(ri- ata* -(,nisi s(sial! er'asar-an

el*han in'ii'* in+(rman yan, 'a)at 'i)er/aya ata*-linisi aha tera'i )en*r*nan yan, si,ni=-an )a'a

+*n,si -(,nisi

Gan,,*an )er+(rma -(,nisi yan, 'i'(-*mentasi-an

'en,an tes ne*r()si-(l(,i ata* )emeri-saan -*antitati+

lainnya

De=sit -(,nisi men,,an,,* -eman'irian 'alam mela-*-ana-tiitas sehari

bimbingan coass 2016 demensia

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