ILOILO DOCTOR’S COLLEGE

BACHELOR OF SCIENCE IN NURSING

West Avenue Timawa, Molo, Iloilo City

NCM 114 (RLE)

CARE OF THE OLDER ADULT CLIENT
CASE SCENARIO 1:
VASCULAR DEMENTIA

A Case Study Presented to the Department of Nursing of Iloilo Doctor’s College

PRESENTED TO: MRS.

Arvi Tenderly V. Melliza, RN, M.A.N.
(NCM 112 RLE & SKILLS CLINICAL INSTRUCTOR)

PRESENTED BY:
Abenido, Mary Claire Cartera, Riza June
Alayon, Hannah Marie Catubay, Jade
Anatan, Raenacet Claro, Meryll Joy
Camariosa, Shelynar B. Feliciano, Dee D Rhae
Camarista, Coleen Mae C.

(BSN III-G GROUP 1)

NOVEMBER 22, 2021

BACHELOR OF SCIENCE IN NURSING
ILOILO DOCTOR’S COLLEGE
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

TABLE OF CONTENTS

I. .. .........................................................................INTRODUCTION

A. Objectives:
1. General Objective
2. Specific objectives (KSA) format
II. ................................................... NURSING HEALTH HISTORY

III . ....................................................... PHYSICAL EXAMINATION

IV. .................................... ANATOMY AND PATHOPHYSIOLOGY

V .. ................. DIAGNOSTICS AND LABORATORY PROCEDURE

VI. ................................................................. NURSING PROCESS

VII. ....................................................................... DRUG STUDY

VIII. ............................ DISCHARGE PLAN/HEALTH TEACHING

IX. ............................................................. ARTICLE/JOURNAL

 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

I. INTRODUCTION
Vascular dementia is the second most common cause of dementia and is characterized by
an uneven, stepwise downward decline in mental function (Grossman & Porth, 2014). Multi-
infarct dementia, the most common form of vascular dementia, has an unpredictable course and
is characterized by variable impairment depending on the affected sites in the brain. The patient
may present with a deficit in only one domain such as word retrieval whereas other cognitive
abilities may be intact. Diagnosis may be even more difficult if a patient has both vascular
dementia and AD. Because vascular dementia is associated with hypertension and cardiovascular
disease, risk factors (e.g., hypercholesterolemia, smoking, heart disease, diabetes) are similar.
Prevention and management are also similar. Measures to decrease blood pressure, control
diabetes, and lower cholesterol levels may slow cognitive decline.

What Causes Vascular Dementia?

Vascular dementia occurs when vessels that supply blood to the brain become blocked or
narrowed. Strokes take place when the supply of blood carrying oxygen to the brain is suddenly
cut off. However, not all people with stroke will develop vascular dementia.
Vascular dementia can occur over time as "silent" strokes pile up. Quite often, vascular dementia
draws attention to itself only when the impact of so many strokes adds up to significant
disability. Avoiding and controlling risk factors such as diabetes, high blood pressure, smoking,
and high cholesterol can help curb the risk of vascular dementia.
Catching the condition early also helps limit the impact and severity of vascular dementia. Early
detection requires an awareness of risk factors and, more importantly, efforts to keep them under
control. Anyone who suspects vascular dementia should talk with their doctor.

Symptoms of Vascular Dementia

Symptoms of vascular dementia depend on what part of the brain is affected and to what extent.
Like Alzheimer's disease, the symptoms of vascular dementia are often mild for a long time.
They may include:

 Problems with short-term memory

 Wandering or getting lost in familiar surroundings
 Laughing or crying at inappropriate times
 Trouble concentrating, planning, or following through on activities
 Trouble managing money
 Inability to follow instructions
 Loss of bladder or bowel control
 Hallucinations or delusions
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

OBJECTIVES
A. General Objectives
This study aims to convey familiarity and to provide an effective nursing
care to a patient diagnosed with Vascular Dementia through understanding the patient
history, disease process, achieve and maintain control of symptoms and prevent further
complications.
B. Specific Objectives
A. Knowledge
• Define the meaning of Vascular Dementia.
• Know the pathophysiological basis of the Vascular Dementia.
• Determine signs and symptoms and risk factors/causes of Vascular Dementia.
• Determine appropriate nursing care management for client with Vascular
Dementia
• Formulate plan of care for clients with Vascular Dementia.
• Provide accurate information about the topic

B. Skills
• Assess client who is experiencing a Vascular Dementia.
• Apply different assessment techniques to determine the patients need
• Evaluate the plan of care needed
• Formulate nursing diagnoses that address the needs of the client experiencing
Vascular Dementia.
• Collaborate with health team member in planning and performing client care
• Document expected outcomes for effectiveness and achievement of care.
C. Attitude
• Build rapport with the client to build trust.
• Respect client decision (race, culture, values and beliefs)
• Maintain confidentiality regarding patient records/information
• Explain the importance of follow up check-up.
• Establish therapeutic relationship with client and family
• Acknowledge client needs using holistic approach
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

• Display confidence in providing nursing care to the client.

• Develop teamwork and collaboration to the health care team member
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

II. NURSING HEALTH HISTORY

I. Patients Data
Admitting Data
 Name: Mr. Batungbakal
 Age: 60 years old
 Sex: Male
 Marital Status: Married
 Occupation: Retired Teacher
 Source of Information: Patient
 Attending Physician: Dr. Juan Dela Cruz
 Chief complaint: Behavioral changes & difficulty in finding words, at times he
stares blankly.
Impression
 Vascular Dementia
Diagnosis
 Impaired memory related to neuronal destruction as evidence by
disorientation to time, place, person and circumstances.
 Chronic confusion related to altered function of brain evidenced by
behavioral changes and difficulty in finding words.

Assessment
 Upon assessment, the patient cannot recall the name of his son, not aware of
the time and date. The patient was irritated when ask. He can’t even recall his
birthday and the name of his wife. He always looks blankly and losses his
appetite.
Present history
 Chief complaint of behavioral changes & difficulty in finding words, at times he
stares blankly.
 The patient cannot recall the name of his son, not aware of the time and date. He
was irritated when ask.
 He can’t even recall his birthday and the name of his wife.
 He always looks blankly and losses his appetite.
 His son also claimed that the patient always wander in his garden in a state of
undress & generally appears unkempt.
 He has trouble making good decision when pressure for time & that he doesn’t plan
as well as he did.
 The family also noticed that he appears to decline suddenly from a cognitive
perspective & then appear to level off before taking another sharp drop in his
thinking & reasoning abilities.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

Past history
 History of hypertension.
 Two months prior to admission the patient was admitted in IDH due to
hypertension and was diagnosed of mild stroke.
 Smoked for 20 years.
Social history
 He is a retired teacher.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

III. PHYSICAL EXAMINATION

PHYSICAL EXAMINATION

Vital signs
Temperature= 36.5 °C
Blood Pressure= 130/90mHg
Pulse rate= 70cpm
Respiratory rate= 23bpm

Cognitive changes
 Memory loss, which is usually noticed by someone else
 Difficulty communicating or finding words
 Difficulty with visual and spatial abilities, such as getting lost while driving
 Difficulty reasoning or problem-solving
 Difficulty handling complex tasks
 Difficulty with planning and organizing
 Difficulty with coordination and motor functions
 Confusion and disorientation

Psychological changes
 Personality changes
 Depression
 Anxiety
 Inappropriate behavior
 Paranoia
 Agitation
 Hallucinations

Physical changes
 balance problems,
 gait disorder
 urinary incontinence; focal lesions may be subtle.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

IV. ANATOMY AND PATHOPHYSIOLOGY

Vascular dementia typically results from multiple small cerebral infarcts (or sometimes
hemorrhages). Although each infarct may be only minimally symptomatic in itself, the combination
of multiple small infarcts can cause enough neuronal or axonal loss to impair brain function.
Vascular dementias include the following:

 Multiple lacunar infarction: Small blood vessels are affected. Multiple lacunar infarcts
occur deep within hemispheric white and gray matter.
 Multi-infarct dementia: Medium-sized blood vessels are affected.
 Strategic single-infarct dementia: A single infarct occurs in a crucial area of the brain (eg,
angular gyrus, thalamus).
 Binswanger dementia (subcortical arteriosclerotic encephalopathy): This uncommon
variant of small-vessel dementia is associated with severe, poorly controlled hypertension
and systemic vascular disease. It causes diffuse and irregular loss of axons and myelin with
widespread gliosis, tissue death due to an infarction, or loss of blood supply to the white
matter of the brain.
 Hereditary vascular dementia: Cerebral autosomal dominant arteriopathy with subcortical
infarcts and
leukoencephalopathy
(CADASIL) is a cerebral
small vessel disease
caused by mutations in
the NOTCH3 (NOTCH
receptor 3) gene, which
codes for a transmembrane
receptor located on
vascular smooth muscle
cells. Cerebral autosomal
recessive arteriopathy with
subcortical infarcts and
leukoencephalopathy
(CARASIL) is also a small
vessel disease; it is caused
by mutations in
the HTRA1 gene.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

V. LABORATORY AND DIAGNOSTICS

Lab test Result Significance

MRI - A non-invasive imaging Not normal: Blood clots can be

technology used to investigate MRI and revealed that there is caused by Hypertension and
anatomy and function of the a build-up of blood clot in the Mild stroke which is called
body in both health and disease brain. Atherosclerosis (the formation
without the use of damaging of plaques of fatty material on
ionizing radiation. It is often Findings are suggestive of: the inner walls of the arteries
used for disease detection, Vascular Dementia which blocks the blood from
diagnosis, and treatment coming through).
monitoring. It is based on
sophisticated technology that
excites and detects changes in
protons found in the water that
makes up living tissues.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

VI. NURSING CARE PLAN

ASSESSMENT NURSING OUTCOME INTERVENTION RATIONALE EVALUATION
DIAGNOSIS IDENTIFICATION
SUBJECTIVE: Impaired SHORT TERM INDEPENDENT: After 1 week of
memory related GOAL: - Assess the - Cognitive nursing
“My father has to neuronal patient’s overall assessment interventions the
greatly After 72 hours cognitive tools such as patient will be
changed destruction in
the brain as of nursing function and the General able to manifest
recently, he is
intervention, memory. Practitioner the following:
showing this evidenced by
unusual the Patient will Assessment of
disorientation
behavior and have Cognition  Achieve
he tends to to time, place,
appropriate (GPCOG) can functional
have difficulty person, and maintenance of be used to ability at his
recalling our circumstance mental and determine the optimum level
name”… as
claimed by the psychological patient’s with
patient’s son function as long cognitive modifications
as possible and function. and alterations
OBJECTIVE: Rationale: reversal of within his
behaviors when - Assess the - May cause environment to
Vital Signs Memory possible. patient for confusion and compensate
impairment is sensory a change in for deficits.
T-36.5◦C defined as deprivation, mental status.
LONG TERM: concurrent use  The Patient will
impaired
PR-70 bpm After 1 week of of CNS drugs, have
ability to learn nursing poor nutrition, appropriate
RR-23 new interventions dehydration, maintenance of
information or the patient will infection, or
c.p.m mental and
to recall achieve other psychological
BP-130/ previously functional concurrent function as
learned ability at his disease long as
90mmHg information. optimum level processes. possible and
with reversal of
modifications - Orient the - Reality behaviors
and alterations patient to the orientation when possible.
within his environment as techniques
environment to needed if the help improve  Family
compensate for patient’s short- patients’ members will
deficits. term memory is awareness of exhibit an
intact. The use self and understanding
of calendars, environment of required
radio, only for care and
newspapers, patients with demonstrate
television, and confusion appropriate
so forth are also related to
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

appropriate. delirium or coping skills

depression. and utilize
community
- Encourage the - These resources.
use of activities can
complementary help reduce
and alternative stress; stress
therapies such can aggravate
as exercises, memory loss.
guided
meditation
massage.

ASSESSMENT NURSING OUTCOME INTERVENTION RATIONALE EVALUATION

DIAGNOSIS IDENTIFICATION
SUBJECTIVE: Chronic SHORT TERM INDEPENDENT: After 1 week of
confusion GOAL: - Place an - Patients with nursing
“I am so related to identification chronic interventions the
concerned that After 72 hours bracelet on the confusion may patient will be
my father has altered function
of brain as of nursing patient. wander and able to manifest
changed
intervention, can become the following:
recently, he evidence by
has this the patient lost;
behavioral
difficulty in remains free identification  Achieve
finding words, changes and from harm and bracelets functional
and at times he difficulty in functions at a increase ability at his
stares finding words. maximal patient safety optimum level
blankly”...
as claimed by cognitive level with
the patient’s Rationale: regaining - Promote reality- - Orientation to modifications
son normal reality oriented one’s participating in
Chronic orientation and relationships environment simple
OBJECTIVE: confusion is level of and increases one’s activities of
progressive consciousness. environment ability to trust daily living
Vital Signs and variable in (e.g., display others.
nature and clocks,  Patient
T-36.5◦C LONG TERM: calendars, remains
may usually
After 1 week of personal items, content and
PR-70 bpm involve
nursing seasonal free from
problems with interventions decorations). harm.
RR-23 memory recall, the patient will
c.p.m problem- achieve - Present one - People with  Patient
solving, functional simple direction chronic functions at a
BP-130/ language, and ability at his at a time and confusion need maximal
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

90mmHg attention. Also, optimum level repeat as time to cognitive level.

there can be with necessary. understand
difficulties with modifications and interpret  Family
perception, participating in directions. members or
rationalizing, simple activities significant
of daily living - Provide a calm - Any extraneous others
judgment,
environment. noise and verbalize
abstract
stimuli can be understanding
thinking, misinterpreted of disease
communication by the process and
, emotional confused prognosis and
expression, patient. Images the patient’s
and the on walls may needs,
performance of be threatening recognize and
routine tasks. for the patient. engage in
interventions
to deal
completely
with the
situation, and
provide for
maximal
independence
while meeting
safety needs of
the patient.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

VII. DRUG STUDY

Drug Name Classification and Indications and Side Effects and Special Nursing
Mechanism of Contraindications Adverse Effects Precautions Responsibilities
Action
Generic Name: Classification: Indications: -swelling of the Check with your •Assess heart rate,
Amlodipine Calcium Channel Amlodipine is a hands, feet, doctor right ECG, and heart
Blockers medicine used to ankles, or lower away if you have sounds, especially
Trade/Brand treat high blood legs. pain or during exercise.
Name: Mechanism of pressure -headache tenderness in •Assess blood
Dosage: Action: (hypertension). It is -upset stomach the upper pressure
10mg Amlodipine is also used to -nausea stomach, pale periodically, and
considered a prevent chest pain -stomach pain stools, dark compare to normal
Route: peripheral arterial caused by heart -dizziness or urine, loss of values.
Oral (per orem) vasodilator that disease (angina). lightheadedness appetite, nausea, •Assess episodes
exerts its action -drowsiness vomiting, or of angina pectoris
Frequency and directly on vascular Contraindications: -excessive yellow eyes or at rest and during
Timing: smooth muscle to Amlodipine is tiredness skin. exercise.
Once a day lead to a reduction contraindicated in •Assess peripheral
in peripheral patients with known edema using girth
vascular hypersensitivity to measurements,
resistance, causing amlodipine or its volume
a decrease in blood dosage form displacement, and
pressure. components. measurement of
pitting edema

Drug Name Classification Indications and Side Effects Special Nursing

and Mechanism Contraindications and Adverse Precautions Responsibilities
of Action Effects
Generic Classification: Indications: -nausea Before using this •Observe the 10
Name: Acetylcholineste ARICEPT is -vomiting medication, tell rights of medication.
Aricept rase Inhibitors indicated for the -diarrhea your doctor or •Instruct patients
treatment of -loss of pharmacist your and caregivers to
Trade/Brand Mechanism of dementia of the appetite/ medical history, take ARICEPT only
Name: Action: Alzheimer's type. weight loss especially of: once per day, as
Aricept is a new Efficacy has been -dizziness breathing prescribed.
Dosage: reversible demonstrated in -drowsiness problems (such •Monitor carefully
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

10 mg inhibitor of the patients with -weakness as asthma and patients with a

enzyme mild, moderate, -trouble chronic history of asthma or
Route: acetylcholinester and severe sleeping obstructive obstructive
Oral (per ase. It may allow Alzheimer's -shakiness pulmonary pulmonary disease.
Orem) a greater disease. (tremor) disease). •Monitor
concentration of -muscle cardiovascular
Frequency acetylcholine in Contraindications: cramps status; drug may
and Timing: the brain, Hypersensitivity- have vagotonic effect
Once a day thereby ty to Aricept. on the heart, causing
At bedtime improving bradycardia,
cholinergic especially in
function. presence of
conduction
abnormalities.

Drug Name Classification and Indications and Side Effects Special Nursing
Mechanism of Action Contraindications and Adverse Precautions Responsibilities
Effects
Generic Classification: Indications: -dizziness Patients should •Assess patient
Name: be warned that, for signs of
A15 Appetite Anorexia of somatic -dry mouth owing to its vitamin
Mosegor Vita Stimulants, Vitamin B- or psychogenic possible deficiency
-nausea
complex origin in sedative effect before and
underweight - of Mosegor Vita periodically
Trade/Brand patients, in whom constipation may slow their during therapy.
Name: Mechanism of Action: prevention of reactions when
vitamin-B -increased driving •Assess
Dosage: deficiency appetite vehicles, nutritional
It has an appetite-
secondary to operating status through
Route: stimulating action -weight gain 24-hr diet
suitable for increasing impaired dietary machinery, etc.
intake or recall.
body weight in -tiredness
•Determine
underweight anorectic absorption
Frequency frequency of
patients. The
and Timing: consumption of
compound is well
vitamin-rich
tolerated, permitting Contraindications:
Once a day foods.
treatment of anorexia Hypersensitivity to
both in children and Mosegor Vita and
adults. its components.
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

Drug Name Classification and Indications and Side Effects and Special Nursing
Mechanism of Contraindications Adverse Effects Precautions Responsibilities
Action
Generic Classification: Indications: -nausea Rivastigmine •Monitor vital
Name: Rivastigmine is in It is indicated to -vomiting may cause signs.
Rivastigmine a class of treat mild to -loss of appetite nausea, •Observe the 10
medications called moderate -heartburn or vomiting, rights of
Trade/Brand cholinesterase dementia of the indigestion diarrhea, medication.
Name: inhibitors. Alzheimer's type. -stomach pain stomach pain, •Monitor
Mechanism of Its indications -weight loss loss of appetite, cognitive function
Dosage: Action: also include the -diarrhea or weight loss. and ability to
3mg Rivastigmine, an treatment of mild -constipation Tell your perform ADLs.
acetylcholinestera to moderate -gas doctor if any of •Monitor
Route: se inhibitor, dementia that is -weakness these problems ambulation as
Oral works by associated with -dizziness are severe, dizziness is a
increasing the Parkinson disease. -headache because they common adverse
Frequency levels of a brain -extreme could cause effect.
and Timing: chemical called Contraindication: tiredness other health •Monitor
Every 12 acetylcholine Hypersensitivity -lack of energy problems such diabetics for loss
hours which allows the to Rivastigmine. -tremor or as dehydration. of glycemic
nerve cells to worsening of control.
communicate. tremor
This may improve -increased
the symptoms of sweating
dementia. -difficulty falling
asleep or staying
asleep
-confusion
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

VIII. DISCHARGE PLAN/HEALTH TEACHING

During Hospitalization
Safety
 Confirm that important information, including dementia diagnosis and any
behavioral concerns or allergies, is noted on the medical chart.
 Inform medical staff if there is a history of wandering or getting lost. o Bring familiar
items from home to make the room feel more secure and comfortable for the person
living with the disease.
Behaviors
 Alert the medical staff of any triggers that may cause unpredictable thinking or
behaviors.
 Offer suggestions on approaches that may help reduce these behaviors. o Inform
medical staff of a history of behavioral reactions to certain medications.
 Discuss limiting the number of visitors if the number of guests or medical staff
visiting the room becomes too stressful.
Nutrition
 Share any dietary preferences with medical staff.
 Arrange to be present during meal times if the person has difficulty feeding him or
herself, or alert hospital staff to this need.
 Offer suggestions to encourage good nutrition and hydration. o Notify medical staff
of any difficulties chewing or swallowing.
Return to the emergency department if you or someone close to you notices:
 You have signs of delirium, such as extreme confusion, and seeing or hearing things
that are not there.
 You become angry or violent, and cannot be calmed down.
 You faint and cannot be woken.
The following may also help you manage dementia:
 Keep your mind and body active.
 Take all of your medicines as directed.
 Write daily schedules and routines.
 Place clocks and calendars where you can see them.
 Do not smoke
 Eat healthy foods
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

IX. ARTICLE/JOURNAL
INTERNATIONAL:
Rhizoma Coptidis for Alzheimer's Disease and Vascular
Dementia: A Literature Review

Background: Alzheimer's disease (AD) and vascular dementia (VaD) are major types of
dementia, both of which cause heavy economic burdens for families and society. However, no
currently available medicines can control dementia progression. Rhizoma coptidis, a Chinese
herbal medicine, has been used for >2000 years and is now gaining attention as a potential
treatment for AD and VaD.

Methods: We reviewed the mechanisms of the active ingredients of Rhizoma coptidis and
Rhizoma coptidis-containing Chinese herbal compounds in the treatment of AD and VaD. We
focused on studies on ameliorating the risk factors and the pathological changes of these
diseases.

Results: The Rhizoma coptidis active ingredients include berberine, palmatine, coptisine,
epiberberine, jatrorrhizine and protopine. The most widely studied ingredient is berberine, which
has extensive therapeutic effects on the risk factors and pathogenesis of dementia. It can control
blood glucose and lipid levels, regulate blood pressure, ameliorate atherosclerosis, inhibit
cholinesterase activity, Aβ generation, and tau hyperphosphorylation, decrease
neuroinflammation and oxidative stress and alleviate cognitive impairment. Other ingredients
(such as jatrorrhizine, coptisine, epiberberine and palmatine) also regulate blood lipids and
blood pressure; however, there are relatively few studies on them. Rhizoma coptidis-containing
Chinese herbal compounds like Huanglian-Jie-Du-Tang, Huanglian Wendan Decoction, Banxia
Xiexin Decoction and Huannao Yicong Formula have anti-inflammatory and antioxidant stress
activities, regulate insulin signaling, inhibit γ-secretase activity, neuronal apoptosis, tau
hyperphosphorylation, and Aβ deposition, and promote neural stem cell differentiation, thereby
improving cognitive function.

Conclusion: The "One-Molecule, One-Target" paradigm has suffered heavy setbacks, but a
"multitarget- directed ligands" strategy may be viable. Rhizoma coptidis active ingredients and
Rhizoma coptidiscontaining Chinese herbal compounds have multi-aspect therapeutic effects on
AD and VaD.

Keywords: Alzheimer's disease; Chinese herbal medicine; Rhizoma coptidis; berberine; mental
disease; vascular dementia.

REFERENCE:
Wang, Z., Yang, Y., Liu, M., Wei, Y., Liu, J., Pei, H., & Li, H. (2020). Rhizoma Coptidis for Alzheimer's Disease and Vascular Dementia: A
Literature Review. Current vascular pharmacology, 18(4), 358–368. https://doi.org/10.2174/1570161117666190710151545
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City

NATIONAL:
Prevalence of Dementia and Associated Risk Factors: A
Population-Based Study in the Philippines

Background: The Philippines is experiencing rapid demographic aging and with it, the
dementia epidemic. Prevalence of dementia and associated risk factors have not been
studied in the Philippines.

Objectives: The study aimed to provide a reliable estimate of dementia prevalence and
identify associated risk factors in the Filipino population.

Methods: 1460 participants 60 years and older were randomly selected from the
Marikina City's senior registry. A multidisciplinary team (nurse, psychologist, and
neurologist) administered a comprehensive assessment to the study population: health
history, neurological examination, Geriatric Depression Scale, Neuropsychiatric
Inventory, Disability Assessment for Dementia, Alzheimer's Disease 8, and Clinical
Dementia Rating Scale. The neurologist analyzed all clinical data to diagnose dementia
based on the DSM-IV criteria, Alzheimer's Disease (AD) on the NINCDS-ADRDA criteria,
vascular dementia (VaD) on the Hachinski Ischemic Scale, cognitive impairment no
dementia (CIND) on a CDR score of 0.5 and not fulfilling DSM-IV criteria for dementia.
Risk factors were correlated with dementia prevalence using multivariate binary logistic
regression.

Results: 1460 persons were randomly selected. 1367 agreed to participate and
underwent all assessments. The response rate was 93.6%. Dementia prevalence was
found to be 10.6% (95% CI 9.0 to 12.4) with the breakdown 85.5% AD, 11.7% VaD, and
2.7% other dementias. In this population, 82.0% of men and 70.4% of women had at
least one cardiovascular risk factor (hypertension, diabetes, dyslipidemia, smoking),
which was associated with VaD prevalence but not AD.

Conclusion: The prevalence of dementia, CIND, and cardiovascular risk factors are high
in the Philippines.

Reference: Dominguez, J., Fe de Guzman, M., Reandelar, M., & Thi Phung, T. K. (2018).
Prevalence of Dementia and Associated Risk Factors: A Population-Based Study in the
Philippines. Journal of Alzheimer's disease: JAD, 63(3), 1065–1073.
https://doi.org/10.3233/JAD-180095
 ILOILO DOCTOR’S COLLEGE
BACHELOR OF SCIENCE IN NURSING
West Avenue Timawa, Molo, Iloilo City