Cerebrasthenic syndrome

Cerebrasthenic syndrome is a neurological disease. Memory and concentration impairment, absent-mindedness, irritability are the main symptoms of this disease. The patient gets tired quickly, normal work becomes hard and difficult to do. Drowsiness and fatigue increase, and a kind of apathy occurs.

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Causes of cerebrasthenic syndrome

The name of the disease is translated from Latin as weakness of the brain. All the above-mentioned signs of cerebrosthenic syndrome are quite similar to ordinary fatigue. But what are the causes of cerebrosthenic syndrome?

The majority of patients with this syndrome are infants, preschoolers and schoolchildren. There are also adults with cerebrosthenic syndrome. Causes of the disease:

• In newborns, the causes of cerebrosthenic syndrome could be oxygen starvation, amniotic fluid infections, or the mother taking medications that adversely affect the development of the fetus's nervous system. Thanks to modern medicine, such children have a chance to recover.
• In preschoolers, schoolchildren and adults, the causes of cerebrosthenic syndrome can be concussions and brain injuries, meningitis, bites of encephalitis ticks or mosquitoes. There is also a high risk in children during surgical operations. Hypoxia of various kinds can also be the beginning of the development of cerebrosthenia.
• Also, in adults, cerebrasthenia can be caused by bacterial and viral infections, which is very common among residents of large cities. Trauma, concussions and blows also occupy not the last place. Atherosclerosis.

But still, the main risk group remains newborns. This disease mainly originates from the bearing of the fetus and the mother's attitude to her health during pregnancy.

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Pathogenesis

A detailed and thorough study by doctors of the origin and development of a disease is called pathogenesis. Thanks to this, it is possible to determine the exact causes of cerebrasthenia and thereby speed up the selection of medications and the beginning of treatment.

The pathogenesis of cerebrosthenic syndrome is primarily infections or damage to brain tissue, lack of oxygen, which leads to "weakness of the brain". The transmission of nerve impulses is significantly reduced, as a result of which the patient becomes absent-minded and loses concentration. Lack of oxygen leads to drowsiness, a desire to rest, to stop all kinds of activity. The entire nervous system suffers, so the patient becomes irritable, there is a constant state of stress.

Cerebrasthenia affects the overall development of children, so this disease has not been studied or treated for many years. A newborn with such a diagnosis may subsequently have developmental difficulties, which is especially noticeable in a children's and school group. Such children are recommended to attend special institutions where there are specialists with experience in teaching and helping with development.

All of the listed signs of cerebrasthenia may well resemble overwork or the onset of a cold. The only difference is that cerebrasthenia does not go away in a few days or a week. The state of irritability and fatigue becomes constant and obsessive. The condition of the brain and nervous system as a whole worsens. The main thing is to understand in time that health problems have appeared and contact a good specialist.

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Symptoms of cerebrasthenic syndrome

"Like a squeezed lemon" or "Out of place" - this is how one can roughly describe the condition of a patient with cerebrosthenic syndrome. Health problems are especially noticeable in those whose work is connected with concentration, large amounts of information, communication with people. A person cannot grasp the essence of a conversation, is constantly distracted by something, already in the middle of the working day there is no strength to perform ordinary duties.

If this condition becomes a constant companion, you should immediately consult a doctor. Early detection of symptoms of cerebrosthenic syndrome and a properly prescribed course of treatment will help to significantly speed up the recovery process.

The symptoms of cerebrosthenic syndrome can be confused with ordinary fatigue or nervous stress. The main indicator of the disease is rapid fatigue and drowsiness, which cannot be "driven away" even by invigorating drinks. But there are a number of other obvious symptoms of cerebrosthenic syndrome. As the saying goes: "He who is informed is armed."

The first signs - don't miss them!

1. With cerebrasthenia, a person begins to tolerate heat and staying in stuffy, poorly ventilated rooms extremely poorly. If you have not observed such a case, this may be the first sign and a reason to contact a specialist.
2. When atmospheric pressure changes, the health also worsens. The pressure can increase or, on the contrary, decrease significantly. Dizziness is also noted.
3. Weakness, desire to rest. The patient cannot force himself to get out of bed for a long time, after a short period of wakefulness an irresistible desire to rest again appears.
4. Nausea for no apparent reason.
5. Apathy.
6. Asthenia.
7. Emotional instability, irritability without any particular reason.
8. Noticeable memory impairment. The patient cannot remember the gist of a conversation or recent events. Absent-mindedness is also evident. All this leads to a decrease in overall performance.
9. Headache without apparent cause. Pain can start regardless of the time of day.

Analyze your health If most of the disease indicators coincide, do not hesitate, consult a doctor. Even if cerebrosthenic syndrome is not detected, this will be an excellent reason to undergo diagnostics.

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Cerebrasthenic syndrome of somatic genesis

Genesis is the mechanism of the disease. The somatic nervous system is responsible for the transmission of motor and sensory impulses. That is why cerebrosthenic syndrome is considered a disease of a somatic nature.

With cerebrosthenic syndrome of somatic genesis, the patient experiences sharp mood swings – from irritability to complete interest in something. Poor transmission of impulses of movement slows down the reaction, increasing fatigue. Everyday duties become difficult to perform.

The fibers of the somatic nervous system directly connect the spinal cord and the brain. The difference between these fibers is that they are not interrupted anywhere. These fibers transmit impulses to the spinal cord. When the somatic nervous system is damaged, the transmission becomes inaccurate and inconsistent. Cerebrasthenic syndrome of somatic genesis is considered one of the most complex diseases. If treatment is not started immediately, this can lead to a number of other adverse effects. If one organ or system does not function properly, the functioning of the entire organism is disrupted.

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Post-traumatic cerebrosthenic syndrome

Post-traumatic syndrome usually occurs in patients with a weak nervous system after some kind of trauma. Cerebrasthenic syndrome greatly weakens and exhausts the nervous system, which is why there is a risk of a difficult post-traumatic period in most patients.

Post-traumatic cerebrosthenic syndrome is characterized by the following complications:

• A state of anxiety. It can arise without any apparent reason.
• Memories of feelings and a difficult period of recovery.
• Sleep disturbances are possible.
• Disorders of the cardiovascular and endocrine systems.

Constant nervous overstrain can lead to secondary exhaustion of the nervous system. Post-traumatic cerebrosthenic syndrome may not manifest itself immediately, but after 3 or more weeks. The duration of treatment depends on the patient, the help of relatives is very important. It is also necessary to exclude all irritants.

In a mild form, the syndrome can be treated with simple drugs to reduce heart rate. In more complex cases, a course of antidepressants is prescribed. 50% of the patient's rapid recovery depends on the help of loved ones.

Cerebrasthenic syndrome on a residual background

Cerebrasthenic syndrome on a residual background is a disease that developed on the basis of a residual phenomenon after a nervous shock that greatly depleted the nervous system.

The residual period can be very long, it occurs after the post-traumatic period. Patients need to be examined by a doctor regularly to reduce the load on the nervous system. The human psyche remembers for a long time all the sensations and the severe physical condition during cerebrasthenia, due to this, the residual period occurs.

The post-traumatic period does not last as long as the residual period. The problems of nervous system recovery are expressed more clearly. The residual period can be characterized as a residual, "sedimentary" phenomenon. Cerebrasthenic syndrome on a residual background can occur with some complications, since the nervous system is already weakened by an injury that has not fully healed. It is necessary to consult a doctor if any symptoms of nervous malaise occur in order to avoid a recurrence of the disorder.

Severe cerebrosthenic syndrome

Cerebrasthenic syndrome manifests itself differently in each person. It may be some of the signs from the list above, or it may be almost all of them. All diseases are divided into well-defined and hidden.

Expressed cerebrosthenic syndrome is visible signs of the disease. The person is irritable, gets tired quickly, and cannot grasp the essence of a conversation. This condition is accompanied by headaches and pressure drops.

The latent type is a more dangerous form of the disease. Several or one of the listed symptoms may bother you. For example, if you feel tired all the time or have a headache. Gradually, the patient gets used to this condition, and he goes to the doctor with a more advanced form.

Expressed cerebrosthenic syndrome is easier to identify in a small child, when he begins to behave restlessly, often cries, shows no interest in objects, toys, events. An adult takes this disease for some other with similar symptoms and tries to treat it on his own.

Cerebrasthenic syndrome in adults

As a result of head trauma, meningitis, concussion or surgery, an adult may develop cerebrosthenic syndrome.

Cerebrasthenic syndrome in adults is often expressed as follows:

• Tolerance to psychological and physical stress decreases.
• Absent-mindedness, decreased concentration.
• The memorization of information noticeably worsens. The patient cannot remember the simplest things and information.
• Disorders of the autonomic nervous system. This may be expressed by a disorder of the circulatory and lymphatic systems, the work of the endocrine and exocrine glands.
• Insomnia or constant desire to sleep.
• Lack of appetite or, conversely, a constant feeling of hunger.
• Pressure surges.
• Sweating.
• Headaches.
• Poor tolerance of travel in transport, stuffiness, bright light, noise.

Cerebrasthenic syndrome in adults is also expressed by other complications, which adversely affects work and communication with people. Almost everything affects the deterioration of health: weather, light, noise, walking. Patients with cerebrasthenic syndrome should exclude driving a car.

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Cerebrasthenic syndrome in children

In children, cerebrosthenic syndrome is expressed in different ways, depending on the child's age. In infants, cerebrosthenia is expressed by anxiety, changes in appetite, and developmental delays. Preschool children may suffer from fears, anxiety, and enuresis. It is much more difficult for schoolchildren to learn the curriculum material.

Cerebrasthenic syndrome in children also manifests itself in the following way:

• Inattention, decreased concentration.
• Headaches.
• Emotional instability.
• Appetite surges.
• Insomnia, waking up much earlier than necessary
• Traveling in any form of transport becomes unbearable. The stuffiness, the noise around, the harsh light are disturbing.
• The child quickly gets seasick on rides or swings.
• Schoolchildren and students have poor academic performance in all subjects.

Cerebrasthenic syndrome in children can occur as a result of trauma or concussion, severe fright or other types of stress. It is necessary to carefully monitor the child's well-being so that at the first sign of the syndrome, immediately consult a doctor.

Complications and consequences

The consequences of cerebrosthenic syndrome vary depending on the cause of the disease. In an adult, it is expressed approximately as follows:

• In post-traumatic cerebrosthenic syndrome, sensitivity to noise and light, outbursts of irritability and anxiety are observed.
• Post-infectious cerebrosthenic syndrome is characterized by excessive vulnerability, tearfulness, and an unstable emotional state.

The consequences of cerebrosthenic syndrome in infants and preschool children may be more severe. Developmental delays in newborns are noted, and it is necessary to constantly carry out supportive and stimulating procedures. In older children, delays in the perception of educational material and low academic performance are also noted. Restlessness and enuresis are possible.

The recovery period can take weeks, months or even years. Patients need to undergo regular diagnostics and medical examinations to fully and comprehensively restore the nervous system.

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Complications

Cerebrasthenic syndrome is considered one of the most severe stress conditions for the nervous system. Therefore, as with any disease, there may be not only consequences, but also complications. The nature of the complications depends mainly on how quickly the patient consulted a doctor, on the state of the nervous system and on the correctness of the chosen treatment method.

Complications mainly occur in preschool and school-age children. They are expressed as follows:

1. Developmental delay.
2. Unwillingness to do anything that requires intellectual effort.
3. In schoolchildren, complications manifest themselves in the fact that the child does not learn and does not have time to perceive the program material. Such children are recommended to attend specialized institutions.

If complications are detected, it is necessary to carefully monitor the child's behavior. The syndrome can lead to a disruption in the development of personality. Therefore, such a child should be constantly encouraged, surrounded by positive emotions, and stressful or emotional situations should be excluded.

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Diagnostics of cerebrasthenic syndrome

Diagnosis of cerebrosthenic syndrome is a whole complex of studies and analyses. It is necessary to make a precise examination of the patient with suspected cerebrosthenia. This disease is very similar to other typical complications of the mental and physical state of a person, such as stress, neuroses, overwork, etc.

In order to determine cerebrasthenia in children and adults, modern diagnostic methods are used - instrumental and differential diagnostics. Thanks to this, doctors can determine the disease much faster and prescribe treatment.

The tests will help to identify possible infections that have adversely affected the nervous system and brain. External examination and testing of the patient are aimed at checking the state of memory, attentiveness, memorization, etc. Diagnosis of cerebrosthenic syndrome takes relatively little time. Since the disease does not always have specific outlines, diagnostics can be carried out again. Diseases of this type should be treated systematically and carefully to avoid repeated unwanted complications.

Tests

If cerebrosthenic syndrome is suspected, the first step is to take a blood test from a vein in the patient.

If it is an infectious disease, there are any pathogens in the blood, a laboratory blood test will certainly show this. This analysis also helps prescribe treatment. If the pathogen is not found in the blood, it will be much easier for the doctor to orient himself in the direction in which to conduct research.

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Instrumental diagnostics

This type of diagnostics involves examining the patient with special equipment that will help determine the condition of the brain and nervous system as a whole. The most common are ZZG and MRI.

• EEG – electroencephalogram of the brain. This method allows you to determine the activity of the brain. Special sensors are attached to the entire surface of the head, forehead, temples and the back of the head. They record activity at each point of contact, allowing you to accurately determine which part of the brain is active and which is not.
• MRI – magnetic resonance imaging. Using magnetic waves, it is possible to study the state of the brain in detail. This method allows us to identify anomalies, changes, the occurrence of tumors, etc.

Instrumental diagnostics allows for a painless, quick and accurate examination of the patient. Any procedure takes relatively little time. The result obtained after diagnostics is summed up with blood tests. This gives the most accurate picture of the patient's health.

Differential diagnosis

Differential diagnostics is aimed at excluding a number of diseases in a complex disease. This type of diagnostics is especially relevant for diseases of the nervous system. When the symptoms are quite vague and resemble many other complications of this kind. The method of exclusion can be used to obtain the only correct result.

A new type of diagnostics is especially effective – PCR diagnostics. Polymerase chain reaction allows for the most accurate detection of any infectious diseases, deviations and anomalies at the gene level. Thanks to this method, all possible diseases can be easily excluded. Ultimately, there will be one diagnosis, which will be correct.

Treatment of cerebrasthenic syndrome

Treatment should be carried out in several directions at once. Prescribed drugs that relieve tension in the nervous system, to normalize sleep. Also very effective is considered to be visiting sanatoriums, highly specialized in the treatment of nervous disorders. Medicines in combination with a positive and calm environment have a favorable effect on the patient's psyche. Anxiety, nervousness gradually pass, blood pressure returns to normal.

Treatment of cerebrosthenic syndrome in more complex forms is carried out with the help of surgical intervention. After the operation, the patient must be under constant supervision of a doctor. Antidepressants and sedatives are prescribed. Psychological help and support of loved ones are of great importance.

The nervous system must receive a signal that the environment does not carry irritants, the emotional background of a person gradually improves. Normalization of blood pressure helps to improve the functioning of all organs in the body. Normalization of sleep helps to restore motor activity and work capacity.

Medicines

There are many medications that can effectively help a patient with cerebrosthenic syndrome recover. The most popular and accessible are:

Bilobil is a nootropic. The medicine helps restore cerebral and peripheral blood circulation. Normalization of blood flow helps improve and restore brain function, which helps the patient recover faster.

Dosage and administration: 1 capsule 3 times a day. Wash down with a small amount of water. The drug is taken without interruption for 3 months. Improvement becomes noticeable only after a month, but a lasting effect is noted.

Overdose and side effects: There are no reports of overdose. But it is better not to deviate from the suggested regimen of taking the drug. There are practically no side effects. Skin rash and itching may appear extremely rarely. Sometimes dizziness or insomnia are observed. With prolonged use of the drug, bleeding may occur. Therefore, it is so important to consult a doctor before each course of taking the drug.

Fezam is a nootropic in combination. The drug perfectly normalizes blood circulation and metabolism of the brain. The work of all systems and organs quickly returns to normal.

Dosage and administration: the drug can be taken not only by adults, but also by children over 5 years old. Adults are recommended to take 1-2 capsules 3 times a day. Children 1-2 capsules 2 times a day. The course should not exceed 3 months.

Overdose side effects: No cases of overdose have been recorded. Side effects may include skin rashes, headaches, and sleep disturbances.

Nicergoline is an antianginal drug. Its action is aimed at improving the functioning and blood circulation of the brain.

Dosage and administration: make a solution for oral use as written in the instructions. Take 2=4 mg twice a day.

Overdose and side effects: noticeable decrease in blood pressure, dizziness, headaches. Drowsiness, nausea, diarrhea. Side effects increase with overdose.

Curantil No. 25 is an excellent drug for restoring blood circulation in the brain and preventing fetal development pathologies in pregnant women (placental insufficiency).

Dosage and administration: Take the tablet orally without chewing. Wash it down with water. The dosage depends on the disease and the course of the disease. The daily dose can be from 50 mg to 600 mg.

Side effects and overdose: Side effects may occur in extremely rare cases. They are expressed in the form of headaches, dizziness, nausea. Skin rashes may also occur.

Vitamins

With such diseases of the nervous system, complex treatment is necessary. Vitamins of various groups will not be superfluous. Particularly important are vitamins of group B, vitamin A and D, acids and microelements. Taking vitamins should first of all be aimed at strengthening the walls of blood vessels, enriching the blood with oxygen.

In the pharmacy, you can buy drugs containing the entire complex of necessary vitamins and minerals. For example, Vitrum. These vitamins appeared in pharmacies quite a long time ago, and mostly have only positive reviews. One capsule contains the entire necessary complex of vitamins for complete recovery of the body. As a rule, you need to take 1 tablet for 4-6 weeks. After a few months, you should repeat the course of treatment.

You can also buy a vitamin complex aimed specifically at restoring the uneven system and brain function. You should pay attention to preparations containing vitamin A, B1, B3, B6, B12, C, E, D. "Vitabalance Multiivit" is a balanced complex for restoring the nervous system.

Physiotherapy treatment

Physiotherapy is a field of medicine that uses various natural and artificially created factors to positively influence the human body. Physiotherapeutic treatment of cerebrosthenic syndrome is carried out in several directions:

• UHF therapy. Thanks to this type of treatment, the walls of blood vessels become more permeable, which facilitates the penetration of drugs to the site of localization of the disease.
• Therapeutic massage with elements of manual therapy. Helps improve blood circulation. The masseur massages the points responsible for relieving nervous tension. The muscles and nervous system relax, the patient's condition gradually returns to normal.
• Balneotherapy. This is one of the types of hydrotherapy. The patient is offered treatment of the body with natural or artificially prepared solutions of mineral salts.
• Light therapy. The body is affected by rays. Due to this, tissues are warmed up, blood circulation is restored, and metabolism is normalized.

Folk remedies

When there were no pills or injections, cerebrasthenia was treated with folk remedies - herbs that grew in nearby forests and meadows. Now it is much easier to go to the pharmacy and buy a couple of packs of pills. Few people know that recipes and herbs of folk medicine have the same, and sometimes much stronger, positive effect on the body.

Pine bark. This method is suitable for both adults and children. 300 grams of pine bark are poured with 5 liters of water, boiled, and infused for about an hour. The strained broth is poured into the bath. The bath should be taken for no more than 15 minutes.

Baths with rosehip root, juniper, oregano, and mint also have a positive effect. You need to make a decoction that is not very concentrated, especially if the bath is being prepared for a child. It is better for children to stay in decoctions of mint and lemon balm for no more than 10 minutes, as there may be skin rashes.

Another folk remedy is potato peelings. Bring some potato peelings to a boil in a small saucepan. Let the water cool down so that you can put your hands in it. Put your hands in the water for a few seconds. The procedure should be repeated for several days. This helps relieve nervousness.

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Herbal treatment

Motherwort or common motherwort. It has a calming effect several times greater than valerian. Motherwort is used to relieve nervous tension, relax the heart muscle and reduce blood pressure.

In midsummer, motherwort is harvested by cutting off the flowering tops. Most often, an infusion is made from dry motherwort: 2 tbsp. Pour boiling water over it and let it cool. Strain and take 2 tbsp. 3 times a day. If you have fresh motherwort, you can take 20-30 drops of fresh juice.

Melissa officinalis. This plant has a wide range of applications. Melissa grows all summer. Only the tops with unopened flowers are suitable for drying. Melissa infusion is used as an anticonvulsant, sedative, and pain reliever.

Essential oil is excellent for relieving nervousness (15 drops). You can also make an infusion. Pour a glass of boiling water over 1 tbsp of dry lemon balm and leave in a warm place for about an hour. Strain and take ¼ glass before meals 3 times a day.

Take 100 grams of fresh birch leaves, chop them and pour 2 cups of lukewarm boiling water over them. Leave for 6 hours. Then strain. Take half a glass 2-3 times a day before meals.

Homeopathy

Homeopathic medicines are often used to treat cerebrosthenic syndrome. Here are the most effective ones suggested by doctors:

Aneuro - the drug helps restore the body after infectious diseases, helps to improve the functioning of the nervous system after concussions and injuries.

Dosage and administration: can be taken by both adults and children from 1 year. Children take 2 granules 3 times a day. From 3 years old, you can take 3-4 granules. Adults - 8 granules.

Overdose and side effects: the drug is practically harmless. No contraindications or side effects have been identified.

Bellandine is a drug that helps with insomnia, severe excitability, and neuroses.

Dosage: Children from 7 years old take 4-6 capsules 3 times a day. Adults take 8=10 granules 3 times a day.

Side effects and overdose: not specified.

Cefalgin is a granule that is prescribed for headaches, migraines and vegetative neurosis.

Dosage and administration: take 3 granules 2-3 times a day.

Side effects and overdose: no data.

Cerebrum compositum - the drug is prescribed for disorders of the brain, developmental delays in children, multiple sclerosis.

Dosage and administration: the patient is prescribed intramuscular injections. 1 ampoule 1 to 3 times a week.

Side effects and overdose: no data.

Physiotherapy

Physiotherapy is a set of exercises aimed at strengthening and restoring the body and muscles. When certain muscle groups are affected, the musculoskeletal system, back, spine are strengthened, and blood circulation is improved.

Physiotherapy is usually prescribed in combination with the main treatment. It is rarely prescribed as a separate procedure. Exercises and duration of the session are selected for each patient individually. If the symptoms are similar in several patients, a group session is held.

The first few sessions last only 10-15 minutes. These may be a few simple exercises that need to be repeated 10-20 times, a few stretches, breathing exercises. After completing the exercises, the patient feels a surge of strength, vigor and emotional uplift.

In the future, the loads will gradually increase. The number of sessions per week is no more than 3 times. With muscle strain, the patient may feel a loss of strength, depression. This will have a negative effect on the general psychological state.

Prevention

Cerebrasthenic syndrome greatly affects the state of the nervous system. Therefore, it is necessary to take care to exclude possible factors causing irritants. Prevention of cerebrasthenic syndrome consists of:

• Avoiding stressful situations.
• Proper nutrition.
• Walks in the fresh air.
• Rest outside the city in nature.
• Emotional relaxation. More positive emotions.

The state of the nervous system can be affected by too much stressful work, an unfavorable stressful environment, constant conflicts. To avoid nervous exhaustion, try to rest more, visit quiet, calm places. For example, take a walk in the forest or park once a week, spend a day without TV and the Internet.

Prevention of cerebrosthenic syndrome will also be the intake of vitamins to strengthen the nervous system. Vitamins of group B, magnesium preparations are excellent. If neuroses of a mild nature occur, use one of the folk remedies or recipes.

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Forecast

The prognosis or expected consequences after cerebrosthenic syndrome are quite favorable. It is necessary to carefully monitor the patient's well-being and behavior, not to violate the established daily routine, nutrition, physical activity. It will also be very desirable to exclude all irritants and stress factors from the environment.

In school-age children, cerebrasthenia can develop into defending certain subjects at school. Such children easily fall under bad influence, are easily hurt, and can become withdrawn.

Therefore, it is this group of patients – schoolchildren – that deserves the most attention. Nootropic drugs are prescribed for some signs of regression. Such children need positive emotions and constant psychological support.

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Cerebrasthenic syndrome and the army

The decision on military service in the presence of cerebrosthenic syndrome is made by a special medical commission at the military registration and enlistment office.

Very often, when the environment changes – from the usual to the stressful – cerebrosthenic syndrome can also develop. That is why cerebrosthenic syndrome and the army are so closely connected. Recruits, accustomed to a measured free life, fall under strict control in a rigid framework. The psyche refuses to accept the new conditions of the environment. Against this background, the disease begins.

Also, in the army, the risk of injury or concussion is very high. This is also one of the reasons for the development of this kind of disease. Unfortunately, cerebrosthenic syndrome and the army are two indicators that are incompatible with each other. If in everyday life a person can go to the doctor when feeling unwell, then in conditions of constant stress, stress, training and duty, a visit to the doctor is constantly postponed.

The physical and psychological state of soldiers and all military personnel must be carefully monitored, and not only their physical health must be checked, but also their memory and attention.

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