Dementia is the progressive loss of various mental functions,
including:
- Memory
- Ability to learn
- Judgment
- Ability to reason
Most people with dementia are eventually unable to care for themselves.
Causes
Alzheimers disease is the most common cause of dementia. Other conditions
that may be associated with
Dementia include:
- Brain damage after multiple small strokes
- Alcoholism
- AIDS
- Multiple sclerosis
- Huntington's disease
- Parkinson's disease
- Creutzfeldt-Jacob disease
- Lewy body disease
- Pick's disease
- Medications, including:
- Benzodiazepines
- Tricyclic antidepressants
- Antipsychotic medications
- Monoamine oxidase inhibitors
- Barbiturates
- Cough preparations
- Digitalis
- Anticholinergic medications
- Conditions that deprive the brain of oxygen including severe heart and
lung disease
- Liver disease
- Severe, long-term abnormalities of blood electrolytes, including:
- Excess calcium
- Excess sodium
- Low sodium
- Encephalitis
- Untreated syphilis
- Toxic levels of aluminum (as can sometimes occur in dialysis patients)
Risk Factors
A risk factor is something that increases your chance of getting a disease or
condition.
- Age: 85 and older
- Family members with dementing illness
- Down syndrome
- Apolipoprotein E status
Symptoms
Symptoms of
Dementia come on gradually. They often begin mildly, but
progress to severe.
Symptoms include:
- Increasing trouble remembering things, such as:
- How to get to familiar locations
- The names of friends, family members
- Where common objects are usually kept
- Simple math
- How to perform usual tasks, such as cooking, dressing, bathing, etc.
- Trouble concentrating on tasks
- Trouble completing sentences, due to lost/forgotten words. This progresses
to complete inability to speak.
- Inability to remember the date, time of day, season
- Mood swings
- Withdrawal, loss of interest in usual activities
- Personality changes
- Slow, shuffling walk
- Poor coordination
- Slowness and then loss of purposeful movement
Diagnosis
Doctors diagnose
Dementia by:
- Talking with the patient
- Observing the patient
- Performing a physical exam
- Performing mental status and psychological tests
There are no tests to diagnose
Dementia. Tests to rule out other
medical conditions may include:
- Blood tests
- CT or MRI scans of the head
- Lumbar puncture – collecting a sample of cerebrospinal fluid by inserting
a needle between two vertebrae
- Electroencephalogram (EEG) – a test that records the brain's activity by
measuring electrical currents through the brain
Treatment
Currently there are no treatments to cure dementia and no certain ways to
slow its progression. Researchers are studying various drugs to see if they can
improve the symptoms of dementia or slow its course.
Medications
Medications being used and studied include:
- Cholinesterase inhibitors
- Anti-oxidants (vitamin E)
- Estrogens
- Monoamine oxidase inhibitors
- Anti-inflammatory agents
- Gingko Biloba (herbal supplement)
Lifestyle Management
Managing the disease includes:
- Creating an environment in which you can receive the care you need
- Optimizing your quality of life
- Keeping yourself safe
- Helping yourself learn to deal with the frustration of your uncontrollable
behavior
- Providing a calm, quiet, predictable environment
- Providing appropriate eyewear and hearing aids, easy-to-read clocks and
calendars
- Playing quiet music
- Light, appropriate exercise to reduce agitation and relieve depression
Psychiatric medications
People with dementia may have psychiatric symptoms. If these symptoms become
severe, medication may be needed, such as:
- Antidepressants
- Anxiolytics - to treat anxiety
- Antipsychotics - to treat severe confusion, paranoia, hallucinations
Caregiver Support
Caring for a person with dementia is extremely difficult and exhausting. The
primary caregiver needs emotional support, as well as regular respite.
Prevention
There are no guidelines for preventing dementia.