Definition
Dementia is a loss of brain function. It is not a single disease. Instead, dementia refers to a group of illnesses that involve memory, behavior, learning, and communicating problems. The problems are progressive, which means they slowly get worse.
Symptoms
- Progressive memory loss
- Inability to concentrate
- Decrease in problem-solving skills and judgment capability
- Confusion , severe
- Hallucinations and delusions
- Altered sensation or perception
- Impaired recognition (agnosia)
- Impaired recognition of familiar objects or persons
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Definition
Dementia is a loss of brain function. It is not a single disease. Instead, dementia refers to a group of illnesses that involve memory, behavior, learning, and communicating problems. The problems are progressive, which means they slowly get worse.
Symptoms
- Progressive memory loss
- Inability to concentrate
- Decrease in problem-solving skills and judgment capability
- Confusion , severe
- Hallucinations and delusions
- Altered sensation or perception
- Impaired recognition (agnosia)
- Impaired recognition of familiar objects or persons
- Impaired recognition through the senses
- Altered sleep patterns
- Insomnia
- Need for increased sleep
- Disturbance or change in sleep-wake cycle
- Motor system impairment
- Impaired skilled motor function ( apraxia )
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Causes
The two major causes of degenerative (non-reversible) dementia are Alzheimer's disease and vascular dementia (loss of brain function due to a series of small strokes). The two conditions often occur together.
Dementia with Lewy bodies (DLB) is a leading cause of degenerative dementia in elderly adults. This condition is linked to abnormal protein structures in certain areas of the brain. The structures and symptoms of DLB are associated with Alzheimer's disease, but it is uncertain whether DLB is a sub-type of Alzheimer's or separate disease. There is no cure for DLB or Alzheimer's.
Conditions that damage blood vessels or nerve structures of the brain can also lead to dementia.
Treatable causes of dementia include normal pressure hydrocephalus , brain tumors, and dementia due to metabolic causes , thyroid conditions, low vitamin B12 levels, and infections.
Dementia may be diagnosed when a patient has ...
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Treatment
The goal of treatment is to control the symptoms of dementia. Treatment depends on the specific condition causing the dementia. Some people may need to stay in the hospital for a short time.
Stopping or changing medications that make confusion worse may improve brain function. Medicines that contribute to confusion include anticholinergics, analgesics (painkillers), cimetidine, central nervous system depressants, and lidocaine.
Medical conditions that can lead to confusion should be treated. Such conditions include heart failure , decreased oxygen ( hypoxia ), thyroid disorders , anemia , nutritional disorders, infections, and psychiatric conditions such as depression. Treatment of co-existing medical and psychiatric disorders often greatly improves a person's mental functioning.
Medications may be needed to control behavior problems. Possible medications include:
- Anti-psychotics, given at night
- Serotonin-affecting drugs (trazodone, buspirone)
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Other Names
Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia
Possible Complications
Complications depend on the cause of the dementia, but they may include the following:
- Loss of ability to function or care for self
- Loss of ability to interact
- Increased infections anywhere in the body
- Reduced life span
- Abuse by an overstressed caregiver
- Side effects of medications used to treat the disorder
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Outlook (Prognosis)
The outcome varies. Dementia usually gets worse and often results in a decreased quality of life and decreased life span.
Prevention
Most causes of dementia are not preventable. The risk of vascular dementia, which is caused by a series of small strokes, can be reduced by quitting smoking and controlling high blood pressure and diabetes. Eating a low-fat diet and exercising regularly may also reduce the risk of vascular dementia. Vascular dementia may also play a role in the progression of Alzheimer's disease.
Exams and Tests
The following tests and procedures may be done to determine the severity of dementia and its cause:
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References
Alva G. Alzheimer disease and other dementias. Clin Geriatr Med . 2003; 19(4): 763-76.
American Academy of Neurology. About Dementia. Neurology . 2004; 63(10); E20.
Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. St. Louis, Mo: Mosby; 2004:283-286.
Goetz, CG. Textbook of Clinical Neurology . 2nd ed. St. Louis, Mo: WB Saunders; 2003: 705-708.
