Dementia

Dementia is a general loss of mental abilities. It can include a loss of ability to think, reason, learn, and understand. To be considered dementia, these mental losses must be severe enough to interfere with day-to-day activities. Dementia must also have:

  • Causes

    Causes of dementia include:

    • Alzheimer's disease
      —the most common cause of dementia

    • Brain damage after multiple small
      strokes
      (also called vascular dementia)
    • Lewy body disease
    • Alcoholism
    • AIDS
    • Multiple sclerosis
    • Huntington's disease
    • Parkinson's disease
    • Creutzfeldt-Jakob disease
      and other prion disorders
    • Front-temporal dementia (including Pick's disease)

    • Normal pressure
      hydrocephalus

    • Untreated
      syphilis

    • Toxic levels of metals, such as aluminum, which can sometimes occur in people who have
      dialysis
      treatment
    • Vitamin B12
      deficiency
    • Thiamine
      deficiency
    • Thyroid dysfunction

  • Definition

    Dementia is a general loss of mental abilities. It can include a loss of ability to think, reason, learn, and understand. To be considered dementia, these mental losses must be severe enough to interfere with day-to-day activities. Dementia must also have:

    • Memory problems

    • Mental loss that is severe enough to cause problems with one or more of the following:

      • Language
      • Visuospatial function
      • Executive function (foresight, planning, anticipation, insight)
      • Praxis (learned motor skills)
    Some Areas of the Brain Affected by Dementia
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    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    Your doctor may diagnose dementia through:

    • An extensive medical history from you and your family
    • Observing your behavior
    • A physical exam
    • Tests for your nervous system
    • Mental status and psychological tests


    There are no blood tests or exams that can diagnose Alzheimer's disease. Certain types of brain imaging such as a SPECT or a
    PET
    scan may aid in a diagnosis. Tests to rule out other causes of dementia and other medical conditions that may mimic dementia include:

    • Blood tests
    • Lumbar puncture
      —a test of the fluid around the brain and spinal cord
    • Electroencephalogram
      (EEG)—a test that records the brain's electrical activity

    Imaging tests take pictures of internal body structures. These may include:

    • CT scan
    • MRI


    The doctor will also check to see if you have
    depression
    . It can often present like dementia.

  • Prevention

    While the exact cause of dementia is not known, these steps may help to reduce your risk:


    • Eat a
      healthy diet
      . This will help you to maintain good levels of
      vitamin B12
      and cholesterol.
    • Exercise regularly
      . This can also enhance cardiovascular health, which may delay the onset of vascular dementia.
    • Alcohol may have some benefits if you use it in moderation. This means no more than two drinks per day for a man, and one drink per day for a woman. Moderate amounts of alcohol may decrease your risk of dementia. Higher amounts of alcohol however, can increase your risk of dementia.

    • Engage in mentally stimulating activity. This may also reduce the risk of
      Alzheimer’s disease
      .

  • Risk Factors

    Increasing age is the most common factor that increases your chance of developing dementia. Other factors include:

    • Family members with dementia
    • Down syndrome
    • Apolipoprotein E status (a genetic risk)
    • Elevated cholesterol
    • Multiple strokes
    • High blood pressure
    • Diabetes
    • High cholesterol
    • Obesity
    • Lack of physical activity
    • Vitamin deficiency
    • Chronic drug use

    • Long-term use of
      hormone replacement therapy

    • Repetitive
      head trauma
      (may occur with contact sports)

    • Overweight or
      obese

  • Symptoms

    Symptoms often begin mildly and get more severe over time. Symptoms vary according to the cause of the dementia, but often include:


    • Increasing trouble remembering things, such as:

      • How to get to familiar locations
      • What the names of family and friends are
      • Where common objects are usually kept
      • How to do simple math
      • How to do usual tasks, such as cooking, dressing, or bathing
      • How to drive
      • How to pay bills
    • Having difficulty concentrating on tasks
    • Having difficulty completing sentences due to lost/forgotten words (may continue to a complete inability to speak)
    • Forgetting the date, time of day, season
    • Getting lost in familiar surroundings
    • Being withdrawn, losing interest in usual activities
    • Having mood swings
    • Having personality changes
    • Walking in a slow, shuffling way
    • Having poor coordination
    • Losing purposeful movement

  • Treatment

    Currently, there are no treatments to cure many types of dementia. Some medication may help to decrease the symptoms of dementia or slow its course.