Dementia

more about Dementia

Description

• Dementia is characterized by a slow deterioration of memory and mental function, usually worsening slowly over months and years.  An individual suffering dementia typically has a clear sensorium (i.e., he is alert and not drowsy, sleepy, or in a stupor).  A rapid onset of confusion or memory loss is not dementia, and needs immediate medical evaluation.

Symptoms

• Memory loss
• Loss of impulse control (may start using profane language)
• Decreased level of function

• A decrease in the ability to perform the activities of daily living

How the diagnosis is made

• Mini-mental status examination
• MRI or CT scan of head to check for Strokes or other causes
• Basic blood tests to check for other conditions, such as underactive thyroid

• Lumbar puncture (spinal tap) may be necessary if there is a concern about tertiary Syphilis or Chronic Meningitis

Treatment

• Alzheimer’s disease — treatments that may have some benefit:
• Donepezil (Aricept)
• Selegiline
• Ginkgo Bilboa
• Vitamin E
• Antidepressants are prescribed if underlying Depression is present
• Anti-anxiety and anti-psychotic medications may be needed for some individuals
• Multi-infarct dementia

• The goal is to prevent further stokes.  Treatments may include an aspirin per day, Plavix, Coumadin, or cholesterol-lowering medications.
  The medications currently available somewhat improve mental function, while slowing the progression of the dementia.  It is important to keep the individual with Alzheimer’s disease in a stable, predictable, environment.  In addition, support from spouses, family members, and caregivers are extremely important.  Generally, there are support organizations in most areas in the United States.

Similar Conditions

• Korsakoff’s Syndrome
• Cerebral atrophy
• Hypothyroidism
• Hyperthyroidism
• Vitamin deficiencies
• Tertiary (late) Syphilis
• Brain Tumor

• Collagen vascular diseases such as lupus

Miscellaneous

• Types of dementia
  

• Primary degenerative dementia
• Alzheimer’s disease is the most common type and, in general, is a steady, degenerating dementia.
• Huntington dementia is associated with chorea, a movement disorder (see chorea).
• Pick’s disease is characterized by personality changes
• Slow viruses such as Creutzfeld-Jakob syndrome or “Mad Cow” disease
• Multi-infarct dementia is caused by multiple small Strokes
• Mixed — both Alzheimer’s disease and multi-infarct dementia are present
• HIV dementia
• Normal pressure hydrocephalus — excess cerebral spinal fluid in the brain
• Parkinson’s Disease (occurs in some individuals)

1. 1. Multiple Sclerosis (occurs in some individuals