Dementia

Dementia is defined as a loss of mental capability that affects a person’s daily life. Usually affected are the person’s memory and his ability to think and plan (executive functions). Dementia gets worse over time, but the duration this happens differs with each person. Some people lose their skills faster than others. Alzheimer’s disease is the most common type of dementia by far.

People tend to have difficulty in remembering things more as they get older. It is a normal and common sign of aging. However, if memory loss is disruptive and affecting the person’s daily functioning it might be a symptom of dementia. A person with dementia may not able to remember names, faces, directions, and can confuse one person with another. Some changes in personality and social behavioral patterns may also be evident.

Symptoms

The first and most common symptom of dementia is memory loss. Family and friends notice the following symptoms as dementia gets worse:

• Tasks that involve planning like making a list and going for shopping may become a struggle for the person.
• Having trouble with the use and understanding of words.
• Getting lost in familiar places
• Acting or behaving differently over time like becoming scared or lashing out at others; sometimes becoming clingy and childlike; patients might stop routine tasks like brushing teeth or bathing
• Difficulty in communication
• Having problems with coordination and motor functions
• Paranoia
• Agitation
• Hallucinations

Diagnosis

Doctors and licensed mental health providers diagnose dementia by asking questions about the person’s medical history and performing physical exam, comprehensive psychiatric evaluation, and laboratory and imaging tests.

These tests help the doctors to find out if dementia is caused by a treatable condition or not. Common reversible dementias are caused by thyroid gland problems, Vitamin B12 or folate deficiencies, vasculitis, syphilis, etc. Proper medication and treatment options will be prescribed with the proper diagnosis and identifying of the type of dementia a person has.

• Medical history. Questionnaires may be required to be answered to help trace back some timelines – when the symptoms began, what other health issues the person have like diabetes, high blood pressure, etc. This will also help determine if other members of the family have been diagnosed with the same or similar conditions before.
• Physical examination. A comprehensive head to toe assessment is required including height and weight measurements, vital signs – blood pressure, temperature, heart rate; heart and lung and abdomen exam.
• Cognitive and neuropsychological tests. Any person screened for dementia will be asked to undergo cognitive function evaluation in order to determine if the person has dementia.
• Neurological evaluation. In order to determine the conditions that may affect the diagnosis, a person’s function on balance, sensory and reflexes have to be examined.
• Brain scans. Doctors may require this to check on the presence of tumors, previous stroke or other problems that are associated with dementia. These scans enable the doctors to see if there are brain structure changes caused by Alzheimer’s disease. Computerized tomography or CT scan and Magnetic Resonance Imaging or MRI scans may be required depending on the doctor’s initial assessment or evaluation.
• Electroencephalogram (EEG). This tool helps doctors to detect and record electrical activity patterns in brain and check for any abnormalities in this area. Any abnormalities can indicate problem in cognitive functions. An EEG may also identify other dementia-associated problems.
• Laboratory tests. Complete blood count or CBC, blood glucose test, blood tests for kidney functions, urinalysis to screen for drug or alcohol abuse, blood testing for thyroid problems help the doctor rule out other medical conditions as causing dementia.
• Psychiatric evaluation. Doctor may require this examination to determine the presence of depression or other comorbid psychiatric conditions.

Treatment

Currently available dementia treatments help to slow down or minimize the progress of symptoms.

• Cholinesterase inhibitors. These are drugs intended for Alzheimer’s that help boost levels of a brain chemical messenger involved in memory and judgment. Side effects include nausea, vomiting, appetite suppression, and diarrhea.
• Memantine (Namenda). This is another Alzheimer’s medication which regulates glutamate activity – glutamate is another brain chemical or neurotransmitter involved in learning functions and memory part of the brain. Dizziness is a common side effect. There are studies suggesting that a combination of memantine and cholinesterase inhibitors may cause even better results. This drug helps improve symptoms in other dementias other than Alzheimer’s.

Doctors may prescribe anti-hypertensive medications if this is a direct cause of dementia. In addition, sedatives, antidepressants, and other medications may be prescribed for some specific symptoms and behavioral problems. For any of these drugs prescribed, the doctor or mental health provider should monitor the person in order to prevent the risk of abuse and other complications.

One Response to “Dementia”

1. Jane Brooks says:

   August 24, 2012 at 4:06 pm

   My dad (he is 65) had symptoms of dementia which started at around 60. He then started playing chess and it helped a lot. Still he sometimes gets lost. Any suggestions?

   Reply