Dementia is the loss of cognitive function (such as thinking, remembering and reasoning) and behavioral abilities to the extent that it interferes with a person’s daily activities. It is characterized by impairments in memory and other cognitive abilities such as atten¬tion, language or problem solving. People with dementia have serious problems with two or more brain functions. Although it is common in elderly people, dementia is not a normal part of the aging process.
Two of the most common causes of dementia in older people are Alzheimer’s disease
and vascular dementia, caused by stroke or other changes in the brain’s blood supply. Other conditions that may cause or mimic dementia include:
- Brain tumors or infections
- Blood clots in the brain
- Vitamin B12 deficiency
- Some disorders of the thyroid, kidney or liver
Symptoms of dementia include:
- Recent memory loss
- Difficulty performing familiar tasks
- Language problem
- Time and place disorientation
- Poor judgment
- Misplacing things
- Mood swings
- Personality changes
One of the biggest indicators of dementia is what physicians learn in taking a family history. Most patients with memory problems come in with a family member who is able to share the changes the patient has been going through. The patient himself is often unable to recognize those changes.
Generally, a patient visiting a neurologist
has been referred by their primary care provider (PCP), who may have noticed some changes from one general exam to the next. In many cases, the PCP already may have performed some of the blood tests a neurologist
Additional evaluation for dementia usually includes CT or MRI imaging of the brain and should always include a mental status examination. Frequently, neuropsychological testing is used to confirm the presence of dementia and even pinpoint the nature of the cognitive changes. This allows for characterization of the type of dementia at work.
In some cases, dementia can be arrested, and even reversed. Depression-induced cognitive changes, hypothyroidism, vitamin B-12 deficiency and normal-pressure hydrocephalus [fluid buildup in the brain] are examples of this.
There are now drugs to specifically treat Alzheimer’s disease and some other progressive dementias. These drugs do not halt the disease or reverse existing brain damage; however, they can improve symptoms and slow the progression of the disease, thus improving the individual’s quality of life and ease the burden on caregivers for a while.