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Dementia is a group of progressive symptoms that slowly but steadily robs people of their ability to think, reason, remember, learn, and function. It’s a painful way for a life full of love and productivity to end; painful both for the person afflicted and for the friends and family members who must watch their loved one’s personality and capabilities change so dramatically.
Dementia is not really the name of a specific disease; it’s the name of a group of symptoms that occur due to a variety of different medical conditions that affect the brain.
A lot of different medical conditions can lead to dementia. Perhaps the most well known is
Alzheimer’s disease
, in which abnormal and destructive changes occur within the brain’s structure. Other conditions that may also cause dementia include:
People with dementia have a variety of symptoms, such as:
- Gradually worsening memory loss (to previously known people, places, tasks)
- Difficulty concentrating
- Increasingly poor judgment
- Confusion
- Disorientation
- Sleep problems
- Loss of motor skills and coordination, including problems washing and dressing oneself, difficulty walking or inability to walk, problems swallowing, loss of bladder and bowel control
- Loss of language skills, eventually leading to the complete inability to speak
- Personality changes, including mood swings, depression, irritability, combativeness, agitation, or hallucinations
- Loss of executive functioning abilities, including calculations, bill paying, spelling, check book balancing
Dementia is diagnosed by testing various mental functions, including memory, thinking, concentration, orientation, and judgment. When these tests are repeated over time, the results will be progressively more abnormal.
Sometimes, medical testing reveals other problems that might be responsible for the symptoms of dementia (such as infections or chemical abnormalities called metabolic problems). In these cases, correcting the underlying problem might lead to improvement in the dementia. When dementia is due to
Alzheimer’s disease
or another progressive illness (such as
Parkinson’s disease
), there are no treatments to halt its progression.
If testing doesn’t uncover a curable cause for dementia, the only treatments are those that attempt to improve its symptoms. Rivastigmine (Exelon), donepezil (Aricept), memantine (Namenda, Axura), and galantamine (Reminyl) are medications given that try to slow the loss of function and improve thinking. Other medications that are under investigation include anti-inflammatory drugs, antipsychotic medications, the herb ginkgo, and the herbal extract huperzine. One study, for example, found that
vitamin E
at the high dosage of 2,000 IU daily may slow the progression of Alzheimer's disease, but another study did not find these results.
Dementia patients who are agitated, suspicious, combative, or who have unwanted thoughts or hallucinations are often treated with anti-psychotic medications. Researchers are currently examining whether anti-psychotic medications might also help improve thinking in patients with dementia. These medications seem to boost the release of the brain chemical acetylcholine, which can improve a patient’s memory, ability to think more clearly, and behavior. Medications known as atypical antipsychotics (eg, clozapine, olanzapine, and risperidone) do the best job of boosting acetylcholine levels, while the typical antipsychotics (haloperidol and thioridazine) offer less of this activity. Other important treatments for dementia involve making sure that the individual is in a safe environment as his or her judgment becomes increasingly impaired. Trying to keep the dementia patient as well-oriented as possible (by the presence of clocks and calendars) can be helpful. Although activity should be encouraged, it’s important to make sure that the activities are not frustrating to the patient. Finally, if you are a caregiver for someone with dementia, make sure that you have some kind of respite care available. It’s an exhausting, emotionally-wrenching job to take care of someone you love who is undergoing changes and progressively becoming severely debilitated. You need care, too, and should make sure that you have regular breaks from your duties, so that you stay fresh and energized. Don’t be afraid to seek support from family, friends, your religious community, support groups, doctor, or social service organizations. Last reviewed January 2006 by Steven Bratman, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved.
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