*Dementia facts medical author :
Charles P. Davis, MD, PhD
- Dementia is a term that describes a collection of symptoms that include
decreased intellectual functioning that interferes with normal life functions
and is usually used to describe people who have two or more major life functions
impaired or lost such as memory, language, perception, judgment or reasoning;
they may lose emotional and behavioral control, develop personality changes and
have problem solving abilities reduced or lost.
- There are different classification schemes for dementias roughly based (and
with overlap) on observed problems; some frequently used are cortical (memory,
language, thinking, social) , subcortical (emotions, movement, memory),
progressive (cognitive abilities worsen over time), primary (results from a
specific disease such as Alzheimer's disease and secondary (occurs because of
disease or injury).
- Alzheimer's disease (AD): is the most common cause of dementia in people over age
65 with cause possibly related to amyloid plaques and neurofibrillary tangles;
almost all brain functions, including memory, movement, language, judgment,
behavior, and abstract thinking, are eventually affected.
- Vascular dementia: is the second most common cause of dementia caused by
brain damage from cerebrovascular or cardiovascular problems (strokes) or other
problems that inhibit vascular function; symptoms similar to AD but personality
and emotions effected only late in the disease.
- Lewy body dementia: is common and progressive where cells in the brain's
cortex die and other contain abnormal structures (Lewy bodies); symptoms overlap
with Alzheimer's disease but also include hallucinations, shuffling gait, and flexed posture with
symptoms that may vary daily.
- Frontotemporal dementia: is dementia linked to degeneration of nerve cells in
the frontal and temporal brain lobes and some evidence for a genetic factor
(many have a family history of the disease); symptoms in patients (usually ages
40 – 65) have judgment and social behavior problems such as stealing, neglecting
responsibilities, increased appetite, compulsive behavior and eventual motor
skill problems and memory loss.
- HIV-associated dementia: is due to infection of the brain with
symptoms include impaired memory, apathy, social withdrawal, and concentration
- Huntington's disease:
is a heredity disorder caused by a faulty gene and
children of a person with the disorder have a 50% chance of getting the disease;
symptoms begin in 30-40 year old people with personality changes such as
anxiety, depression and progress to show psychotic behavior severe dementia and
chorea - involuntary jerky, arrhythmic movements of the body.
- Dementia pugilistica: is also termed Boxer's syndrome, is due to traumatic
injury (often repeatedly) to the brain; symptoms commonly are dementia and
parkinsonism (tremors, gait abnormalities) and other changes depending where
brain injury has happened.
- Corticobasal degeneration: is a progressive nerve cell loss in multiple areas
of the brain; symptoms begin at about age 60 on one side of the body and include
poor coordination and rigidity with associated visual-spatial problems that can
progress to memory loss, hesitant speech and
dysphagia (difficulty swallowing).
- Creutzfeldt-Jakob disease:
is a rare disease that seems related to a gene
mutation that causes rapid (death about one year after symptoms begin to
develop) degenerative and fatal brain disease in people usually over 60 years
old; personality changes and reduced coordination develop, rapidly followed by
impaired judgment and vision and many patients develop a
coma before they die.
- Other rare hereditary dementias: – Most of these diseases develop in people
between 50 – 60 years old and most have variable symptoms of poor reflexes,
dementia, hallucinations, paralysis and most develop coma before death; some of
the names of these diseases are Gerstmann-Straussler-Scheinker disease, familial
British dementia, familial Danish dementia and fatal familial
- Secondary dementias: These dementias occur in patients with other
disorders of movement such as Parkinson's disease or
multiple sclerosis and may
because by one or more problems listed above; these dementias may share symptoms
with any of the above mentioned dementias but researchers are unsure if this is
due to disease overlap or other causes.
- Dementias in children: While infections, trauma and poisoning can lead to
dementia in both children and adults, there are some dementias that are unique
to children but may result in mental problems,
seizures, reduction or loss of
motor skills, blindness, neurodegeneration and death; many are inherited
disorders such as Niemann-Pick disease, Batten disease, Lafora disease and
- Other conditions that may cause dementia: Reactions to medications,
endocrine and metabolic problems, nutritional deficiencies, infections,
hematomas, poisoning, brain tumors, anoxia (lack of oxygen), heart and lung
- What conditions are not dementia: Although these conditions may resemble
some aspects of dementia, they have different causes, usually are treatable and
have better outcomes; examples are depression, delirium, mild cognitive
impairment and age-related cognitive decline.
- Dementia causes: All causes of dementia result from death and damage of
nerve cells in the brain; genetics and possibly the formation of different types
of inclusions in the brain cells are likely the major causes, although some
researchers suggest that certain inclusions may be only side effects of an
- Risk factors for dementia include advancing age, genetics (family history),
smoking, alcohol use,
high plasma homocysteine levels, mild cognitive impairment,
- Dementia is diagnosed by using many methods such as patient's medical and
family history, physical exam, neurological evaluations, cognitive and
neuropsychological testing, CT's,
MRI's and other brain scans,
exams, electroencephalograms, blood tests, psychiatric evaluations, and even
some pre-symptomatic tests are available for some patients that may have a
genetic link to dementia.
- Most treatments for dementia will neither reverse or stop the disease;
however, there are treatments and medications that may reduce the symptoms and
slow the disease progression; they are tight glucose control by
persons with diabetes,
intellectual stimulating activities, lowering cholesterol and homocysteine
levels, regular exercise, education, controlling inflammation of body tissues,
using NSAID's and possibly other medications.
Reviewed on 5/16/2012
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