Dementing disorders can be classified many different ways. These classification schemes attempt to group disorders that have particular features in common, such as whether they are progressive or what parts of the brain are affected. Some forms of dementia are
classified as either primary or secondary dementia. Examples of primary dementia include:
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
HIV virus;
symptoms include impaired memory, apathy, social withdrawal, and concentration
problems.
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
insomnia.
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
mitochondrial abnormalities.
Other conditions that may cause dementia: Reactions to medications,
endocrine and metabolic problems, nutritional deficiencies, infections,
subdural
hematomas, poisoning, brain tumors, anoxia (lack of oxygen), heart and lung
problems.
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
underlying disorder.
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,
mental status
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.
Introduction to Dementia
A woman in her early 50s was admitted to a hospital because of increasingly odd behavior. Her family reported that she had been showing memory problems and strong feelings of jealousy. She also had become disoriented at home and was hiding objects. During a doctor's examination, the woman was unable to remember her husband's name, the year, or how long she had been at the hospital. She could read but did not seem to understand what she read, and she stressed the words in an unusual way. She sometimes became agitated and seemed to have hallucinations and irrational fears.
This woman, known as Auguste D., was the first person reported to have the disease now known as Alzheimer's disease * (AD) after Alois Alzheimer, the German doctor who first described it. After Auguste D. died in 1906, doctors examined her brain and found that it appeared shrunken and contained several unusual features, including strange clumps of protein called plaques and tangled fibers inside the nerve cells. Memory impairments and other symptoms of dementia, which means "deprived of mind," had been described in older adults since ancient times. However, because Auguste D. began to show symptoms at a relatively early age, doctors did not think her disease could be related to what was then called "senile dementia. "The word senile is derived from a Latin term that means, roughly, "old age."
It is now clear that AD is a major cause of dementia in elderly people as well as in relatively young adults. Furthermore, we know that it is only one of many disorders that can lead to dementia. The U. S. Congress Office of Technology Assessment estimates that as many as 6.8 million people in the United States have dementia, and at least 1.8 million of those are severely affected. Studies in some communities have found that almost half of all people age 85 and older have some form of dementia. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. Many people live into their 90s and even 100s without any symptoms of dementia.
Besides senile dementia, other terms often used to describe dementia include senility and organic brain syndrome. Senility and senile dementia are outdated terms that reflect the formerly widespread belief that dementia was a normal part of aging. Organic brain syndrome is a general term that refers to physical disorders (not psychiatric in origin) that impair mental functions.
Research in the last 30 years has led to a greatly improved understanding of what dementia is, who gets it, and how it develops and affects the brain. This work is beginning to pay off with better diagnostic techniques, improved treatments, and even potential ways of preventing these diseases.
What Is Dementia?
Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory, language skills, perception, or cognitive skills including reasoning and judgment - are significantly impaired without loss of consciousness.
There are many disorders that can cause dementia. Some, such as AD, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment.
With AD and many other types of dementia, disease processes cause many nerve cells to stop functioning, lose connections with other neurons, and die. In contrast, normal aging does not result in the loss of large numbers of neurons in the brain.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
A brain tumor can be either benign (non cancerous) or malignant (cancerous), primary, or secondary. Causes and risk factors include age, gender, family history, and exposure to chemicals. Symptoms range from headaches, leg and feet numbness to seizures. Treatment is dependant upon the type and location of the brain tumor.
HIV (human immunodeficiency virus) is the cause of AIDS (acquired immunodeficiency syndrome). HIV is a type of virus called a retrovirus, which infects humans when it comes in contact with a break in the skin or tissues such as those that line the vagina, anal area, mouth, or eyes.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
Hypoglycemia is a syndrome caused by low blood sugar. Symptoms of hypoglycemia include palpitations, trembling, intense hunger, sweating, nervousness, and weakness. Consuming lifesavers, table sugar, soda, and juice are good treatment options for hypoglycemia.
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Parkinson's disease is a slowly progressive neurologic disease characterized by a fixed inexpressive face, a tremor at rest, slowing of voluntary movements, a gait with short accelerating steps, peculiar posture and muscle weakness, caused by degeneration of an area of the brain called the basal ganglia, and by low production of the neurotransmitter dopamine. Most patients are over 50, but at least 10 percent are under 40.
Pernicious anemia is a blood disorder in which the body does not make enough red blood cells due to a lack of vitamin B12 in the blood. Pernicious anemia can develop from a lack of a protein that helps the body absorb vitamin B12, not getting enough B12 in the diet, and certain intestinal conditions that interfere with the absorption of vitamin B12 such as Crohn's disease, celiac sprue, or ulcerative colitis. There is no cure for pernicious anemia, thus treatment is life-long.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
Huntington's disease is the result of degeneration of neurons in areas of the brain. Huntington's disease is an inherited disorder. Early symptoms include mood swings, apathy, depression, and anger uncharacteristic of the individual. Judgement, memory, and other cognitive functions may become impaired. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Treatment includes medication and therapy for symptoms.
Alzheimer's disease is a common cause of dementia. Symptoms and warning signs of Alzheimer's disease include memory loss, difficulty performing familiar tasks, disorientation to time and place, misplacing things, and more. The biggest risk factor for Alzheimer's disease is increased age. Treatment for Alzheimer's is often targeted toward decreasing the symptoms and progression of the disease.
Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include lethargy, dementia, seizures, tremors, and coma. Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Aphasia is a condition that is the result of damage to portions of the brain. It can be caused by stroke, head injury, brain tumor, or infection. There are two types of aphasia, fluent and non-fluent. Some patients may fully recover from aphasia over time, while others may not.
Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) is a neurological disease that progresses rapidly. The disease attacks the nerve cells responsible for the control of voluntary muscles. Early symptoms include cramping, twitching, or stiffness of the muscles; slurred nasal speech; difficulty swallowing or chewing, and muscle weakness in an arm or leg. Currently, the cause of ALS is not known. ALS is a fatal disease. No cure has been found for ALS, however, the drug riluzole (Rilutek) is FDA approved, and this drug reduces the damage to motor neurons by decreasing the release of glutamate.
Learn about mitochondrial disease, genetic disease in which include a group of neuromuscular diseases that are caused by damage to the mitochondria Common mitochondrial myopathies include Kearns–Sayre syndrome, myoclonus epilepsy, and mitochondrial encephalomyopathy. Symptoms of mitochondrial disease include heart failure, exercise intolerance, dementia, muscle weakness, movement disorders, deafness, blindness, stroke-like episodes, and more. There is no specific treatment for mitochondrial disease.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Creutzfeldt-Jakob disease (CJD) is a rare, degenerative, invariably fatal brain disorder. CJD generally appears in the later years and runs a rapid course. Symptoms of CJD include failing memory, lack of coordination, visual disturbances, failing memory, blindness, weakness, and eventually coma. There are three major categories of CJD; 1) sporadic CJD, 2) hereditary CJD, and 3) acquired CJD. There is no cure for Creutzfeldt-Jakob disease.
MELAS syndrome, a rare form of dementia, stands for Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes. Mutations in the genetic material (DNA) in the mitochondria cause MELAS syndrome. Symptoms of MELAS include brain dysfunction (encephalopathy) with seizures and headaches, muscle disease with lactic acid build-up in the blood, temporary local paralysis, and abnormal thinking (dementia). There is no known treatment for MELAS.
Advance directives are designed to outline a person's wishes and preferences in regard to medical treatments and interventions. Advance directives generally fall into three categories: living will, power of attorney, and health-care proxy.
Frontotemporal dementia (FTD) is a syndrome that is associated with shrinking of the frontal and temporal lobes of the brain. Frontotemporal dementia used to be referred to as Pick's disease. Frontotemporal dementia has a strong genetic component. Symptoms of frontotemporal dementia include changes in behavior or problems with language. There is no treatment that slows the progression of frontotemporal dementia. Medication may be prescribed to improve symptoms. The outcome for patient's with frontotemporal dementia is poor.
Anemia is a condition in which the body does not have a sufficient number of
red blood cells or hemoglobin. Hemoglobin is present within red blood cells and
is important for carrying oxygen to all tissues of the body. In males,
anemia is
typically defined as hemoglobin level of less than 13.5 gram/100ml, while in
women, a hemoglobin level of less than 12.0 gram/100ml is considered to be
indicative of anemia. These definitions may vary slightly depending on the
source and the laboratory reference used. Pernicious is a term that means
destructive, injurious or deadly.
Pernicious anemia is a disease where large,
immature, nucleated cells (megaloblasts, which are forerunners of red blood
cells) circulate in the blood, and do not function as blood cells; it is a
disease caused by impaired uptake of vitamin B-12 due to the lack of intrinsic
factor (IF) in the gastric mucosa. It was termed "pernicious" because ...
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