Dementia

  • Medical Author:
    Danette C. Taylor, DO, MS, FACN

    Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

View Dementia Slideshow Pictures

Lewy Body Dementia

Recently, Robin Williams, one of my favorite comic actors, committed suicide. During his autopsy, Lewy bodies were found in his brain. In addition, reports are that he also suffered from Parkinson's disease. Since his death, there has been a growing interest in Lewy body dementia (referred to as LBD throughout the rest of this article), and some individuals suggest his suicide was caused by his disease(s). The following is a brief over view of Lewy body disease that may explain why such speculation about Robin Williams occurred.

In general, there are two main types of LBD; doctors and researchers use the "one year rule" to diagnose LBD:

  • If cognitive symptoms appear within a year of movement problems, the diagnosis is dementia with Lewy bodies.
  • If cognitive problems develop more than a year after the onset of movement problems, the diagnosis is Parkinson's disease dementia.

These diagnoses are usually made by a neurologist. LBD disease is also termed dementia with Lewy bodies (DLB) in the medical literature.

Picture of Dementia

Quick GuideDementia Pictures Slideshow: Disorders of the Brain

Dementia Pictures Slideshow: Disorders of the Brain

Dementia facts

  • Dementia is a broad description which includes many different symptoms, including memory loss, word-finding difficulties, impaired judgment, and problems with day-to-day activities, which are caused by injury or loss of brain cells (neurons).
  • Risk factors for dementia include age, family history, heavy alcohol use, hardening of the arteries, high blood pressure, diabetes, high cholesterol, and smoking.
  • Causes of dementia are factors which lead to damage to neurons. Once the brain cells are injured, they lose their ability to communicate with other cells, leading to dysfunction.
  • Signs and symptoms of dementia are varied, but typically include memory loss, problems with speaking or communicating (word-finding difficulties, repetition), problems focusing, impairments in judgment, struggles with completing tasks, or even difficulty comprehending what is seen.
  • The types of dementia include Lewy body dementia, vascular dementa, and frontotemporal dementia. Other types include dementia associated with Parkinson's disease or Huntington's disease. Senile dementia (“senility”) is a term that was once used to describe all dementias; this term is no longer used as a diagnosis.
  • The stages of dementia are used when a progressive dementia has been diagnosed. The stages include:
    • Stage 1: No impairment. The patient has no problems.
    • Stage 2: Questionable impairment. The patient begins to have some difficulty but can still function independently.
    • Stage 3: Mild impairment. The patient has obvious, but still mild difficulty with daily activities.
    • Stage 4: Moderate impairment. The patient needs help with caring for him or herself as well as with carrying out daily activities.
    • Stage 5: Severe Impairment; patients are unable to function independently.
  • Dementia is diagnosed after a series of assessments, including a physical evaluation and determination of the history of any problems. Memory tests, imaging studies, and blood work may exclude other problems which might mimic dementia. The diagnosis of dementia can take a long time.
  • The treatment for dementia is primarily supportive. Prescription medications cannot reverse or stop the process. Environmental changes, a structured schedule, regular exercise, and staying engaged with others can all be beneficial.
  • Home care for dementia can be beneficial for patients and families, as a way for patients to remain close to family members. However, caregivers should confirm that they have help to avoid burnout.
  • Prescription drugs to treat dementia include donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), and memantine (Namenda). A new combination of donepezil and memantine (Namzaric) was recently approved by the FDA.
  • Although there is no way to absolutely prevent dementia, modifying the risk factors of high blood pressure, high cholesterol, alcohol intake, and keeping diabetes as well-controlled as possible, as well as exercising regularly can help.
  • The prognosis for a person with dementia is individual. Some patients have a rapidly progressive course, while others progress very slowly. Factors which contribute to the progression of dementia haven't been fully identified.

What is dementia?

Dementia is often one of the most misunderstood conditions in medicine today. Some people believe that senility or senile dementia is an inevitable result of aging, and never seek evaluation for family members who show signs of memory loss. Others believe that any evidence of forgetfulness is evidence of dementia. Neither of these conclusions is accurate.

Additionally, many questions have been raised about dementia. Does dementia differ from Alzheimer's disease or are all forms of dementia Alzheimer's disease? If someone has memory loss associated with another condition, does that turn into Alzheimer's disease? What can be expected if someone has been diagnosed with dementia?

What causes dementia?

Dementia is a broad term which covers many different conditions, including Alzheimer's disease, vascular dementia, frontotemporal dementia, and other disorders. Simple forgetfulness is not enough to lead to a diagnosis of dementia, as there needs to be evidence of problems in at least two areas of cognition (brain function) to confirm this diagnosis. Possible symptoms or signs of dementia include memory loss, problems with speaking, including difficulty completing sentences or finding the right word to say, difficulty completing tasks, difficulty recognizing items or people, and showing signs of poor judgment. People with dementia may have problems preparing food, performing household chores, or paying bills. They may repeat questions or stories regularly, or forget appointments. They may get lost in familiar environments. Personality changes, including irritability or agitation, may also occur. In some cases, people with dementia develop hallucinations (or see things which aren't really there).

Medically Reviewed by a Doctor on 3/3/2016

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