Dementia is a phrase that describes the symptoms of an individual who experiences a regular decline in cognitive processing. Dementia can be caused by damage or disease of the brain besides a normal aging process. Dementia is coined from the Latin words de – meaning apart or away and mens meaning mind.
Areas of cognitive functioning affected by dementia are attention, memory, language and problem soling skills. In late stages of dementia a person can become disoriented – whether in time, place or the people they known. This disorientation can present as the patient not knowing what day or year it is, where they are (even if it is their home) and not knowing family members or friends.
Dementia can be reversible or irreversible depending on the cause. Less than 10% of dementia cases are reversible. Dementia is a term that describes a symptom caused by a variety of diseases, such as nausea or fever.
Dementia cases are increasing around the world as life expectancy is becoming greater.
Dementia usually becomes evident during an attack of delirium. Patients who experience an episode of extreme confusion while hospitalized have a higher risk of developing dementia.
Symptoms of dementia can occur with language, motor skills, short-term memory, identifying common household items, reaction time, affect, comprehension, and executive functioning.
Patients with dementia may also show signs of depression and psychosis, due to fear of surroundings and uncertainty.
Different types of dementia are classified by the cause. The most common causes of dementia are Alzheimer’s disease, vascular dementia (also referred to as multi-infarct dementia), Binswanger’s disease, dementia with Lewy bodies (DLB), alcohol induced persisting dementia and Frontotemporal lobar degeneration. Frontotemporal lobar degeneration includes Pick’s disease. Frontotemporal lobar degeneration has there variants: progressive non-fluent aphasia, semantic dementia (also referred to as temporal variant FTLD) and frontotemporal dementia (also referred to as frontal variant FTLD).
Less common causes of dementia are Creutzfelt-Jakob disease, Huntington’s disease, Parkinson’s disease, Aids dementia complex, Head trauma and some patients with Down’s syndrome develop a form of Alzheimer’s type dementia.
The treatable causes of dementia are hypothyroidism, vitamin B1 deficiency, vitamins B12 and A deficiency, depressive pseudo-dementia, normal pressure hydrocephalus and tumors. Treatable dementia occurs in only up to 10% of dementia patients.
Certain tests need to be performed by qualified specialists to determine dementia. Examples of the tests are the mini mental state examination (MMSE) and the abbreviated mental test score (AMTS). Qualified professionals are a geriatric psychiatrist, geriatric internist, neurologist, geropsychologist or a neuropsychologist. The tests take about five to fifteen minutes to perform and have a good accuracy. The tests can be performed in an office, hospital or home.
Blood tests are performed to rule out the reversible causes of dementia. Tests that are performed on a blood withdrawal are vitamin levels, thyroid-stimulating hormone, C-reactive protein, full blood count (CBC), calcium, renal functioning, electrolytes and liver enzymes.
Medical imaging is used to assess if a stroke or tumor has occurred and to determine normal pressure hydrocephalus. Diagnosis is determined by a complete clinical presentation of the patient.
Treatment of dementia depends on the type. There is no cure for irreversible dementia. Cognitive and behavioral interventions can be attempted. Education and support is necessary for caregivers, as well.
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