What Is Dementia?
Dementia is a syndrome that involves a significant global impairment of cognitive abilities such as attention, memory, language, logical reasoning, and problem-solving severe enough to interfere with social or occupational functioning.
What Is not Dementia?
Dementia is not temporary confusion or forgetfulness that might result from a self-limited infection, underlying illness, or side effects of medications. Dementia typically worsens over time.
How Is Dementia Diagnosed?
In diagnosing dementia, a doctor uses certain criteria. Criteria for the diagnosis of dementia include impairment of attention, orientation, memory, judgment, language, motor and spatial skills, and function. (By definition, dementia is not due to major depression or schizophrenia.)
How Common Is Dementia?
Dementia is reported in as many as 1% of adults age 60. It has been estimated that the frequency of dementia doubles every five years after age 65.
What Are Causes of Dementia?
There are a number of causes of dementia. In general, dementia is more frequent with increasing age. Alzheimer's disease is the most common form of dementia. Among other causes are Lewy Body Dementia, vascular dementia, dementia related to Parkinson's Disease, frontotemporal lobar degeneration (FTLD), and dementias caused by other medical conditions (thyroid disease, drug toxicity, thiamine deficiency with alcoholism, and others) as well as brain injury, strokes, multiple sclerosis, infection of the brain (such as meningitis and syphilis), HIV infection, fluid build-up in the brain (hydrocephalus), Pick's disease, and brain tumors.
How Is Dementia Evaluated?
Dementia is first evaluated by a doctor who reviews the patient's history and performs a physical exam. Further testing is chosen according to clues from the history and physical. This testing might include blood and urine tests, chest X-ray, brain scanning (MRI or CT scanning), electroencephalogram (EEG), and spinal fluid analysis by lumbar puncture procedure.
How Is Dementia Treated?
Dementia treatment is directed toward managing symptoms, and identifying whether or not there may be a reversible cause. Medicines such as acetylcholinesterase inhibitors (e.g., galantamine, donepezil) can sometimes help to slow the progression of cognitive changes, but quite often the effects of medicines are only modest and cannot prevent eventual worsening of the underlying condition. Agitation and other emotional concerns are generally addressed as part of the overall treatment plan.