Dementia

Definition

Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

Alternative Names

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment; MCI

Causes

Dementia usually occurs in older age. It is rare in people under age 60. The risk of dementia increases as a person gets older.

Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer disease is the most common type of dementia.

Another common type of dementia is vascular dementia. It is caused by many small strokes.

Lewy body disease is a common cause of dementia in older adults. People with this condition have abnormal protein structures in certain areas of the brain.

The following medical conditions can also lead to dementia:

Some causes of dementia may be stopped or reversed if they are found soon enough, including:

Symptoms

Dementia symptoms include difficulty with many areas of mental function, including:

Dementia usually first appears as forgetfulness.

Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They often know about their forgetfulness. Not everyone with MCI develops dementia.

Symptoms of MCI include:

Early symptoms of dementia can include:

As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include:

People with severe dementia can no longer:

Other symptoms that may occur with dementia:

Exams and Tests

A skilled health care provider can often diagnose dementia using the following:

Other tests may be ordered to find out if other problems may be causing dementia or making it worse. These conditions include:

The following tests and procedures may be done:

Treatment

Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time.

Sometimes, dementia medicine can make a person's confusion worse. Stopping or changing these medicines is part of the treatment.

Certain mental exercises can help with dementia.

Treating conditions that can lead to confusion often greatly improve mental function. Such conditions include:

Medicines may be used to:

Someone with dementia will need support in the home as the disease gets worse. Family members or other caregivers can help by helping the person cope with memory loss and behavior and sleep problems. It is important to make sure the homes of people who have dementia are safe for them.

Outlook (Prognosis)

People with MCI do not always develop dementia. When dementia does occur, it usually gets worse over time. Dementia often decreases quality of life and lifespan. Families will likely need to plan for their loved one's future care.

When to Contact a Medical Professional

Call your provider if:

Prevention

Most causes of dementia are not preventable.

The risk of vascular dementia may be reduced by preventing strokes through:

References

Galvin JE, Sadowsky CH; NINCDS-ADRDA. Practical guidelines for the recognition and diagnosis of dementia. J Am Board Fam Med. 2012;25(3):367-382. PMID: 22570400 www.ncbi.nlm.nih.gov/pubmed/22570400.

Knopman DS. Alzheimer disease and other dementias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 402.

Mitchell SL. CLINICAL PRACTICE. Advanced Dementia. N Engl J Med. 2015;372(26):2533-2540. PMID: 26107053 www.ncbi.nlm.nih.gov/pubmed/26107053.

Peterson R, Graff-Radford J. Alzheimer disease and other dementias. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 95.



Review Date: 8/13/2015
Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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