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More on Dementia
Research and Clinical Trials
More on Dementia
Neurology and Neuroscience
Dementia, a term for a decline in memory and cognitive function so severe that it interferes with a person's normal activities and relationships, can be caused by a variety of diseases and conditions. All forms of dementia result from the death of nerve cells and/or the loss of communication among these cells. Alzheimer's disease is the most common cause of dementia, accounting for 50 to 60 percent of all cases. Among the estimated 50 or more other causes of dementia are:
- Vascular dementia, which is caused by brain damage from cerebrovascular or cardiovascular problems such as strokes, heart problems, and genetic diseases.
- Lewy body dementia, a progressive dementia linked to the abnormal protein present in Parkinson's disease.
- Frontotemporal dementia, in which nerve cells in the frontal and temporal lobes of the brain deteriorate. Its prevalence among people with a family history of dementia suggests a strong genetic factor in the disease.
- HIV-associated dementia, which occurs in people with HIV. The drugs used to treat AIDS can delay onset of the disease and reduce symptoms.
- Huntington's disease, a hereditary disorder caused by a faulty gene, which causes degeneration in many regions of the brain and spinal cord.
- Dementia pugilistica, which results from repeated head trauma. Dementia symptoms can appear many years after the trauma ends.
- Corticobasal degeneration, a progressive disorder linked to the accumulation of an abnormal protein in the brain.
- Secondary dementias, dementia that occurs in patients with disorders that primarily affect movement – Parkinson's disease, multiple sclerosis, motor neuron diseases such as amyotrophic lateral sclerosis (Lou Gehrig's disease), olivopontocerebellar atrophy, Wilson's disease, and normal pressure hydrocephalus.
About NewYork-Presbyterian's Approach to Dementia
At NewYork-Presbyterian Hospital patients with dementia are in the care of a large, multidisciplinary team of healthcare professionals including neurologists, neuropsychologists, social workers, nurse practitioners, and rehabilitation specialists. This team provides comprehensive diagnostic services, neuropsychological assessments, sophisticated neuroimaging techniques, patient and caregiver education, state-of-the-art treatment, and assistance planning and managing patient care.
Medical Treatment for Dementia
Some dementias are caused by treatable medical conditions. When doctors treat the underlying condition the patient's mental function may be restored. Most dementias cannot be reversed, though, and in these cases doctors' goal in treatment is to improve symptoms. Symptoms are sometimes alleviated by medications including:
- Antidepressants for patients whose dementia is accompanied by depressive symptoms.
- Cholinesterase inhibitors, medications used for Alzheimer's disease, which increase the levels of neurotransmitters in the brain.
- Parkinson's disease medications, which can help reduce Parkinson's-like symptoms in some patients with Lewy body dementia.
- Antipsychotic medications, which can alleviate delusions and hallucinations in some dementia patients.
Rehabilitation for Dementia Patients
In the early stage of dementia patients may benefit from a form of rehabilitation called cognitive training. Using memory aids such as mnemonics, computerized recall devices, or note-taking, for example, patients with dementia can sometimes improve their cognitive functioning.
Research for Dementia
Investigators at NewYork-Presbyterian's Columbia University Medical Center campus participate in research programs sponsored through the Gertrude H. Sergievsky Center, the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the Alzheimer's Disease Research Center, one of 28 national Alzheimer's disease centers sponsored by the National Institutes of Health. Current research is directed toward:
- Medications that may be effective in preventing dementia.
- Neuroimaging studies to help understand changes in brain activity as people age and their disease progresses.
- Antidepressant studies for patients with both depression and memory complaints.
- Studies on cognition, perception and aging.
Researchers in the Memory Disorders Program at NewYork-Presbyterian's Weill Cornell Medical Center campus focus on turning basic research into effective clinical treatments. Dementia research at Weill Cornell is conducted by the Appel Center for Alzheimer's Translational Clinical Research; clinical trials are performed at the NIH-sponsored Clinical Translational Science Center; and clinical and research brain imaging studies are carried out at the Citigroup Biomedical Imaging Center. Current projects are investigating:
- Techniques to improve the detection of treatable conditions that are sometimes confused with dementia.
- The identification of naturally occurring antibodies that may help defend against dementias and other neurodegenerative diseases.