Rose Marie Mathew, M.D.
Adapting to the aging process may often pose a challenge, especially when changes include memory loss or dementia. Dementia is a collection of symptoms that may include memory loss, personality change and impaired intellectual functioning, language or judgment. Dementia has many causes some of which may be treatable or reversible. The progression and outcome of dementia vary, but are largely determined by the type of dementia.
Types of Dementia:
- 1. Alzheimer’s disease – most common cause of dementia in people older than age 65. An early onset form of the disease may occur usually as a result of a genetic defect. Two types of brain cell damage occur including plaques and tangles. This damage prevents the normal neural pathways of the brain and prevents memories from being formed or retrieved.
- 2. Vascular dementia – second most common cause of dementia resulting from damage to the brain secondary to problems with the arteries supplying the brain and heart. Symptoms may begin after a stroke or heart attack. It may also occur in people with long standing high blood pressure, diabetes, heart disease or high cholesterol. Often this dementia occurs with or is precursor to Alzheimer’s disease.
- 3. Frontotemporal dementia – tends to occur at a younger age generally between ages of 40-70. Degeneration of nerve cells is seen in areas of the brain associated with personality, behavior and language, which are the frontal and temporal lobes of the brain. Some cases are related to certain genetic mutations. One form of this type of dementia is Pick disease, which associates with inappropriate behaviors, language problems, difficulty with thinking and concentration
- 4. Lewy Body Dementia – affects approximately 20 percent of people with dementia. Lewy bodies are abnormal clumps of protein that have been found in brains of people with this type of dementia, Alzheimer’s disease and Parkinson’s disease. Unique features of Lewy body dementia include fluctuations between confusion and clear thinking, visual hallucinations and Parkinson’s symptoms such as tremors and stiffness. A sleep behavior disorder may also occur that involves acting out dreams.
Secondary dementias, some of which may have reversible causes include:
- 1. Repetitive head trauma.
- 2. HIV infections and immune disorders.
- 3. Metabolic abnormalities and nutritional deficiencies.
- 4. Heavy metal poisoning.
- 5. Brain tumors
- 6. Anything causing lack of oxygen to the brain.
Risk factors of dementia include:
- 1. Age
- 2. Family history
- 3. Down syndrome
- 4. Chronic alcohol use
- 5. Smoking
- 6. Diabetes
- 7. High blood pressure
- 8. High cholesterol
Diagnosis of dementia includes: thorough medical history and physical examination by an experienced physician. Cognitive and neuropsychological testing, brain scans to identify underlying causes, EEG and laboratory studies to help rule out reversible causes are all tests that your physician may order. A psychiatric evaluation may be performed to assess for underlying depression or other psychiatric disorder.
Treatments of dementia include medications that work by increasing levels of a chemical messenger involved in memory and judgment. Treatment is often disappointing but there currently are a lot of investigational studies that are underway. Controlling risk factors is key in prevention of dementia.