Dementia overview

Dementia Microchapters
Patient Information
Overview
Classification
Causes Alzheimer's Disease Parkinson's Disease Binswanger's Disease Dementia with Lewy bodies Thiamine deficiency Vascular dementia Marijuana abuse AIDS Neurosyphilis Normal pressure hydrocephalus Vitamin B12 deficiency Vitamin B6 deficiency
Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

Dementia (from Latin de- "apart, away" + mens (genitive mentis) "mind") is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal ageing.

Particularly affected areas may be memory, attention, language, and problem solving. Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are).

Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10 percent of cases of dementia have been reversed. Dementia is a non-specific term encompassing many disease processes, just as fever is attributable to many etiologies.

Without careful assessment, delirium can easily be confused with dementia and a number of other psychiatric disorders because many of the signs and symptoms are also present in dementia (as well as other mental illnesses including depression and psychosis).

Diagnosis

CT

A CT scan is commonly performed, although this modality (as is noted below) may not have optimal sensitivity for the diffuse metabolic changes associated with dementia in a patient who shows no gross neurological problems (such as paralysis or weakness) on neurological exam. CT may suggestnormal pressure hydrocephalus, a potentially reversible cause of dementia, and can yield information relevant to other types of dementia, such as infarction (stroke) that would point at a vascular type of dementia.

MRI

A MRI is commonly performed, although this modality (as is noted below) may not have optimal sensitivity for the diffuse metabolic changes associated with dementia in a patient who shows no gross neurological problems (such as paralysis or weakness) on neurological exam. MRI may suggestnormal pressure hydrocephalus, a potentially reversible cause of dementia, and can yield information relevant to other types of dementia, such as infarction (stroke) that would point at a vascular type of dementia.

Other Imaging Findings

Recently, the functional neuroimaging modalities of SPECT and PET have shown quite similar ability to diagnose dementia as clinical exam . SPECT's ability to differentiate vascular type from Alzheimer disease types of dementias appears to be superior to clinical exam.

Treatment

Primary Prevention

Prevention of dementia is the attempt to avoid developing dementia. Although no cure for dementia is available, there are many ways to decrease the risk of acquiring dementia in the first place, including both lifestyle changes and medication.