What is dementia?
Dementia is a gradual loss of mental functions such as the
ability to think, remember, reason, and plan. Dementia is
not a disease, but a group of symptoms. As dementia gets
worse, the person is no longer able to do everyday tasks.
Behavior and personality also change.
Dementia is not a normal part of aging. In normal aging
memory loss is slow, not sudden. As they age, people may
forget names, phone numbers, or where objects are. People
with dementia also have problems with problem-solving and
thinking things through.
Contact your healthcare provider if you are unsure whether
symptoms are due to normal aging or to another cause.
How does it occur?
The most common cause of dementia is Alzheimer's disease.
Strokes, sometimes in the form of many small strokes you
may not be aware of having, also can cause dementia. Other
conditions that can cause dementia include:
- Huntington's disease
- multiple sclerosis
- vascular disease
- Pick's Disease
- Creutzfeldt-Jakob disease
- Parkinson's disease
- Lewy body disease (a disorder similar to Alzheimer's)
- alcoholism or drug abuse
- AIDS.
Medicines or untreated depression may cause symptoms that
look like dementia.
Damaged brain cells that can no longer store or work with
information in the normal way cause the symptoms of
dementia. As the disease causing the dementia progresses,
more brain functions are lost.
What are the symptoms?
Many symptoms are possible. At the beginning of dementia,
symptoms may be mild. However, as time passes, people may
have more of the following symptoms:
- memory problems (trouble remembering recent events or
trouble remembering people, places, times, and dates)
- poor judgment and not being able to understand the
results of their actions
- decline in thinking ability (for example, not being
able to figure out the correct order to put clothing on
when getting dressed)
- inability to follow instructions or stay with a task
(problems paying bills, fixing meals, shopping, taking
medicines)
- lack of emotions (lack of interest in what is going on
around them, less participation in activities previously
enjoyed, withdrawal from people)
- loss of interest in food and less concern about looking
neat and being clean
- irritability and a tendency to overreact
- tendency to wander away from home or get lost
- believing that someone is taking money or belongings or
that family members are impostors.
As the disease grows worse, more problems with control of
the body occur. The person may:
- be unable to control bowel or bladder
- be unsteady while walking, leading to falls and the
eventual inability to walk
- forget how to eat or have trouble chewing and swallowing
- have a hard time speaking and thinking of the right words
and eventually become unable to speak.
How is it diagnosed?
Family members or friends need to tell the provider how long
the person has had symptoms and whether they started
suddenly or came on gradually.
The healthcare provider will do a physical exam to find out
whether the person has had a stroke or has another condition
that could cause the symptoms. The provider will ask about
symptoms and any drug or alcohol use. The following tests
also may be done:
- blood tests
- brain wave tracing (EEG, or electroencephalogram)
- heart wave tracing (EKG, or electrocardiogram)
- CT scan
- MRI
- tests to check how well the person can concentrate,
remember, understand, and make decisions.
How is it treated?
There is no cure for dementia. You need to make sure the
person is safe and well cared for. Medicine may help calm
agitation and frightening thoughts. There are some medicines
that slow the progress of early symptoms of Alzheimer's in
some people. Donepezil (Aricept), galantamine (Razadyne),
and rivastigmine (Exelon) are drugs that may slow memory
loss early in the disease. Memantine (Namenda) may help
slow memory loss in later stages of the disease. Vitamin E
and other medicines continue to be studied to see whether
they might be helpful. None of these medicines can cure or
reverse Alzheimer's disease. You should not expect big
improvements when these medicines are given. Not all people
with dementia should take these medicines. Those whose
disease is very severe will not benefit. It is important to
talk to your healthcare provider about these issues.
What happens to people with dementia?
A few medical conditions, such as encephalitis (a viral
infection in the brain), cause symptoms of dementia that can
be reversed with treatment.
Most dementias do not get better and will get worse over time.
Your healthcare provider can explain more about what to
expect.
What can a family member or friend do?
The most important thing is to understand that a person with
dementia is not responsible for his or her behavior. It
occurs because of damage to brain cells. A person with
dementia may say or do hurtful things that family and
friends must overlook.
It can be difficult to know how to care for persons with
dementia. They may need care 24 hours a day. Keep these
things in mind:
- Give them choices when you can.
- Decide what kind of care they need and who will give them
care.
- See that anyone caring for them treats them with respect.
- Make sure you know what kind of care they are getting.
Written by Carolyn Norrgard, RNC, BA, MEd; Carol Matheis-Kraft, PhD, RNC; and Sally Rigler, MD, for McKesson Corporation
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2007 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.