Dementia is a general loss of mental abilities. It can include a loss of ability to think, reason, learn, and understand. To be considered dementia, these mental losses must be severe enough to interfere with day-to-day activities. Dementia must also have:
- Memory problems
Mental loss that is severe enough to cause problems with one or more of the following:
- Visuospatial function
- Executive function—foresight, planning, anticipation, and insight
- Praxis—learned motor skills
Some Areas of the Brain Affected by Dementia
Causes of dementia include:
- Alzheimer's dementia (most common)
- Brain damage after multiple small strokes—also called vascular dementia
- Lewy body disease
- Alcohol use disorder
- Multiple sclerosis
- Huntington's disease
- Parkinson's disease
- Creutzfeldt-Jakob disease and other prion disorders
- Front-temporal dementia, including Pick's disease
- Normal pressure hydrocephalus
- Untreated syphilis
- Toxic levels of metals, such as aluminum, which can sometimes occur in people who have dialysis treatment
- Vitamin B12 deficiency
- Thiamine deficiency
- Thyroid dysfunction
Increasing age is the most common factor that increases your chance of developing dementia. Other factors include:
- Family members with dementia
- Down syndrome
- Apolipoprotein E status—a genetic risk
- Elevated cholesterol
- Multiple strokes
- High blood pressure
- High cholesterol
- Lack of physical activity
- Vitamin deficiency
- Chronic drug use
- Long-term use of hormone replacement therapy
- Repetitive head trauma—may occur with contact sports
- Overweight or obese
Symptoms often begin mildly and get more severe over time. Symptoms vary according to the cause of the dementia, but often include:
Increasing trouble remembering things, such as:
- How to get to familiar locations
- What the names of family and friends are
- Where common objects are usually kept
- How to do simple math
- How to do usual tasks, such as cooking, dressing, or bathing
- How to drive
- How to pay bills
- Having difficulty concentrating on tasks
- Having difficulty completing sentences due to lost/forgotten words—may continue to a complete inability to speak
- Forgetting the date, time of day, season
- Getting lost in familiar surroundings
- Being withdrawn, losing interest in usual activities
- Having mood swings
- Having personality changes
- Walking in a slow, shuffling way
- Having poor coordination
- Losing purposeful movement
Your doctor may diagnose dementia through:
- An extensive medical history from you and your family
- Observing your behavior
- A physical exam
- Tests for your nervous system
- Mental status and psychological tests
Imaging tests take pictures of internal body structures. These may include:
Cerebrospinal fluid that protects the brain and spinal cord can be analyzed with a lumbar puncture.
Currently, there are no treatments to cure many types of dementia. Some medication may help to decrease the symptoms of dementia or slow its course.
Two types of medications that may be used to reduce the symptoms of dementia include:
- Cholinesterase inhibitors
- N-methyl-D-aspartate (NMDA) receptor antagonists
Treatments that are being studied include:
- Gamma-secretase inhibitors.
- Tau fiber aggregation inhibitors.
- Herbs and supplements, such as vitamin E , ginkgo biloba , or huperzine A. Currently, evidence is mixed as to the effectiveness of these natural remedies.
This type of support is critical for people with dementia. Behavioral and environmental support includes:
- Keeping you safe in your home
- Providing a calm, quiet, predictable environment
- Providing appropriate eyewear and hearing aids, easy-to-read clocks, and calendars
- Participating in music therapy and/or dance therapy
- Participating in physical and occupational therapy for daily activities
- Encouraging light exercise
- Eating a healthful diet
- Discussing healthcare wishes with family members and doctors and appointing a healthcare proxy and a legal power of attorney
People with dementia often develop psychiatric symptoms. You may need appropriate treatment, such as:
- Antianxiety medications
- Mood stabilizers
Caring for a person with dementia is difficult. Those providing care will need support. The Alzheimer’s Association is an excellent resource for families and caregivers.
While the exact cause of dementia is not known, these steps may help to reduce your risk:
- Eat a healthful diet. This will help you to maintain good levels of vitamin B12 and cholesterol.
- Exercise regularly. This can also enhance cardiovascular health, which may delay the onset of vascular dementia.
- Alcohol may have some benefits if you use it in moderation. This means no more than two drinks per day for a man, and one drink per day for a woman. Moderate amounts of alcohol may decrease your risk of dementia. Higher amounts of alcohol however, can increase your risk of dementia.
- Engage in mentally stimulating activity. This may also reduce the risk of Alzheimer’s disease.
American Academy of Neurology
Alzheimer Society Canada
Toronto Dementia Network
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Last reviewed September 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.