Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment; MCI
Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.
See also: Alzheimer's disease
Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the most common type of dementia.
Lewy body disease is a leading cause of dementia in elderly adults. People with this condition have abnormal protein structures in certain areas of the brain.
Dementia also can be due to many small strokes. This is called vascular dementia.
The following medical conditions also can lead to dementia:
Some causes of dementia may be stopped or reversed if they are found soon enough, including:
Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.
Dementia symptoms include difficulty with many areas of mental function, including:
Dementia usually first appears as forgetfulness.
Mild cognitive impairment is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops dementia.
Symptoms of MCI include:
The early symptoms of dementia can include:
As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of yourself. The symptoms may include:
People with severe dementia can no longer:
Other symptoms that may occur with dementia:
Dementia can often be diagnosed with a history and physical exam by a skilled doctor or nurse. A health care provider will take a history, do a physical exam (including a neurological exam), and perform some tests of mental function called a mental status examination.
The health care provider may order tests to help determine whether other problems could be causing dementia or making it worse. These conditions include:
The following tests and procedures may be done:
For information on how to take care of a loved one with dementia, see: Dementia - home care
The goal of treatment is to control the symptoms of dementia. Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time.
Stopping or changing medications that make confusion worse may improve brain function.
There is growing evidence that some kinds of mental exercises can help dementia.
Treating conditions that can lead to confusion often greatly improve mental functioning. Such conditions include:
Medications may be needed to control behavior problems caused by a loss of judgement, increased impulsivity, and confusion. Possible medications include:
Certain drugs may be used to slow the rate at which symptoms worsen. The benefit from these drugs is often small, and patients and their families may not always notice much of a change.
A person's eyes and ears should be checked regularly. Hearing aids, glasses, or cataract surgery may be needed.
Psychotherapy or group therapy usually does not help because it may cause more confusion.
People with mild cognitive impairment do not always develop dementia. However, when dementia does occur, it usually gets worse and often decreases quality of life and lifespan.
Complications depend on the cause of the dementia, but may include the following:
Call your health care provider if:
Most causes of dementia are not preventable.
You can reduce the risk of vascular dementia, which is caused by a series of small strokes, by quitting smoking and controlling high blood pressure and diabetes. Eating a low-fat diet and exercising regularly may also reduce the risk of vascular dementia.
Brewer JB, Gabrieli JDE, Preston AR, Vaidya CJ, Rosen AC. Memory. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 5.
Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med, 2007;120:388-397.
Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.doi:10.1136/bmj.b158.
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