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Dementia

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia 

Symptoms:

• Progressive memory loss
• Inability to concentrate
• Decrease in problem-solving skills and judgment capability
• Confusion , severe
• Hallucinations and delusions
• Altered sensation or perception
• Impaired recognition (agnosia)
  • Impaired recognition of familiar objects or persons
  • Impaired recognition through the senses
• Altered sleep patterns
  • Insomnia
  • Need for increased sleep
  • Disturbance or change in sleep-wake cycle
• Motor system impairment
  • Impaired skilled motor function ( apraxia )
    • Inability to reproduce geometric figures
    • Inability to mimic hand positions
    • Inability to dress self
  • Gait changes
  • Inappropriate movements
  • Other motor system impairment
• Disorientation
  • Person, place, time disorientation
  • Visual-spatial disorientation
  • Inability to interpret environmental cues
• Specific disorders of problem-solving or learning
  • Inability to generalize
  • Loss of abstract thinking
  • Impaired calculating ability
  • Inability to learn
• Memory deficit
  • Short-term memory problems (can't remember new things)
  • Long-term memory problems (can't remember past)
• Absent or impaired language ability ( aphasia )
  • Inability to comprehend speech
  • Inability to read
  • Inability to write
  • Inability to speak , without muscle paralysis
  • Inability to form words
  • Inability to name objects
  • Poor enunciation
  • Inappropriate speech; use of jargon or wrong words
  • Inability to repeat a phrase
  • Persistent repetition of phrases
  • Other language impairment
• Personality changes
  • Irritability
  • Poor temper control
  • Anxiety
  • Depression
  • Indecisiveness
  • Self-centeredness
  • Inflexibility
  • No observable mood (flat affect)
  • Inappropriate mood or behavior
  • Withdrawal from social interaction
  • Inability to function or interact in social or personal situations
  • Inability to maintain employment
  • Decreased ability to care for oneself
  • Decreased interest in daily living activities
• Lack of spontaneity

Additional symptoms that may be associated with this disease are as follows:

• Swallowing problems
• Incontinence

Signs and tests:

The following tests and procedures may be done to determine the severity of dementia and its cause:

• Serum electrolytes
• Blood chemistry ( chem-20 )
• Serum calcium
• Glucose test
• Thyroid stimulating hormone level
• Thyroid function tests
• Liver function tests
• Blood ammonia levels
• B-12 level
• Drug or alcohol levels ( toxicology screen )
• Urinalysis
• Blood gas analysis
• EEG (electroencephalograph)
• Head CT
• MRI of head
• CSF (cerebrospinal fluid) analysis

References:

Alva G. Alzheimer disease and other dementias. Clin Geriatr Med . 2003; 19(4): 763-76.

American Academy of Neurology. About Dementia. Neurology . 2004; 63(10); E20.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. St. Louis, Mo: Mosby; 2004:283-286.

Goetz, CG. Textbook of Clinical Neurology . 2nd ed. St. Louis, Mo: WB Saunders; 2003: 705-708.

• Review Date: 5/10/2006
• Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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