Dementia is not a single disorder, but rather a combination of age-related symptoms involving a loss of mental skills and deteriorating brain function. Dementia literally translates to "deprived of mind," and may be the result of several different underlying conditions, some of which are treatable and some of which are not. Patients with dementia gradually lose memory, communication skills, the ability to reason, and the facility to complete the tasks of everyday living.
Causes of Dementia
The most common cause of dementia is Alzheimer's disease, a condition in which nerve cells lose the ability to communicate with one another, and slowly die. Other causes of dementia include:
- Parkinson's disease or Huntington's disease
- Vascular dementia or stroke
- Chronic abuse of alcohol or drugs
- Nutritional deficiencies
- Infections (such as AIDS or Creutzfeldt-Jakob disease)
- Developmental abnormalities
- Severe depression
- Hormonal imbalance
- Traumatic or chronic brain injury
- Brain tumor
- Severe kidney, liver or lung disease
Symptoms of Dementia
The symptoms of dementia develop gradually and may not be noticed until they worsen. Symptoms may include:
- Memory loss
- Difficulty speaking
- Difficulty understanding words
- Changes in personality, mood or behavior
- Difficulty planning or performing sequential tasks
- Getting lost in familiar places
- Neglecting personal safety and hygiene
Types of Dementia
There are two basic types of dementia: cortical and subcortical, characterized by the part of the brain affected. In cortical dementia, the variety that includes Alzheimer's and Creutzfeldt-Jakob disease, the cerebral cortex is affected. Patients with these disorders experience memory loss and aphasia, the inability to use language effectively. In subcortical dementia, the area beneath the cerebral cortex is affected. Patients with this type of dementia may have intact memory and language skills, but have trouble coming up with ideas or thinking quickly.
Treatment of Dementia
The success of dementia treatment depends a great deal on the root causes of the problem. Certain forms of dementia can be cured if caught before permanent brain damage has occurred.
Curable Dementia
When dementia results from nutritional lacks, such a vitamin deficiency, for example, vitamin supplements can bring the patient back to normal functioning. This is also true of the dementia resulting from hypothyroidism. Once the necessary thyroid hormone is administered, the patient's brain function may improve greatly, assuming the condition has been diagnosed at an early stage.
In situations in which the dementia results from a brain tumor or hydrocephalus, surgical intervention can make a tremendous difference. There is also a condition known as pseudodementia, in which the symptoms of dementia result from severe depression. Once diagnosed, this disorder usually responds well to antidepressants.
Incurable Dementia
For patients with Alzheimer's disease and other organic forms of dementia, the prognosis is much worse. Although much research is being conducted to find successful treatments for the disease, there is no medication at present that will cure such dementia or reverse its symptoms.
Nonetheless, there are psychotropic medications available to help manage symptoms such as agitation and depression. Medications called cholinesterase inhibitors, such as Aricept® (donepezil HCI), have been demonstrated to have some positive effect on brain activity. Cognitive behavioral therapy, eating a proper diet, engaging in physical exercise and having social contact have also been found to improve daily functioning or slow the progression of the disease.
