DEMENTIA

General Information

DEFINITION--Mental impairment caused by a variety of diseases that produce brain deterioration.

BODY PARTS INVOLVED--Brain.

SEX OR AGE MOST AFFECTED--Adults over 60.

SIGNS & SYMPTOMS

• Forgetfulness, especially of recent events.
• Unpredictable, sometimes violent, behavior.
• Confusion.
• Loss of interest in normal activities.
• Disorientation, especially at night.
• Poor personal hygiene and appearance.
• Depression, sleep disturbances.
• Poor judgment.
• Fecal incontinence (late).

CAUSES--

Degeneration and loss of the gray matter from the brain. The causes include:

• Alzheimer's disease (its underlying cause is not known).
• Inadequate blood supply to the brain due to blood clots, hypertension or atherosclerosis.
• Severe head injury or repeated head injury (e.g., boxing).
• Brain tumor.
• AIDS.
• Parkinson's disease, Huntington's disease.
• Secondary dementias caused by hypothyroidism, syphilis, normal pressure hydrocephalus, vitamin B deficiency and some medications. These may be reversible with treatment of primary disorder.

RISK INCREASES WITH

• High blood pressure or atherosclerotic disease.
• Adults over 60.

HOW TO PREVENT

• Obtain early medical treatment for underlying causes.
• Protect yourself from head injury. Wear seat belts in vehicles. Wear protective head gear for riding bicycles, motorcycles and participating in contact sports.
• To prevent atherosclerosis, don't smoke, eat a diet low in fat (see Low-fat Diet in Appendix), exercise regularly and reduce stress whenever possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies, EEG (See Glossary); x-rays of the head (to rule out potentially reversible causes).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Home care if symptoms are mild to moderate.
• Nursing-home care, if the disorder is too advanced for home care.
• Psychotherapy or counseling for family members.
• Occupational therapy.

POSSIBLE COMPLICATIONS--Infections, constipation, falls and injuries, and poor nutrition. These occur because the ill person cannot care for himself or herself.

PROBABLE OUTCOME--Primary dementia is currently considered incurable and progressive. Medicine may help a few to keep the condition from worsening, but it cannot restore lost brain function.

How To Treat

GENERAL MEASURES----Family members can help:

• Notice early behavior changes and seek prompt medical care.
• Provide simple reminders, such as a clock, daily calendar or name tag. Help the person with their personal hygiene.
• Minimize changes in daily routine and environment.
• Encourage social activities and contacts. Consider adult day care.
• Treat the person with respect and kindness.
• Provide a protected, non-judgmental environment when the patient cannot provide self-care. When home care is no longer possible, find a good extended-care facility.
• Visit the patient often--even if he or she doesn't seem to recognize you.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe medication appropriate to treat the underlying condition or drugs to treat the behavioral symptoms if other treatment has failed.

ACTIVITY--Encourage as much activity as possible. Caregivers should accident-proof the home.

DIET--Provide a well-balanced diet.

Call Your Doctor If

You observe symptoms of dementia in a family member.