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Dementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. Many causes of dementia symptoms exist. Alzheimer's disease is the most common cause of a progressive dementia.
Memory loss generally occurs in dementia, but memory loss alone doesn't mean you have dementia. Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language. Dementia can make you confused and unable to remember people and names. You also may experience changes in personality and social behavior. However, some causes of dementia are treatable and even reversible.
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
When to see a doctor
See a doctor if you or a loved one experiences memory problems or other dementia symptoms. Some medical conditions can cause symptoms of dementia and are treatable, so it's important that a doctor determine the underlying cause.
Alzheimer's disease is a type of dementia that worsens over time. Early diagnosis gives a person time to plan for the future while he or she can participate in making decisions.
Dementia has many causes. Some dementias such as Alzheimer's disease occur on their own, not as a result of another disease. Much is still unknown about how some diseases may be linked to dementia.
Dementias can be classified in a variety of ways and are often grouped by what they have in common, such as what part of the brain is affected, or whether they worsen over time (progressive dementias). Some dementias, such as those caused by a reaction to medications or an infection, are reversible with treatment.
Types of dementias that worsen over time include:
Several types of vascular dementia exist and vary in their causes and symptoms. Some types affect only one side of the body, and some cause memory loss, confusion and mood changes. In some forms, symptoms may progressively worsen, while in others, they may be temporary. In general, vascular dementia is more common with age. Often this dementia coexists with Alzheimer's disease.
Other disorders linked to dementia
Dementia causes that can be reversed
Some causes of dementia or dementia-like symptoms can be reversed. Your doctor can identify, treat and sometimes cure these causes:
Many factors can eventually lead to dementia. Some, such as age, can't be changed. Others can be addressed to reduce your risk.
Risk factors that can't be changed
Risk factors you can change
To reduce your risk of dementia, you can take steps to control the following factors.
Dementia can affect the functioning of many body systems and, therefore, the ability to carry out day-to-day tasks. Dementia may lead to problems such as:
Most likely, you'll first see your primary care provider if you have concerns about dementia. In some cases, you may be referred to a doctor who specializes in specific symptoms, such as a neurologist for brain and nerve disorders.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. If you're a caregiver for someone with more advanced dementia, you'll likely be the one gathering information from the doctor. Here's some information to help you get ready.
What you can do
Preparing a list of questions will help make the most of your time with the doctor. List questions from most important to least important in case time runs out. For dementia, some basic questions to ask the doctor include:
Don't hesitate to ask any other questions that come up.
What to expect from your doctor
The doctor is likely to ask you and your caregiver a number of questions such as:
Memory loss and other dementia symptoms have many causes, so diagnosis can be challenging and may require several doctor visits. Diagnosis involves a number of tests.
Medical history and physical exam
Medical history. The doctor will ask about how and when symptoms began and about any health issues that may help identify the cause of the problem, for example diabetes, high blood pressure or a family history of dementia.
In addition, the doctor may request information from your caregiver or family member to find out whether your concerns represent a change from your earlier level of functioning.
Physical examination. A physical exam helps your doctor rule out treatable causes of dementia and identify signs of stroke or other disorders that may cause similar symptoms. It also helps your doctor determine the best course of treatment. As part of an exam, your doctor may collect urine or blood samples, check blood pressure and review what medications you're using.
This examination can also help identify signs of other illnesses, such as heart disease, diabetes or thyroid abnormalities and any medication side effects, which can overlap with dementia.
Cognitive and neuropsychological tests
Anyone screened for dementia needs his or her cognitive function evaluated. A number of tests measure orientation, general intellectual skills, academic skills, language skills, spatial skills, attention, memory, reasoning and judgment. The goal is to determine whether dementia is present, how severe it is and what part of the brain is affected.
This part of the examination evaluates balance, sensory function and reflexes to identify conditions that may affect the diagnosis or are treatable with medication.
A look at your brain can help your doctor identify strokes, tumors or other problems that can cause dementia. Alzheimer's disease changes brain structure over time and can also be seen with a brain scan. Several types of scans are used.
A variety of lab tests can help rule out other conditions, such as kidney failure, that can contribute to symptoms. Treatable medical conditions are often associated with dementia. Medication and other treatments can improve many symptoms and quality of life.
Tests that help identify treatable medical conditions include:
This examination may be performed to determine whether depression or another psychiatric disorder is contributing to symptoms.
Treatment of dementia may help slow or minimize the development of symptoms.
Treatment of the underlying causes of dementia can also slow or sometimes stop its progress. To prevent a stroke, for example, your doctor may prescribe medications to control high blood pressure, high cholesterol, heart disease and diabetes. Doctors may also prescribe medication to treat conditions such as blood clots, anxiety and insomnia for people with vascular dementia.
In addition, some specific symptoms and behavioral problems can be treated with sedatives, antidepressants and other medications, but some of these drugs may worsen other symptoms.
Creutzfeldt-Jakob disease has no known treatments. Care is focused on making sure the person is comfortable.
You can take steps to improve quality of life as the disease progresses.
Carry a reminder calendar
Use a calendar to record upcoming events as well as things you want to remember later and activities you need to complete on a daily basis. Then check off those activities when done. If you can make this process a habit when memory problems are mild, you'll be more likely to retain this skill as the disease progresses. For example, if you can't remember if you took your pills or who called that morning, you can check your calendar.
Maintain a calm and stable home environment
A calm and stable home environment reduces problems such as anxiety, agitation and excess confusion. New situations or people, disrupted routines, loud noises, feeling rushed, or being asked to complete multistep tasks can cause frustration and lead to anxiety. When you have dementia such as Alzheimer's disease, becoming upset reduces the ability to think clearly even more.
Establish a nighttime ritual
Dementia behaviors may be worse at night when the person with dementia is more tired, strained by the demands of the day or perhaps confused because of the decrease in daylight. Try to establish going-to-bed rituals that are calming. It can be helpful to retreat from the noise of television, meal cleanup and active family members. Leaving night lights on helps prevent disorientation. In addition, limiting caffeine during the day, avoiding daytime napping and exercising during the day may help prevent nighttime restlessness.
Create a plan
Develop a comprehensive plan that identifies goals for care. Various support agencies, care centers, primary and specialty doctors, legal advisers, and other family members can help achieve these goals. This process may or may not be something in which a person with dementia can participate. Here are some things for families to consider:
Keep in mind that the disease will evolve over time, and care needs to be adjusted as symptoms change and progress. People with dementia should be encouraged to continue their normal activities as long as they're safe and the activities don't cause frustration or confusion. Mental, social and physical activities help maintain a person's health and well-being.
Use caution when considering alternative remedies to ward off or slow the progression of dementia, especially if taking other medications. Dietary supplements, vitamins and herbal remedies aren't regulated, and claims about their benefits are often based on personal testimonials rather than scientific research. Some of the more popular alternatives for Alzheimer's disease and other forms of dementia are:
Receiving a diagnosis of dementia can be devastating to you and your loved ones. Many things need to be considered to ensure that you and those around you are as prepared as possible for dealing with a condition that's unpredictable and continually changing.
Care and support for the person with the disease
Throughout the disease you may experience a wide range of feelings. Here are some things you can do to help yourself cope:
Helping someone with dementia
You can help a person cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing unconditional love, and doing your best to help the person retain dignity and self-respect.
Providing care for a person with dementia is physically and emotionally demanding. Often, the primary caregiver is a spouse or other family member. Feelings of anger and guilt, frustration and discouragement, worry and grief, and social isolation are common. If you're a caregiver for someone with dementia:
There's no sure way to prevent dementia, but there are steps you can take that might help. More research is needed, but it can't hurt to do the following:
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