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Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior
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brain damage primarily affects the brain's cortex, or outer layer. Cortical dementias tend to cause problems with memory, language, thinking, and social behavior. Subcortical dementia: dementia that affects parts of the brain below the cortex. Subcortical dementia tends to cause changes in emotions and movement in addition to problems with memory.
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gets worse over time, gradually interfering with more and more cognitive abilities. Primary dementia: dementia such as Alzihmer Disease that does not result from any other disease. Secondary dementia: dementia that occurs as a result of a physical disease or injury.
(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.
Parkinson's disease
Multiple sclerosis
Huntington's disease Pick's disease
Some causes of dementia may be stopped or reversed if they are found soon enough, including:
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Brain tumors
levels (see: Dementia due to metabolic causes) Low vitamin B12 levels Normal pressure hydrocephalus Use of certain medications, including cimetadine and some cholesterol-lowering medications Chronic alcohol abuse
Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.
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Dementia symptoms include difficulty with many areas of mental function, including: Language Memory Perception Emotional behavior or personality Cognitive skills (such as calculation, abstract thinking, or judgment)
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)is the
stage between normal forgetfulness due to aging and the development of dementia.
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activities
name of familiar objects Misplacing items Getting lost on familiar routes Personality changes and loss of social skills Losing interest in things you previously enjoyed, flat mood Difficulty performing tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines
As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of yourself. The symptoms may include:
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Forgetting details about current events Forgetting events in your own life history, losing awareness of who you are Change in sleep patterns, often waking up at night More difficulty reading or writing Poor judgment and loss of ability to recognize danger
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correctly, speaking in confusing sentences Withdrawing from social contact Having hallucinations, arguments, striking out, and violent behavior Having delusions, depression, agitation Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving
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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: Thyroid disease Vitamin deficiency Brain tumor Intoxication from medications Chronic infection Anemia Severe depression
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determine whether other problems could be causing dementia or making it worse. These conditions include: Thyroid disease Vitamin deficiency Brain tumor Intoxication from medications Chronic infection Anemia Severe depression
B12 level Blood ammonia levels Blood chemistry (chem-20) Blood gas analysis Cerebrospinal fluid (CSF)
Head CT Liver function tests Mental status test MRI of head Serum calcium
analysis Drug or alcohol levels (toxicology screen) Tests for exposure to metals such as lead or arsenic Electroencephalograph (EEG) Glucose test
Serum electrolytes Thyroid function tests Thyroid stimulating hormone level Urinalysis
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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
Treating conditions that can lead to confusion often greatly improve mental functioning. Such conditions include:
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3 . DEPRESSION
4 . HEART FAILURE 5 . INFECTIONS 6 . NUTRITIONAL DISORDERS 7 . THYROID DISORDERS
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problems caused by a loss of judgments, increased impulsivity, and confusion. Possible medications include: Antipsychotics (haloperidol, risperdal, olanzapine) Mood stabilizers (fluoxetine, imipramine, citalopram) Serotonin-affecting drugs (trazodone, buspirone) Stimulants (methylphenidate)
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symptoms worsen. The benefit from these drugs is often small, and patients and their families may not always notice much of a change. Donepezil (Aricept), rivastigmine (Exelon), galantam ine (Razadyne, formerly called Reminyl) Memantine (Namenda)
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Hearing aids, glasses, or cataract surgery may be needed. Psychotherapy or group therapy usually does not help because it may cause more confusion.
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is caused by a series of small strokes, 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.
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. [PubMed] Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.doi:10.1136/bmj.b158. [PubMed]