First of all, dementia doesnt exist as a disease in its own right. Its an inexact term for a collection of symptoms. Geriatricians now recognize that confusion and disorientation the symptoms usually associated with the term may be due to a wide variety of underlying conditions, ranging from:
Inadequate blood circulation in the brain
Depression
Infection
Brain tumor
Changes in blood sugar, sodium, and calcium levels
Low vitamin B12 levels
Normal pressure hydrocephalus
Use of certain medications, including cimetadine and some cholesterol-lowering medications
Chronic alcohol abuse
And it is neither inevitable nor hopeless; one out of five cases with underlying causes is treatable --and as we learn more about brain chemistry that percentage may increase.
Also recent research suggests there are a number of factors that may delay, or prevent, the onset of dementia in some people. For example, studies have shown that people who conscientiously control their glucose levels tend to score better on tests of cognitive function than those with poorly controlled diabetes. Several studies also have suggested that people who engage in intellectually stimulating activities such as crossword puzzles, chess, crossword puzzles, and playing a musical instrument, as well as frequently socializing, lower their risk of developing certain forms of dementia. Scientists believe mental activities may stimulate the brain in a way that increases the person's "cognitive reserve" - the ability to cope with or compensate for the pathologic changes associated with dementia.
A task force of the National Institutes of Aging suggests that an elderly person who begins to show signs of mental deterioration should see a doctor immediately, preferably a geriatrics expert specially trained in the problems of the elderly. The doctor should take a very detailed medical history from either the patient or a relative, or a close friend, including a comprehensive list of all the drugs the patient takes. The patient should have a thorough exam with blood, urine, and thyroid, neurological, psychological and intellectual tests. The doctor may also take an MRI of the head.
Theres a good chance the problem may be treatable. About 90 percent of all men and women over sixty-five and many well into their eighties and nineties have no serious mental deterioration. A change in diet or medication, a hearing aid, antidepressant drugs, even exercise may be suggested by the doctor.
Not long ago doctors believed that confusion and disorientation were inevitable aspects of old age. Now they suspect that these symptoms result from a change in brain chemistry and they are employing several drugs to treat it. Certain drugs may be used to slow the rate at which symptoms worsen. The benefit from these drugs is often small, and patients and their families may not always notice much of a change. These include: Donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne, formerly called Reminyl) Memantine (Namenda). Some doctors also believe certain mental exercises can slow the progression of the disease.
If youre looking for a geriatric specialist, contact a major medical center or a local agency for the aged.
Some medical conditions not related to aging can lead to dementia, they include:
Parkinson's disease
Multiple sclerosis
Huntington's disease
Pick's disease
Progressive supranuclear palsy
Infections that can affect the brain, such as HIV/AIDS and Lyme disease
Robin Westen is ThirdAges medical reporter. Check for her daily updates. She is the author of Ten Days to Detox: How to Look and Feel a Decade Younger.
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