You have a word on the tip of your tongue, but cannot recall it. You put your keys in a safe place, but cannot find them. These memory lapses may be frustrating, but most likely are not serious. However, you may have cause for concern if you have difficulty performing familiar tasks, lose interest in usual activities, or exhibit personality changes. These may be symptoms of dementia, a neurological disorder that makes it difficult to communicate, learn and remember.
Dementia is not a specific disease, but instead refers to a group of symptoms caused by brain disorders. The difference between simple memory lapses and dementia is that the signs and symptoms of dementia gradually worsen over time. The diagnosis of dementia may be made when two or more brain functions are significantly impaired, such as memory, speech, perception, or cognitive skills such as reasoning or judgment.
The most common form of dementia is Alzheimer’s disease, a condition that results from the death of nerve cells in areas of the brain that control cognitive function and memory. Other forms of dementia include vascular dementia, which is caused by narrowed or blocked arteries in the brain, Lewy body dementia, the result of abnormal clumps of protein in the brain, and frontotemporal dementia, which is characterized by the deterioration of nerve cells in the front and temporal areas of the brain. Certain conditions also may cause dementia or dementia-like symptoms, such as reactions to medications, infections, emotional distress, endocrine or metabolic disturbances, nutritional deficiencies or brain tumors. In some cases, these conditions may be reversed with appropriate treatment.
Genes have been shown to play a role in the onset of certain types of dementia, but lifestyle choices and environmental factors may influence the progression of the disorder as well. Risk factors for developing dementia include advancing age, family history of the condition, smoking or alcohol abuse, high cholesterol, diabetes, Down syndrome, elevated homocysteine (an amino acid in the blood) level or atherosclerosis (plaque buildup in the arteries).
Dementia can be diagnosed using several different approaches. A typical medical evaluation may include:
- Taking a health history and completing a physical examination to rule out treatable conditions.
- Performing a neurological evaluation to check the patient’s balance, sensory abilities or reflexes.
- Reviewing results from laboratory tests, such as a blood test or urinalysis, to exclude possible metabolic conditions or vitamin deficiencies.
- Using cognitive or neuropsychological tests to evaluate mental functions, such as memory, problem-solving, language or judgment.
- Performing brain scans using magnetic resonance imaging or computed tomography to show evidence of a stroke or tumor.
Depending on the form of dementia that has been diagnosed, treatment may include cognitive training using memory aids to perform certain tasks or taking medications. Taking drugs may improve the patient’s quality of life and slow the onset of symptoms, but they will not stop the disease or reverse brain damage. For more information about dementia, talk with your doctor or visit the National Institute of Neurological Disorders and Stroke Web site at www.ninds.nih.gov.