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Dementia Information

  • Dementia is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Particularly affected areas may be memory, attention, language and problem solving, although particularly in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, what month or even what year it is), place (not knowing where they are) and person (not knowing who they are). Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10% of all dementias are reversible. Dementia is a non-specific term that encompasses many disease processes, just as fever is attributable to many etiologies...
  • Proper differential diagnosis between the types of dementia (see below) will require, at the least, referral to a specialist, e.g. a geriatric internist, geriatric psychiatrist, neurologist, neuropsychologist or geropsychologist. However, there are some brief (5-15 minutes) tests that have good reliability and can be used in the office or other setting to evaluate cognitive status. Examples of such tests include the abbreviated mental test score (AMTS) and the mini mental state examination (MMSE).

    An AMTS score of less than six and an MMSE score under 24 suggests a need for further evaluation. Of course, this must be interpreted in the context of the person's educational and other background, and particular circumstances. Routine blood tests are usually performed to rule out treatable causes. These tests include vitamin B12, folic acid, thyroid-stimulating hormone (TSH), C-reactive protein, full blood count, electrolytes, calcium, renal function and liver enzymes. Abnormalities may suggest vitamin deficiency, infection or other problems that commonly cause confusion or disorientation in the elderly. Chronic use of substances such as alcohol can also predispose the patient to cognitive changes suggestive of dementia.

    A CT scan or magnetic resonance imaging (MRI scan) is commonly performed. This may suggest normal pressure hydrocephalus, a potentially reversible cause of dementia, and can yield information relevant to other types of dementia, such as infarction (stroke) that would point at a vascular type of dementia. Sometimes neuropsychological testing is helpful as well.

    The final diagnosis of dementia is made on the basis of the clinical picture. For research purposes, the diagnosis depends on both a clinical diagnosis and a pathological diagnosis (ie, based on the examination of brain tissue, usually from autopsy).

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Health Blogs

A brief at-home test newly designed by researchers at The Ohio State University Wexner Medical Center may be able to detect early signs of dementia. The test, which can be self-administered with just a pen and paper, takes about 10 to 15 minutes to complete and can be scored by a physician. Called the Self-Administered Gerocognitive ... Read More »
Cognitive Remediation (CR) is not a new technique but one that is seeing a resurgence, which is proving incredibly useful to those suffering from moderate to severe mental illness. CR is different from Cognitive Behavioral Therapy (CBT) but employs some of the same techniques. CBT teaches you to think your way through emotionally challenging ... Read More »
Turns out, it’s not what you think. Chronic medical problems like diabetes, high blood pressure, and heart disease do bring men and women to the doctor but not as often as other things. The most common reasons folks in the U.S. go to the doctor may surprise you, and skin is a huge player.
1. Skin disorders. Actinic keratosis, ... Read More »

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