Dementia is not diseased itself, instead its groups of diseases characterized by loss of previously acquired intellectual function in the absence of impairment of consciousness. It affects mental tasks like thinking, reasoning and memory severe enough to interfere with day to day activities. However, only memory loss can’t be dementia.
Epidemiology: who gets dementia?
Dementia mostly develops in older adults. Very rare below 55yrs of age.5%-10% Above 65yrs,20% occur above 80yrs and almost 70% of those over 100yrs. It became a social problem day by day as the number of older adults is increasing.
What causes dementia?
Dementia developed when different parts of the brain involved in memory, learning, language and decision making are affected by the various disease. There are many factors that may cause dementia.Degenerative/inherited diseases like Alzheimer’s, Wilson’s, Pick’s disease. A diffuse vascular illness like multiple strokes. A deadly/Nutritional disease like excess alcohol intake, Thiamin and vitamin-B12 deficiency. Brain and spinal cord infection like Syphilis, HIV, Creutzfeldt-Jakob disease. Communicative/non-communicative normal pressure hydrocephalus. Single severe or multiple small head injuries occur in boxing; chronic subdural hematoma may cause dementia. However, rarer causes of dementia should be more actively sought in younger patients and those with short histories. See more about Types of Dementia
Is memory loss only conclude dementia?
If anybody is experiencing some troubling memory problem, we should not conclude it as dementia. In addition to remembering a person needs to have at least one type following of impairments like communication or language problems, reasoning, focus or personality disturbance.
Investigations to diagnose Dementia
The aim is to ensure treatable cause. Imaging of the brain (CT and or MRI) is essential to find out the treatable cause. Blood tests-Full blood count, ESR, Urea and electrolytes, glucose, Thyroid function tests, Vitamin B12, VDRL, ANA, anti-dsDNA, Chest X-ray, EEG. In some rare cases lumber puncture, HIV serology and brain biopsy also done.
Management of Dementia
Removing correctable causes and providing support for the patient is the primary aim of treatment. Anticholinesterases, such as donepezil, rivastigmine and galantamine, or NMDA ( N-methyl-D-aspartate receptor antagonist improve cognitive function to some extent in Alzheimer’s disease.