Dementia

• Definition
· Dementia is the age-related disease of progressive deterioration in the functioning of the brain.

· Dementia is usually the result of some type of brain damage. The damage can result from: deposition of certain proteins inhibiting nerve function, premature nerve cell death, nerve cell death from obstructed blood flow, head injuries, and exposure to toxins.

· Impairments include short-term memory loss, decreasing intellect, difficulty recalling names and in advanced states impairment in balance, speaking and swallowing.

· Impairment in cognitive function is in excess for age.

· Alzheimer’s disease is the most common form of dementia.

· Dementia is a chronic disease.

• Overview:
· Alzheimer’s disease is the most common form of dementia and is the eighth leading cause of death in the United States. The prevalence of dementia increases with age and reaches 50% by age 85.

· Factors associated with the development of dementia include: advanced age, a family history of dementia, lower education level, hypertension, high cholesterol, elevated levels of homocysteine, excessive alcohol intake, and previous head trauma.

· In contrast to dementia, benign forgetfulness associated with normal aging is usually limited to difficulties with word-finding and slight impairments in concentration.

· Potentially reversible forms of dementia can be caused by: diseases of the thyroid, deficiencies in vitamins B1 and B12, high blood calcium levels, a hemorrhage around the brain, infection with HIV and medications side effects. Depression can mimic dementia and should resolve with treatment of depression.

• Types of dementia
· Alzheimer’s disease is the most common form dementia affecting 24 million people worldwide. We believe the disease results from the deposition of abnormal proteins called amyloid plaques and tangles.

· Vascular dementia is dementia resulting from multiple silent stokes. This is the second most common form of dementia in the United States

· Dementia with Lewy bodies is a form of dementia resulting impaired nerve function from the abnormal deposition of a protein within nerve cells throughout the brain and these proteins are called Lewy bodies.

· Pick’s disease is the fourth most common form of dementia and results from a genetic mutation leading to atrophy of the frontal and temporal areas of the brain.

· Alcohol-Induced Dementia is a form of dementia that develops in chronic alcoholics and is believed to result from the toxic affect of alcohol on nerves leading to impaired nerve function.

· Korsakoff’s syndrome is a form of dementia which develops from a deficiency of Thiamine (Vitamin B1). This form of dementia can occur in chronic alcoholics and in people with serve malnutrition.

• Treatment
· Acetylcholinesterase inhibitors are the most common medications used in the treatment of dementias.

· Acetylcholinesterase inhibitors are a group of medications that inhibit the breakdown of the neurotransmitter acetylcholine.

· Higher levels of brain acetylcholine facilitates the communication between nerves.

• Prognosis:
· The life expectancy for patients diagnosed with Alzheimer’s disease is usually 3-15 years. Other forms of dementia and Lewy body disease usually deteriorate faster.

References
EMBO J. 2008 Jan 23;27(2):336-49.PMID: 18216876
Trinh NH et al: Efficacy of cholinesterase inhibitors in the treatment of neuropsychiatric symptoms and functional impairment in Alzheimer disease: a meta-analysis. JAMA 2003;289:210. [PMID: 12517232]
J Mol Neurosci. 2008;34(1):1-7. Epub 2007 Apr 17. Review. PMID: 18157652
Lancet Neurol. 2008 Jan;7(1):2-3. PMID: 18093545

Posted on November 24, 2008

One Response to “Dementia”

  1. Health and Wellness: Medicues Tremor may indicate increased risk of Dementia says:
    August 28, 2009 at 9:06 pm

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