Shopping on line can be easy, simple and save you lots of money. It can also take a lot of your time, frustrate you, and result in unwanted purchases. Now the same can be said for regular high street shopping, but with the vast opportunity presented by the Internet it will pay you to spend a few minutes reading this and understanding how to better optimize your Dementia shopping experience:
1. Compare - without doubt the biggest advantage that the Dementia offers shoppers today is the ability to compare thousands of Dementia at a time. This is a great thing, but not necessarily all the time! Too much can be daunting at times so take advantage of the great comparison sites and where possible let them do the hard work for you.
2. Research - if it has been said it will be on the internet. Ignorance is no longer a justifiable reason for buying the wrong thing. Take the time to research in detail everything that you could possible want to know about
3. Testimonials - don't know anybody that has bought a Dementia? Wrong! If the Dementia is good the internet will let you know. Use the Internet as a friend and get testimonials before you buy.
4. Questions - Got a question about Dementia then search the Forums, FAQ's, Blogs etc. Don't be afraid to ask .....
5. Reputation - Never heard of the company selling Dementia? Don't worry, no reason why you should know every company in the world, but you know someone that does! Use the internet to find out what people are saying about Dementia and build up a picture of their reputation for sales, returns, customer service, delivery etc.
6. Returns - still worried that even after all of the above your Dementia wont be what you want? Check out the returns policy. There is so much competition now that someone, somewhere is bound to offer the terms that you are comfortable with.
7. Feedback - happy with your Dementia then let people know, after all you are depending on others people input in your buying decision, so why not give a little back.
8. Security - check for the yellow padlock on the Dementia site before you buy, and the s after http:/ /i.e. https:// = a secure site
9. Contact - got a question about Dementia, or want to leave a comment then check out the sites contact page. Reputable companies have them and respond.
10. Payment - ready to pay for your Dementia, then use your credit card or PayPal! Be aware of companies that don't accept them, there may be genuine reasons but given the huge amount of choice you have when buying online there is no reason at all not to buy via credit card or PayPal.
{{DiseaseDisorder infobox |Name = Dimentia |
ICD10 = {{ICD10|F|00||f|00-->-{{ICD10|F|07||f|00-->|
ICD9 = {{ICD9|290-->-{{ICD9|294--> |
ICDO = |
Image = |
Caption = |
OMIM = |
MedlinePlus = 000739 |
eMedicineSubj = |
eMedicineTopic = |
DiseasesDB = 29283 |
-->
Dementia (from
Latin de- "apart, away" +
mens (
genitive case mentis) "mind") is the progressive decline in
cognition due to damage or disease in the
brain beyond what might be expected from normal ageing.
Particularly affected areas may be
memory, attention,
language, and
problem solving. Especially in the later stages of the condition, affected persons may be disorientation in time (not knowing what day of the week, day of the month, month, or even what year it is), in place (not knowing where they are), and in 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 percent of cases of dementia have been reversed. Dementia is a non-specific term encompassing many disease processes, just as
fever is attributable to many etiologies.
Without careful assessment, delirium can easily be confused with dementia and a number of other
psychiatric disorders because many of the signs and
symptoms are also present in dementia (as well as other mental illnesses including
depression (mood) and psychosis). American Family Physician, March 1, 2003 Delirium
Epidemiology
The
prevalence of dementia is rising as the global life expectancy is rising. Particularly in Western countries, there is increasing concern about the economic impact that dementia will have in future, older populaces. In Australia, the 2006 estimated prevalence of dementia is 1.03% of the population as a whole. Though reports of some of the longest living people claim them to be free of it (e.g. Yone Minagawa), it is a disease which is strongly associated with age; 1% of those aged 60-65, 6% of those aged 75-79, and 45% of those aged 95 or older suffer from the disease.
Diagnosis
The final diagnosis of dementia is made on the basis of the clinical picture, increasingly with neuroimaging results for backup. For research purposes, the diagnosis depends on both a clinical diagnosis and a pathological diagnosis (i.e., based on the examination of brain tissue, usually from
autopsy).
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), the mini mental state examination (MMSE), Modified Mini-Mental State Examination (3MS)Teng E L, Chui H C. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987;48:314–18. PMID 3611032, the Cognitive Abilities Screening Instrument (CASI)Teng E L, Hasegawa K, Homma A, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr 1994;6:45–58. PMID 8054493, and the clock drawing test.
An
abbreviated mental test score score of less than six (out of a possible score of ten) and an Mini-mental state examination score under 24 (out of a possible score of 30) suggests a need for further evaluation. Scores must be interpreted in the context of the person's educational and other background, and the particular circumstances (for example, a person in great pain will not be expected to do well on many tests of mental ability).
Mini-mental state examination
The U.S. Preventive Services Task Force (USPSTF) reviewed tests for cognitive impairment and concluded :
sensitivity 71% to 92%
specificity 56% to 96%
A copy of the
Mini-mental state examination can be found in the appendix of the original publication.
Modified Mini-Mental State examination (3MS)
A copy of the 3MS is online. A meta-analysis concluded that the Modified Mini-Mental State (3MS) examination has:Cullen B, O'Neill B, Evans JJ, Coen RF, Lawlor BA. A review of screening tests for cognitive impairment.J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):790-9. Epub 2006 Dec 18. PMID 17178826
sensitivity 83% to 94%
specificity 85% to 90%
Abbreviated mental test score
A meta-analysis concluded:
sensitivity 73% to 100%
specificity 71% to 100%
Other examinations
Many other tests have been studied including the clock-drawing test example form). Although some may emerge as better alternatives to the MMSE, presently the MMSE is the best studied. However, access to the MMSE is now limited by enforcement of its copyright (mini mental state examination ).
Further evaluation includes retesting at another date, and administration of other (and sometimes more complex) tests of mental function, such as formal neuropsychological testing.
Laboratory tests
Routine blood tests are also 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 in biology, 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
alcoholic beverage can also predispose the patient to cognitive changes suggestive of dementia.
Imaging
A Computed axial tomography or
magnetic resonance imaging (MRI scan) is commonly performed, although these modalities (as is noted below) may not have optimal sensitivity for the diffuse metabolic changes associated with dementia in a patient who shows no gross neurological problems (such as paralysis or weakness) on neurological exam. CT or MRI 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. Recently, the functional neuroimaging modalities of SPECT and
PET have shown quite similar ability to diagnose dementia as clinical exam (PMID 16785801). SPECT's ability to differentiate vascular type from Alzheimer disease types of dementias appears to be superior to clinical exam (PMID 15545324).
Types
Cortical dementias
Subcortical dementias
- Dementia due to Huntington's disease
- Dementia due to Hypothyroidism
- Dementia due to Parkinson's disease
- Dementia due to Vitamin B1 deficiency
- Dementia due to Vitamin B12 deficiency
- Dementia due to Folate deficiency
- Dementia due to Syphilis
- Dementia due to Subdural hematoma
- Dementia due to Hypercalcaemia
- Dementia due to Hypoglycemia
- AIDS dementia complex
- Pseudodementia (associated with clinical depression and bipolar disorder)
- Substance-induced persisting dementia (related to psychoactive use and formerly Absinthism)
- Dementia due to multiple etiologies
- Dementia due to other general medical conditions (i.e. end stage renal failure, cardiovascular disease etc.)
- Dementia not otherwise specified (used in cases where no specific criteria is met)
Dementia and early onset dementia have been associated with neurovisceral porphyrias. Porphyria is listed in textbooks in the differential diagnosis of dementia. Because acute intermittent porphyria, hereditary coproporphyria and variegate porphyria are aggravated by environmental toxins and drugs the disorders should be ruled out when these etiologies are raised.
Treatment
Except for the treatable types listed above, there is no cure to this illness, although scientists are progressing in making a type of medication that will slow down the process.
Acetylcholinesterase inhibitors are often used early in the disease course. Cognitive and behavioral interventions may also be appropriate. Educating and providing emotional support to the
caregiver (or carer) is of importance as well (
see also Elderly care).
A
Canadian study found that a lifetime of bilingualism has a marked influence on delaying the onset of dementia by an average of four years when compared to
monolingualism patients. The researchers determined that the onset of dementia symptoms in the monolingual group occurred at the mean age of 71.4, while the bilingual group was 75.5 years. The difference remained even after considering the possible effect of cultural differences, immigration, formal
education, employment and even gender as influences in the results.
Snoezelen that provide patients with a soothing and stimulating environment of light, color, music and scent have been used in the therapy of dementia patients.
Medications
Tacrine (Cognex),
donepezil (Aricept),
galantamine (Reminyl), and rivastigmine (Exelon) are approved by the United States Food and Drug Administration (FDA) for treatment of dementia induced by Alzheimer disease. They may be useful for other similar diseases causing dementia such as Parkinsons or vascular dementia.Lleo A, Greenberg SM, Growdon JH. Current pharmacotherapy for Alzheimer's disease. Annu Rev Med. 2006;57:513-33. Review. PMID 16409164
- N-methyl-D-aspartate Blockers
Drugs within the class known as
N-methyl-D-aspartate (NMDA) blockers include
memantine (Namenda), which has been approved by the FDA for the treatment of moderate-to-severe dementia.
Off label
- Amyloid deposit inhibitors
Minocycline and
Clioquinoline, antibiotics, may help reduce
amyloid deposits in the brains of persons with Alzheimer disease.Choi, Y., Kim, H.S., Shin, K.Y., Kim, E.M., Kim, M., Kim, H.S., Park, C.H., Jeong, Y.H., Yoo, J., Lee, J.P., Chang K.A., Kim S., & Suh, Y.H. Related Minocycline Attenuates Neuronal Cell Death and Improves Cognitive Impairment in Alzheimer's Disease Models.
Neuropsychopharmacology. 2007 Apr 4; PMID 17406652
Haloperidol (Haldol),
risperidone (Risperdal),
olanzapine (Zyprexa), and quetiapine (Seroquel) are frequently prescribed to help manage
psychosis and agitation. Treatment of dementia-associated psychosis or agitation is intended to decrease psychotic symptoms (for example, paranoia, delusions, hallucinations), screaming, combativeness, and/or violence.Wei, Z., Mousseau, D.D., Dai, Y., Cao, X., Li, X.M. (2006). Haloperidol induces apoptosis via the sigma2 receptor system and Bcl-XS.
Pharmacogenomics J. 6(4):279-88. Epub 2006 Feb 7. PMID 16462815Wang, H., Xu, H., Dyck, L.E., & Li, X.M. (2005). Olanzapine and quetiapine protect PC12 cells from beta-amyloid peptide(25-35)-induced oxidative stress and the ensuing apoptosis.
Journal Neuroscience Res, 81(4):572-80. PMID 15948179
Clinical depression is frequently associated with dementia and generally worsens the degree of cognitive and
behavioral impairment. Antidepressants may be helpful in alleviating cognitive and behavior symptoms by reuptaking neurotransmitter regulation through reuptake of serotonin, noradrenaline and
dopamine.
Many patients with dementia experience
anxiety symptoms. Although
benzodiazepines like diazepam (Valium) have been used for treating anxiety in other situations, they are often avoided because they may increase agitation in persons with dementia or are too sedating. Buspirone (Buspar) is often initially tried for mild-to-moderate anxiety.
Selegiline, a drug used primarily in the treatment of Parkinson's disease, appears to slow the development of dementia. Selegiline is thought to act as an
antioxidant, preventing
free radical damage. However, it also acts as a stimulant, making it difficult to determine whether the delay in onset of dementia symptoms is due to protection from free radicals or to the general elevation of brain activity from the stimulant effect.
Prevention
Since there is no cure for dementia, the best an individual can do is to prevent it from developing in the first place.
The main method to prevent dementia is to live an active life, both mentally and physically. It appears that the regular moderate consumption of alcohol (beer, wine or distilled spirits) may reduce risk. Mulkamal, K.J.,
et al. Prospective study of alcohol consumption and risk of dementia in older adults.
Journal of the American Medical Association, 2003 (March 19),
289, 1405-1413; Ganguli, M.,
et al. Alcohol consumption and cognitive function in late life: A longitudinal community study.
Neurology, 2005,
65, 1210-12-17; Huang, W.,
et al. Alcohol consumption and incidence of dementia in a community sample aged 75 years and older.
Journal of Clinical Epidemiology, 2002,
55(10), 959-964; Rodgers, B.,
et al. Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: The PATH Through Life Project.
Addiction, 2005,
100(9), 1280-1290; Anstey, K. J.,
et al. Lower cognitive test scores observed in alcohol are associated with demographic, personality, and biological factors: The PATH Through Life Project.
Addiction, 2005,
100(9), 1291-1301; Espeland, M.,
et al. Association between alcohol intake and domain-specific cognitive function in older women.
Neuroepidemiology, 2006,
1(27), 1-12; Stampfer, M.J.,
et al'. Effects of moderate alcohol consumption on cognitive function in women. New England Journal of Medicine
, 2005, 352
, 245-253; Ruitenberg, A., et al
. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet
, 2002, 359(9303)
, 281-286; Scarmeas, N., et al
. Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology
, 2006 (published online April 18, 2006). Furthermore, there are medications which might contribute to prevent the onset of dementia, including hypertension medications, anti-diabetic drugs and NSAIDs West Virginia Department of Health and Human Resources (with further links to experiments respectively).
Risk to self & others
Driving with Dementia could lead to severe injury or even death to self and others. Doctors should advise appropriate testing and on when to quit driving Drivers with dementia a growing problem, MDs warn, CBC News, Canada, September 19, 2007.
Services
Adult daycare centers as well as special care units in nursing homes often provide specialized care for dementia patients. Adult daycare centers offer supervision, recreation, meals, and limited health care to participants, as well as providing respite for caregivers.
==mnemonics to remember causes
References
External links
- "turmericextract.com" presents recent research on the effect of turmeric extract on plaque prevention in the alzheimer's form of dementia.
- An Amazing Documentary About Dementia Produced by Knowledge Network
- Dementia Research News from ScienceDaily
- The Dementia Services Development Centre, University of Stirling
- Dementia tutorial for U.K. practitioners by the Alzheimer's Society
-
- AlzheimersDementiaInfo - Articles and information regarding Alzheimer's disease and other elder care issues.
- Understanding Dementia: a primer of diagnosis and management
- AlzOnline - AlzOnline provides education, information, and support to persons caring for someone with Alzheimer's disease or a related memory problem.
- Drivers with dementia a growing problem, MDs warn, CBC News, Canada, September 19, 2007
{{DiseaseDisorder infobox |Name = Dimentia |
ICD10 = {{ICD10|F|00||f|00-->-{{ICD10|F|07||f|00-->|
ICD9 = {{ICD9|290-->-{{ICD9|294--> |
ICDO = |
Image = |
Caption = |
OMIM = |
MedlinePlus = 000739 |
eMedicineSubj = |
eMedicineTopic = |
DiseasesDB = 29283 |
-->
Dementia (from Latin
de- "apart, away" +
mens (
genitive case mentis) "mind") is the progressive decline in
cognition due to damage or
disease in the brain beyond what might be expected from normal
ageing.
Particularly affected areas may be memory, attention, language, and
problem solving. Especially in the later stages of the condition, affected persons may be
disorientation in time (not knowing what day of the week, day of the month, month, or even what year it is), in place (not knowing where they are), and in 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 percent of cases of dementia have been reversed. Dementia is a non-specific term encompassing many disease processes, just as fever is attributable to many etiologies.
Without careful assessment, delirium can easily be confused with dementia and a number of other psychiatric disorders because many of the signs and
symptoms are also present in dementia (as well as other
mental illnesses including depression (mood) and
psychosis). American Family Physician, March 1, 2003 Delirium
Epidemiology
The prevalence of dementia is rising as the global
life expectancy is rising. Particularly in Western countries, there is increasing concern about the economic impact that dementia will have in future, older populaces. In Australia, the 2006 estimated prevalence of dementia is 1.03% of the population as a whole. Though reports of some of the longest living people claim them to be free of it (e.g. Yone Minagawa), it is a disease which is strongly associated with age; 1% of those aged 60-65, 6% of those aged 75-79, and 45% of those aged 95 or older suffer from the disease.
Diagnosis
The final diagnosis of dementia is made on the basis of the clinical picture, increasingly with neuroimaging results for backup. For research purposes, the diagnosis depends on both a clinical diagnosis and a pathological diagnosis (i.e., based on the examination of brain tissue, usually from
autopsy).
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), the mini mental state examination (MMSE), Modified Mini-Mental State Examination (3MS)Teng E L, Chui H C. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987;48:314–18. PMID 3611032, the Cognitive Abilities Screening Instrument (CASI)Teng E L, Hasegawa K, Homma A, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr 1994;6:45–58. PMID 8054493, and the clock drawing test.
An
abbreviated mental test score score of less than six (out of a possible score of ten) and an Mini-mental state examination score under 24 (out of a possible score of 30) suggests a need for further evaluation. Scores must be interpreted in the context of the person's educational and other background, and the particular circumstances (for example, a person in great pain will not be expected to do well on many tests of mental ability).
Mini-mental state examination
The U.S. Preventive Services Task Force (USPSTF) reviewed tests for cognitive impairment and concluded :
sensitivity 71% to 92%
specificity 56% to 96%
A copy of the
Mini-mental state examination can be found in the appendix of the original publication.
Modified Mini-Mental State examination (3MS)
A copy of the 3MS is online. A meta-analysis concluded that the Modified Mini-Mental State (3MS) examination has:Cullen B, O'Neill B, Evans JJ, Coen RF, Lawlor BA. A review of screening tests for cognitive impairment.J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):790-9. Epub 2006 Dec 18. PMID 17178826
sensitivity 83% to 94%
specificity 85% to 90%
Abbreviated mental test score
A
meta-analysis concluded:
sensitivity 73% to 100%
specificity 71% to 100%
Other examinations
Many other tests have been studied including the clock-drawing test example form). Although some may emerge as better alternatives to the MMSE, presently the MMSE is the best studied. However, access to the MMSE is now limited by enforcement of its copyright (mini mental state examination ).
Further evaluation includes retesting at another date, and administration of other (and sometimes more complex) tests of mental function, such as formal neuropsychological testing.
Laboratory tests
Routine blood tests are also 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 in biology, 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 alcoholic beverage can also predispose the patient to cognitive changes suggestive of dementia.
Imaging
A
Computed axial tomography or magnetic resonance imaging (MRI scan) is commonly performed, although these modalities (as is noted below) may not have optimal sensitivity for the diffuse metabolic changes associated with dementia in a patient who shows no gross neurological problems (such as paralysis or weakness) on neurological exam. CT or MRI 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. Recently, the functional neuroimaging modalities of
SPECT and
PET have shown quite similar ability to diagnose dementia as clinical exam (PMID 16785801). SPECT's ability to differentiate vascular type from Alzheimer disease types of dementias appears to be superior to clinical exam (PMID 15545324).
Types
Cortical dementias
Subcortical dementias
- Dementia not otherwise specified (used in cases where no specific criteria is met)
Dementia and early onset dementia have been associated with neurovisceral porphyrias. Porphyria is listed in textbooks in the differential diagnosis of dementia. Because acute intermittent porphyria, hereditary coproporphyria and variegate porphyria are aggravated by environmental toxins and drugs the disorders should be ruled out when these etiologies are raised.
Treatment
Except for the treatable types listed above, there is no cure to this illness, although scientists are progressing in making a type of medication that will slow down the process. Acetylcholinesterase inhibitors are often used early in the disease course. Cognitive and behavioral interventions may also be appropriate. Educating and providing emotional support to the caregiver (or carer) is of importance as well (
see also Elderly care).
A Canadian study found that a lifetime of bilingualism has a marked influence on delaying the onset of dementia by an average of four years when compared to monolingualism patients. The researchers determined that the onset of dementia symptoms in the monolingual group occurred at the mean age of 71.4, while the bilingual group was 75.5 years. The difference remained even after considering the possible effect of cultural differences, immigration, formal
education, employment and even gender as influences in the results.
Snoezelen that provide patients with a soothing and stimulating environment of light, color, music and scent have been used in the therapy of dementia patients.
Medications
Tacrine (Cognex), donepezil (Aricept),
galantamine (Reminyl), and rivastigmine (Exelon) are approved by the United States Food and Drug Administration (FDA) for treatment of dementia induced by Alzheimer disease. They may be useful for other similar diseases causing dementia such as Parkinsons or vascular dementia.Lleo A, Greenberg SM, Growdon JH. Current pharmacotherapy for Alzheimer's disease. Annu Rev Med. 2006;57:513-33. Review. PMID 16409164
- N-methyl-D-aspartate Blockers
Drugs within the class known as
N-methyl-D-aspartate (NMDA) blockers include
memantine (Namenda), which has been approved by the FDA for the treatment of moderate-to-severe dementia.
Off label
- Amyloid deposit inhibitors
Minocycline and Clioquinoline, antibiotics, may help reduce amyloid deposits in the brains of persons with Alzheimer disease.Choi, Y., Kim, H.S., Shin, K.Y., Kim, E.M., Kim, M., Kim, H.S., Park, C.H., Jeong, Y.H., Yoo, J., Lee, J.P., Chang K.A., Kim S., & Suh, Y.H. Related Minocycline Attenuates Neuronal Cell Death and Improves Cognitive Impairment in Alzheimer's Disease Models.
Neuropsychopharmacology. 2007 Apr 4; PMID 17406652
Haloperidol (Haldol), risperidone (Risperdal), olanzapine (Zyprexa), and
quetiapine (Seroquel) are frequently prescribed to help manage psychosis and
agitation. Treatment of dementia-associated psychosis or agitation is intended to decrease psychotic symptoms (for example, paranoia, delusions, hallucinations), screaming, combativeness, and/or violence.Wei, Z., Mousseau, D.D., Dai, Y., Cao, X., Li, X.M. (2006). Haloperidol induces apoptosis via the sigma2 receptor system and Bcl-XS.
Pharmacogenomics J. 6(4):279-88. Epub 2006 Feb 7. PMID 16462815Wang, H., Xu, H., Dyck, L.E., & Li, X.M. (2005). Olanzapine and quetiapine protect PC12 cells from beta-amyloid peptide(25-35)-induced oxidative stress and the ensuing apoptosis.
Journal Neuroscience Res, 81(4):572-80. PMID 15948179
Clinical depression is frequently associated with dementia and generally worsens the degree of cognitive and behavioral impairment. Antidepressants may be helpful in alleviating cognitive and behavior symptoms by reuptaking neurotransmitter regulation through reuptake of
serotonin,
noradrenaline and
dopamine.
Many patients with dementia experience anxiety symptoms. Although
benzodiazepines like diazepam (Valium) have been used for treating anxiety in other situations, they are often avoided because they may increase agitation in persons with dementia or are too sedating.
Buspirone (Buspar) is often initially tried for mild-to-moderate anxiety.
Selegiline, a drug used primarily in the treatment of Parkinson's disease, appears to slow the development of dementia. Selegiline is thought to act as an
antioxidant, preventing
free radical damage. However, it also acts as a stimulant, making it difficult to determine whether the delay in onset of dementia symptoms is due to protection from free radicals or to the general elevation of brain activity from the stimulant effect.
Prevention
Since there is no cure for dementia, the best an individual can do is to prevent it from developing in the first place.
The main method to prevent dementia is to live an active life, both mentally and physically. It appears that the regular moderate consumption of alcohol (beer, wine or distilled spirits) may reduce risk. Mulkamal, K.J.,
et al. Prospective study of alcohol consumption and risk of dementia in older adults.
Journal of the American Medical Association, 2003 (March 19),
289, 1405-1413; Ganguli, M.,
et al. Alcohol consumption and cognitive function in late life: A longitudinal community study.
Neurology, 2005,
65, 1210-12-17; Huang, W.,
et al. Alcohol consumption and incidence of dementia in a community sample aged 75 years and older.
Journal of Clinical Epidemiology, 2002,
55(10), 959-964; Rodgers, B.,
et al. Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: The PATH Through Life Project.
Addiction, 2005,
100(9), 1280-1290; Anstey, K. J.,
et al. Lower cognitive test scores observed in alcohol are associated with demographic, personality, and biological factors: The PATH Through Life Project.
Addiction, 2005,
100(9), 1291-1301; Espeland, M.,
et al. Association between alcohol intake and domain-specific cognitive function in older women.
Neuroepidemiology, 2006,
1(27), 1-12; Stampfer, M.J.,
et al'. Effects of moderate alcohol consumption on cognitive function in women. New England Journal of Medicine
, 2005, 352
, 245-253; Ruitenberg, A., et al
. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet
, 2002, 359(9303)
, 281-286; Scarmeas, N., et al
. Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology
, 2006 (published online April 18, 2006). Furthermore, there are medications which might contribute to prevent the onset of dementia, including hypertension medications, anti-diabetic drugs and NSAIDs West Virginia Department of Health and Human Resources (with further links to experiments respectively).
Risk to self & others
Driving with Dementia could lead to severe injury or even death to self and others. Doctors should advise appropriate testing and on when to quit driving Drivers with dementia a growing problem, MDs warn, CBC News, Canada, September 19, 2007.
Services
Adult daycare centers as well as special care units in nursing homes often provide specialized care for dementia patients. Adult daycare centers offer supervision, recreation, meals, and limited health care to participants, as well as providing respite for caregivers.
==mnemonics to remember causes
References
External links
- "turmericextract.com" presents recent research on the effect of turmeric extract on plaque prevention in the alzheimer's form of dementia.
- An Amazing Documentary About Dementia Produced by Knowledge Network
- Dementia Research News from ScienceDaily
- The Dementia Services Development Centre, University of Stirling
- Dementia tutorial for U.K. practitioners by the Alzheimer's Society
-
- AlzheimersDementiaInfo - Articles and information regarding Alzheimer's disease and other elder care issues.
- Understanding Dementia: a primer of diagnosis and management
- AlzOnline - AlzOnline provides education, information, and support to persons caring for someone with Alzheimer's disease or a related memory problem.
- Drivers with dementia a growing problem, MDs warn, CBC News, Canada, September 19, 2007
Dementia Introduction - Health encyclopaedia - NHS Direct
Mental deterioration due to physical changes in the brain ... Dementia is the loss (usually gradual) of mental abilities such as thinking, remembering, and reasoning.
Dementia Research Centre
Centre for clinical research into dementia based at The National Hospital for Neurology and Neurosurgery, London. Site contains details of research projects.
for dementia: homepage
Works in partnership to provide the specialist Admiral Nurse Service to support the carers of people with dementia; and through its training arm Carers of the Elderly, provides ...
Dementia
Dementia is an illness of the brain. When someone has dementia, brain cells are damaged and die faster than they would normally. Losing brain cells means that the brain does not ...
Dementia
The summary of the published clinical guideline on alzheimer's disease, dementia with Lewy bodies (DLB), frontotemporal dementia, vascular dementia and mixed dementias, as well as ...
BBC - Health - Conditions - Dementia
A guide to dementia ... Dementia. Dr Trisha Macnair. Many people assume a loss of mental agility is an evitable part of ageing.
Understanding dementia
Introduction page to dementia guide. ... Print options and next steps. Print an information prescription containing all the facts you need on Dementia and where to get help in your ...
The Dementia Services Development Centre
Registered charity based at the University of Stirling seeking to improve understanding of dementia and improve the standard of care for dementia patients. Services on offer ...
Causes of dementia - Alzheimer's Society
Alzheimer's Society - Causes of dementia - Information about different causes of dementia ... The term 'dementia' is used to describe the symptoms that occur when the brain is ...
About dementia - Alzheimer's Society
about dementia - information on living with dementia, carers, family and friends, information for health professionals