DementiaReed Radford

What is dementia? Dementia is a serious loss of global cognitive ability, beyond

what might be expected from normal aging. To put it simply, it is a result of the general atrophy of the

brain.

What is dementia? The word "Dementia" stems from the Latin prefix 'de'

meaning without, and 'ment' meaning the mind. Dementia literally means the loss of the mind.

It can be classified as a psychological disorder and as a symptom of neurological diseases like Alzheimer's.

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History Mental decline with age has been observed for thousands of

years, but was not differentiated from what we consider dementia until more recently.

 Up until the early nineteenth century, all neurodegenerative diseases were classified as dementias, including syphilis and Parkinson's. It was, at this time, believed to be caused by the hardening of arteries with age.

As scientists discovered the common underlying causes for dementia, it became considered a symptom of neurological diseases and a psychological disorder, rather than a neurological disorder itself.

Causes Many disorders can cause dementia. The most common include Alzheimer’s and strokes in the

elderly, and traumatic brain injury among younger people. It can be caused by vascular problems, neurological damage

on a cellular or regional level, or liver failure.

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Diagnosis/Symptoms Dementia is diagnosed based on, according to the DSM-IV:

"A. The development of multiple cognitive deficits manifested by both:1.Memory impairment (impaired ability to learn new information or to recall previously learned information)2.One or more of the following cognitive disturbances:(a) aphasia (language disturbance)(b) apraxia (impaired ability to carry out motor activities depite intact motor function)(c) agnosia (failure to recognize or identify objects despite intact sensory function)(d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)

Diagnosis/Symptoms B. The cognitive deficits in criteria A1 and A2 each cause

significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.C. The course is characterized by gradual onset and continuing cognitive decline.E. The deficits do not occur exclusively during the course of a delirium."

Treatment Every individual cause of dementia generally has it's own

associated treatment Some dementia causing diseases, like Creutzfeldt–Jakob

disease, have no cure nor any effective treatments. Some, like Rabies, can be prevented but not cured. In some cases, the effects of dementia can lessen over time

without treatment.

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Treatment of Alzheimers Alzheimer's induced dementia can be treated with the use of

drugs that block NMDA receptors, because hyperactive NMDA associated with Alzheimer's is thought to play a large role in the neurodegeneration associated with the disease, and also means useful nerve transmissions don't get drowned out by too much activity in cells utilizing NMDA.

Drugs that prevent the breakdown of the neurotransmitter acetylcholine are also used, since acetylcholine plays a large role in executive brain functioning.

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Treatment of Vascular Dementia Antiplatelet drugs and controlling major vascular risk factors

(hypertension, hypercholesterolemia, smoking and diabetes mellitus to mention a few) are utilized to treat vascular dementias.

These reduce the risk of further stroke, but do not lessen the cognitive impairment.

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