Overview

Dementia is a term used to describe a group of symptoms affecting memory, thinking, and social abilities. In people who
have dementia, the symptoms interfere with their daily lives. Dementia isn’t one specific disease. Several diseases
can cause dementia.

Dementia generally involves memory loss, which is often one of the early symptoms of the condition. However, having
memory loss alone doesn’t necessarily mean one has dementia, as memory loss can have different causes.

Alzheimer’s disease is the most common cause of dementia in older adults, but there are other causes of dementia, and
depending on the cause, some dementia symptoms might be reversible.

Symptoms

Dementia symptoms vary depending on the cause. Common symptoms include:

Cognitive changes

  • Memory loss, which is usually noticed by someone else.
  • Problems communicating or finding words.
  • Trouble with visual and spatial abilities, such as getting lost while driving.
  • Problems with reasoning or problem-solving.
  • Trouble performing complex tasks.
  • Trouble with planning and organizing.
  • Poor coordination and control of movements.
  • Confusion and disorientation.

Psychological changes

  • Personality changes.
  • Depression.
  • Anxiety.
  • Agitation.
  • Inappropriate behavior.
  • Being suspicious, known as paranoia.
  • Seeing things that aren’t there, known as hallucinations.

When to See a Doctor

See a health care professional if you or a loved one has memory problems or other dementia symptoms. It’s important to
determine the cause, as some medical conditions that cause dementia symptoms can be treated.

Causes

Dementia is caused by damage to or loss of nerve cells and their connections in the brain. The symptoms depend on the
area of the brain that’s damaged. Dementia can affect people differently.

Dementias are often grouped by what they have in common, such as the protein or proteins deposited in the brain or the
part of the brain that’s affected. Additionally, some diseases have symptoms similar to dementia, and certain
medications can cause reactions that include dementia symptoms. Some cases of dementia-like symptoms can be reversed
with treatment, such as infections, immune disorders, metabolic or endocrine problems, low levels of certain nutrients,
or medicine side effects.

Progressive dementias get worse over time and include Alzheimer’s disease, vascular dementia, Lewy body dementia, and
frontotemporal dementia. Other disorders linked to dementia include Huntington’s disease, traumatic brain injury,
Creutzfeldt-Jakob disease, and Parkinson’s disease.

Risk Factors

Many factors can contribute to dementia, and some can’t be changed. Age, family history, and Down syndrome are
risk factors that can’t be changed. However, there are risk factors that can be addressed, including diet and exercise,
alcohol consumption, cardiovascular risk factors, depression, air pollution exposure, head trauma, sleep problems, low
levels of certain vitamins and nutrients, and certain medicines that can worsen memory.

Complications

Dementia can affect many body systems and, therefore, the ability to function. It can lead to poor nutrition,
pneumonia, inability to perform self-care tasks, personal safety challenges, and, in late-stage dementia, coma and
death.

Prevention

There’s no sure way to prevent dementia, but there are steps that might help reduce the risk. Keeping the mind active,
being physically and socially active, quitting smoking, getting enough vitamins, managing cardiovascular risk factors,
treating health conditions, maintaining a healthy diet, getting good-quality sleep, and treating hearing problems are
some of the preventive measures that might be beneficial.

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Diagnosis

To diagnose the cause of dementia, a health care professional must recognize the pattern of loss of skills and function.
They will review your medical history and symptoms and conduct a physical exam. Cognitive and neuropsychological tests
will be used to evaluate your thinking ability, and a neurological evaluation will assess various areas of brain
function. Brain scans, such as CT or MRI, can check for evidence of stroke, bleeding, tumor, or fluid buildup. PET scans
can show patterns of brain activity and determine if Alzheimer’s disease-related proteins like amyloid or tau have been
deposited in the brain. Laboratory tests, including blood tests and spinal fluid examination, can detect physical
problems that may affect brain function. A psychiatric evaluation may also be conducted to rule out mental health
conditions contributing to the symptoms.

Treatment

Most types of dementia cannot be cured, but there are ways to manage symptoms. Medications, such as cholinesterase
inhibitors (donepezil, rivastigmine, and galantamine) and memantine, can be used to temporarily improve dementia
symptoms by boosting chemical messengers involved in memory and brain function. Other medicines may be prescribed to
treat specific symptoms or conditions like depression, sleep problems, hallucinations, or agitation.

In 2021, the FDA approved aducanumab (Aduhelm) for the treatment of Alzheimer’s disease in some people. The medicine was
studied in people living with early Alzheimer’s disease and has shown promise in removing amyloid plaques in the brain.
However, its effectiveness in slowing cognitive decline is still debated, and insurance coverage is limited.

Another Alzheimer’s medicine, lecanemab (Leqembi), has also shown promise for people with mild Alzheimer’s disease and
mild cognitive impairment due to Alzheimer’s disease. It works by preventing amyloid plaques from clumping, and a phase
3 clinical trial found that it slowed cognitive decline in people with early Alzheimer’s disease by 27%. Side effects
include infusion-related reactions and swelling in the brain for some individuals.

Researchers are also studying the effectiveness of donanemab, which targets and reduces amyloid plaques and tau proteins.
A phase 3 clinical trial found that the medicine slowed cognitive and functional decline in people with early
Alzheimer’s disease by 35%.

Therapies other than medication can be used to treat dementia symptoms and behavior problems, including occupational
therapy, environmental changes, and simpler tasks. Lifestyle and home remedies, such as enhancing communication,
encouraging exercise, engaging in activities, establishing a nighttime routine, and keeping a calendar, can also help
manage symptoms.

Alternative Medicine

Several dietary supplements, herbal remedies, and therapies have been studied for people with dementia, but there’s no
convincing evidence that these treatments are effective. Caution is advised when considering such treatments, as claims
about their benefits are not always based on scientific research. Some studies suggest that vitamin E supplements may be
helpful for Alzheimer’s disease, but high doses can pose risks.

Other Therapies

Various techniques can help reduce agitation and promote relaxation in people with dementia, such as music therapy, light
exercise, watching videos of family members, pet therapy, aromatherapy, massage therapy, and art therapy.

Coping and Support

After being diagnosed with dementia, coping strategies and support systems become essential. Learning about the disease,
writing about feelings in a journal, joining support groups, seeking individual or family counseling, engaging in
activities for people with memory loss, and finding new ways to express oneself can be helpful. Caregivers and care
partners can offer reassurance, support, and positive communication to help the person with dementia retain dignity and
self-respect. Supportive services in the community, caregiver education programs, and caregiver support groups can also
be beneficial.

Preparing for Your Appointment

When preparing for an appointment with a health care professional regarding concerns about dementia, it’s helpful to make
a list of symptoms, personal information, and questions to ask the professional. Questions may include the likely cause
of symptoms, necessary tests, temporary or chronic nature of the condition, the best course of action, alternatives to
suggested approaches, management of dementia and other health issues together, and recommended resources for more
information.

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