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Dementia Definition Dementia isn't a specific disease.

Instead, it describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. It's caused by conditions or changes in the brain. Different types of dementia exist, depending on the cause. Alzheimer's disease is the most common type. Memory loss generally occurs in dementia, but memory loss alone doesn't mean you have dementia. Dementia indicates problems with at least two brain functions, such as memory loss along with impaired judgment or language. Dementia can make you confused and unable to remember people and names. You may also experience changes in personality and social behavior. However, some causes of dementia are treatable and even reversible. Symptoms Dementia symptoms vary depending on the cause, but common signs and symptoms include: Memory loss Difficulty communicating Inability to learn or remember new information Difficulty with planning and organizing Difficulty with coordination and motor functions Personality changes Inability to reason Inappropriate behavior Paranoia Agitation

Hallucinations When to see a doctor See a doctor if you or a loved one experiences memory problems or other dementia symptoms. Some medical conditions can cause symptoms of dementia and are treatable, so it's important that a doctor determine the underlying cause. Early diagnosis is also important so that treatment can begin before symptoms get worse.

If the diagnosis is a dementia that will progressively worsen over time, such as Alzheimer's disease, early diagnosis also gives a person time to plan for the future while he or she can still participate in making decisions.

If a cause of dementia has already been diagnosed, talk with a doctor if symptoms seem to be getting worse.

Causes By Mayo Clinic staff Dementia has many causes. It's not always caused by the same disease. And some dementias such as Alzheimer's disease occur on their own, not as a result of another disease. Much is still unknown about how some diseases may be linked to dementia.

Dementias can be classified in a variety of ways and are often grouped together by what they have in common, such as what part of the brain is affected, or whether they get worse with time (progressive dementias). Some dementias, such as those caused by a reaction to medications or an infection, are reversible with treatment.

Progressive dementias Several main types of progressive dementia dementias that get worse with time exist.

Alzheimer's disease. Alzheimer's disease is caused by the destruction of brain cells. Although the exact cause isn't known, two types of brain cell (neuron) damage

are common in people who have Alzheimer's disease. These include plaques (clumps of a normally harmless protein called beta-amyloid) and tangles (fibrous tangles made up of an abnormal protein called tau protein). Alzheimer's disease usually progresses slowly, over seven to 10 years, causing a gradual decline in cognitive abilities. Eventually, the affected part of the brain isn't able to work properly because of limited functions, including those involving memory, movement, language, judgment, behavior and abstract thinking. Alzheimer's disease is the most common cause of dementia in people age 65 and older. Symptoms usually appear after age 60, although early-onset forms of the disease can occur, usually as the result of a defective gene. Lewy body dementia. Lewy bodies are abnormal clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease. The symptoms of this dementia are similar to Alzheimer's disease, but its unique features often include fluctuations in confusion and clear thinking (lucidity), visual hallucinations and Parkinson's signs like tremor and rigidity. These people will often have a condition called REM sleep behavior disorder (RBD) that involves acting out dreams, including thrashing or kicking during sleep. Vascular dementia. This dementia is a result of damage to your brain caused by problems with the arteries serving your brain or heart. Symptoms begin suddenly, often after a stroke, and may occur in people with high blood pressure, or previous strokes or heart attacks. Vascular dementia may also be caused by infection of a heart valve (endocarditis) or a buildup of amyloid protein in the brain's blood vessels (amyloid angiopathy) that sometimes causes "bleeding" (hemorrhagic) strokes. Several types of vascular dementia exist and vary in their causes and symptoms. Some types only affect one side of the body, and some cause memory loss, confusion and mood changes. In some forms, symptoms may progressively worsen while in others, they may appear only temporarily. In general, vascular dementia is more common with age. Often this dementia coexists with Alzheimer's disease.

Frontotemporal dementia. This is a group of diseases characterized by the

degeneration of nerve cells in the frontal and temporal lobes of the brain the areas generally associated with personality, behavior and language. The cause isn't known, although in some cases this dementia is related to certain genetic mutations. But many people have no family history of dementia. Also, for some people with a form of this condition called Pick's disease, the affected parts of the brain contain fibrous tangles made up of the abnormal protein called tau protein. Pick's disease causes progressive dementia. Signs and symptoms of frontotemporal dementia which can include socially inappropriate behaviors, loss of mental flexibility, language problems and difficulty with thinking and concentration usually appear between the ages of 40 and 65. Other disorders linked to dementia

Huntington's disease. This inherited disease causes certain nerve cells in your brain and spinal cord to waste away. Signs and symptoms typically appear during your 30s or 40s. They may include mild personality changes at first irritability, anxiety and depression and progress to severe dementia. Huntington's disease also causes difficulty with walking and movement, weakness and clumsiness. Dementia pugilistica. This condition, also called chronic traumatic encephalopathy or boxer's dementia, is caused by repetitive head trauma, such as experienced by boxers. Depending on the part of the brain injured, it can cause dementia signs and symptoms such as memory problems, poor coordination and impaired speech, as well as tremors, slow movement and muscle stiffness (parkinsonism). Symptoms may not appear until many years after the actual trauma. A single traumatic head injury can cause posttraumatic dementia, which is much like dementia pugilistica, but may include long-term memory problems. HIV-associated dementia. Infection with the human immunodeficiency virus (HIV), which causes AIDS, leads to widespread destruction of brain matter and results in impaired memory, apathy, social withdrawal and difficulty

concentrating. Often, problems with movement also develop. Creutzfeldt-Jakob disease. This rare, fatal brain disorder most often occurs sporadically in people with no known risk factors. However, a few cases are hereditary or caused by exposure to diseased brain or nervous system tissue. Signs and symptoms usually appear around age 60 and initially include problems with coordination, personality changes and impaired memory, judgment, thinking and vision. Mental impairment becomes severe as the illness progresses, and it often leads to blindness. Pneumonia and other infections also are common. Secondary dementias. Sometimes, people with other disorders that primarily affect movement, for example, Parkinson's disease, may eventually develop symptoms of dementia. The relationship between these disorders and dementia isn't completely understood. Dementia causes that can be reversed Some causes of dementia or dementia-like symptoms can be reversed. Your doctor can identify and treat causes such as:

Infections and immune disorders. Dementia can result from fever or other side effects of your body's attempt to fight off an infection. Examples of such infections include brain infections like meningitis and encephalitis, untreated syphilis, Lyme disease, and conditions that cause a completely compromised immune system, such as leukemia. Conditions such as multiple sclerosis that arise from the body's immune system attacking nerve cells also can cause dementia. Metabolic problems and endocrine abnormalities. These include thyroid problems, too little sugar in the bloodstream (hypoglycemia), too little or too much sodium or calcium, and an impaired ability to absorb vitamin B-12. Nutritional deficiencies. Symptoms can occur as a result of dehydration, not having enough thiamin (vitamin B-1) a condition common in people with chronic alcoholism and deficiencies in vitamins B-6 and B-12. Bananas, lentils, spinach, fortified breakfast cereals, salmon, pork, chicken, whole-wheat bread,

milk and eggs are all good sources of these B vitamins. Reactions to medications. Dementia may occur as a reaction to a single medication or because of an interaction of several drugs. Subdural hematomas. These are caused by bleeding between the brain's surface and its outer covering. Poisoning. Dementia symptoms can occur as a result of exposure to heavy metals, such as lead or manganese, and other poisons, such as pesticides. People who have abused alcohol and recreational drugs also sometimes display symptoms. In all of these instances, symptoms may go away after treatment or after exposure to the substance has ended. Brain tumors. It's rare, but dementia can be the result of damage caused by a brain tumor. Anoxia. This condition, also called hypoxia, occurs when not enough oxygen gets to organ tissue. Causes include heart attack, severe asthma, carbon monoxide poisoning, strangulation, high-altitude exposure or an overdose of anesthesia. Recovery depends on the severity of the oxygen deprivation. Symptoms may occur during recovery. Heart and lung problems. Your brain can't survive without oxygen. Symptoms may occur in people with chronic lung problems or a heart condition that deprives the brain of the oxygen it needs. Risk factors By Mayo Clinic staff Many factors can eventually lead to dementia. Some, such as age, can't be changed. Others can be addressed to reduce your risk.

Risk factors that can't be changed

Age. The risk of Alzheimer's disease, vascular dementia and several other

dementias increases significantly with age. However, dementia isn't a normal part of aging. Family history. People with a family history of dementia are at greater risk of developing it. However, many people with a family history never develop symptoms, and many people without a family history do. If you have specific genetic mutations, you're at significantly greater risk of developing certain types of dementia. Tests to determine whether you have such genetic mutations are only available for the disorders in which the specific mutation is known, for example Huntington's disease. Risk factors you can change To reduce your risk of dementia, you can take steps to control the following factors.

Alcohol use. Consuming large amounts of alcohol appears to increase the risk of dementia. Although studies have shown that moderate amounts of alcohol one drink a day for women and two for men especially red wine, have a protective effect, abuse of alcohol puts you at increased risk of developing dementia. Atherosclerosis. This buildup of fats and other substances in and on your artery walls (plaques) is a significant risk factor for vascular dementia because it interferes with blood flow to your brain. This can lead to stroke. Studies have also shown a possible link between atherosclerosis and Alzheimer's disease. Blood pressure. Blood pressure that's too high, and also possibly too low, can put you at risk of developing Alzheimer's disease and vascular dementia. Cholesterol. High levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, can significantly increase your risk of developing vascular dementia. Some research has also linked it to an increased risk of developing Alzheimer's disease. Depression. Although not yet well understood, late-life depression, especially in men, may be an indication for the development of Alzheimer's-related

dementia. Diabetes. If you have type 2 diabetes, you're at increased risk of developing both Alzheimer's disease and vascular dementia. High estrogen levels. High levels of total estrogen in women have been associated with greater risk of developing dementia. This can be determined through a blood test. Homocysteine blood levels. Elevated blood levels of homocysteine a type of amino acid produced by your body may increase your risk of developing Alzheimer's disease and vascular dementia. When working properly, your body breaks down homocysteine using vitamins B-6, B-12 and folic acid. If this isn't happening properly, it may be because you don't metabolize these vitamins well, or you don't have enough of them in your diet. Blood tests can determine whether you have elevated homocysteine levels. Smoking. Smoking likely increases the risk of developing dementia because it puts you at a higher risk of atherosclerosis and other types of vascular disease.

Complications By Mayo Clinic staff Dementia can affect the functioning of many body systems and, therefore, the ability to carry out day-to-day tasks. Dementia may lead to problems such as:

Inadequate nutrition. Nearly everyone who has dementia will at some point reduce or stop eating and drinking. Often, advanced dementia causes people to lose control of the muscles used to chew and swallow, putting them at risk of choking or aspirating food into their lungs. If this happens, it can block breathing and cause pneumonia. People with advanced dementia also lose the feeling of hunger and, with it, the desire to eat. Depression, side effects of medications, constipation, and other conditions such as infections also can decrease a person's interest in food.

Reduced hygiene. In the moderate to severe stages of dementia, you lose the ability to independently complete daily living tasks. You may no longer be able to bathe, dress, brush your teeth and go to the toilet on your own. Difficulty taking medications. Because a person's memory is affected, remembering to take the correct amount of medications at the right time can be challenging. Deterioration of emotional health. Dementia changes behaviors and personality. Some of the changes may be caused by the actual deterioration happening in a person's brain, while other behavioral and personality changes may be reactions to the emotional challenges of coping with the deterioration changes. Dementia may lead to depression, aggression, confusion, frustration, anxiety, a lack of inhibition and disorientation. Difficulty communicating. As dementia progresses, the ability to remember the names of people and things may be lost. This makes communication difficult at all levels, whether to let a caregiver know what you need and how you feel or simply to communicate socially. Difficulty communicating can lead to feelings of agitation, isolation and depression. Delirium. This state is characterized by a decline in attention, awareness and mental clarity. Delirium is common in people with dementia, especially when admitted to the hospital. It appears that the sudden change in surroundings, activity level and other routines may be the cause. Problems sleeping. Disruption of the normal sleep-wake cycle being up at night and sleeping during the day is very common. Insomnia is another common complication, as are restless legs syndrome and sleep apnea, which can also interfere with sleep. Personal safety challenges. Because of a reduced capacity for decision making and problem solving, some day-to-day situations can present safety issues for people with dementia. These include driving, cooking, falling and negotiating obstacles. Preparing for your appointment By Mayo Clinic staff

Most likely, you'll first see your primary care provider if you have concerns about dementia. In some cases, you may be referred to a doctor who specializes in specific symptoms, such as a neurologist for brain and nerve disorders. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your appointment.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance. Write down any symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment. Write down key personal information, including any major stresses or recent life changes. Make a list of all medications, as well as any vitamins or supplements, being taken. Take a family member, friend or caregiver along, if possible. Sometimes it can be difficult to soak up all the information provided during an appointment. Time with the doctor is limited, so preparing a list of questions will help make the most of that time. List questions from most important to least important in case time runs out. For dementia, some basic questions to ask the doctor include:

What is likely causing symptoms? Are there other possible causes for symptoms? What kinds of tests are necessary? Is the condition likely temporary or chronic? What's the best course of action?

What are the alternatives to the primary approach being suggested? How can dementia and additional health issues best be managed together? Are there any restrictions? Should a specialist be consulted? What will that cost, and will insurance cover it? Is there a generic alternative to the medicine being prescribed? Are there any brochures or other printed material or Web sites to look at? In addition to these questions, don't hesitate to ask questions about anything you don't understand during the appointment.

What to expect from your doctor The doctor is likely to ask you and your caregiver a number of questions such as:

What are the symptoms, for example, trouble finding words, remembering events, focusing attention, changes in personality, getting lost? When did symptoms begin? Have symptoms been continuous or occasional? How severe are symptoms? What, if anything, seems to improve symptoms? What, if anything, appears to worsen symptoms? Is there a family history of dementia or related conditions such as Huntington's or Parkinson's disease? Are there any activities that have had to stop because of difficulty thinking through them?

Tests and diagnosis By Mayo Clinic staff Memory loss and other dementia symptoms have many causes, so diagnosis can be challenging and may require several doctor visits. Diagnosis involves a number of tests.

Medical history and physical exam

Medical history. The doctor will ask about how and when symptoms began and about any health issues that may help identify the cause of the problem, for example diabetes, high blood pressure or a family history of dementia. In addition, the doctor may request information from your caregiver or family member to find out whether your concerns represent a change from your earlier level of functioning.

Physical examination. A physical exam helps your doctor rule out treatable causes of dementia and identify signs of stroke or other disorders that may cause similar symptoms. It also helps your doctor determine the best course of treatment. As part of an exam, your doctor may collect urine or blood samples, check blood pressure and review what medications you're using. This examination can also help identify signs of other illnesses, such as heart disease, diabetes or thyroid abnormalities and any medication side effects, which can overlap with dementia.

Cognitive and neuropsychological tests Anyone screened for dementia needs his or her cognitive function evaluated. A number of tests measure orientation, general intellectual skills, academic skills, language skills, spatial skills, attention, memory, reasoning and judgment. The goal is to determine whether dementia is present, how severe it is and what part of the brain is affected.

Neurological evaluation This part of the examination evaluates balance, sensory function and reflexes to identify conditions that may affect the diagnosis or are treatable with medication.

Brain scans A look at your brain can help your doctor identify strokes, tumors or other problems that can cause dementia. Alzheimer's disease changes brain structure over time and can also be seen with a brain scan. Several types of scans are used.

CT and MRI scans. The most common imaging techniques for identifying dementia are computerized tomography (CT) and magnetic resonance imaging (MRI). A CT scan is an X-ray technique that produces images of your body that show internal structures in cross section. MRI is a technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues in your body. These scans help identify brain-size changes, strokes and other problems such as excess fluid in the brain (hydrocephalus) or bleeding on the surface of the brain (subdural hematoma). Electroencephalogram (EEG). Using electrodes placed on your scalp, your doctor can detect and record patterns of electrical activity and check for abnormalities. If found, these abnormalities can indicate cognitive dysfunction, a condition common in people with moderate to severe Alzheimer's disease. An EEG may also detect seizures, Creutzfeldt-Jakob disease and other disorders associated with dementia. Laboratory tests A variety of lab tests can help rule out other conditions, such as kidney failure, that can contribute to symptoms. Treatable medical conditions are often associated with dementia. Medication and other treatments can improve many symptoms and quality of life.

Tests that help identify treatable medical conditions include:

A complete blood count (CBC) to rule out anemia A blood glucose test to rule out diabetes Blood tests to estimate kidney function, to estimate liver function and to measure vitamin B-12 levels

A blood or urine screen to identify drugs or alcohol Cerebrospinal fluid analysis (spinal tap) to rule out brain infections Analysis of thyroid and thyroid-stimulating hormone levels to rule out hypothyroidism Psychiatric evaluation This examination may be performed to determine whether depression or another psychiatric disorder is contributing to symptoms.

Treatments and drugs By Mayo Clinic staff Treatment of dementia may help slow or minimize the development of symptoms.

Cholinesterase inhibitors. These drugs donepezil (Aricept), rivastigmine (Exelon) and galantamine hydrobromide (Razadyne) are Alzheimer's drugs that work by boosting levels of a chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting and diarrhea. Although primarily used as Alzheimer's drugs, they're also used to treat vascular, Parkinson's and Lewy body dementias. Memantine (Namenda). This drug for Alzheimer's disease works by regulating the activity of glutamate, another chemical messenger involved in all brain function, including learning and memory. Its most common side effect is dizziness. Some research has shown that combining memantine with a cholinesterase inhibitor may have even better results. Although primarily used to treat Alzheimer's disease, it may help improve symptoms in other dementias. Other medications. Although no standard treatment for dementia exists, some symptoms can be treated. Additional treatments aim to reduce the risk factors for further brain damage. Treatment of the underlying causes of dementia can also slow or sometimes stop its progress. To prevent a stroke, for example, your doctor may prescribe medications to control high blood pressure, high cholesterol, heart disease

and diabetes. Doctors may also prescribe medication to treat conditions such as blood clots, anxiety and insomnia for people with vascular dementia. In addition, some specific symptoms and behavioral problems can be treated with sedatives, antidepressants and other medications, but some of these drugs may worsen other symptoms. Creutzfeldt-Jakob disease has no known treatments. Care is focused on making sure the person is comfortable.

Lifestyle and home remedies By Mayo Clinic staff You can take steps to improve quality of life as the disease progresses.

Carry a reminder calendar Record not just upcoming events, but things that happen and activities you need to complete on a daily basis. And check off those activities when done. If you can make this process a habit before your memory problems worsen, you'll be more likely to retain this skill as the disease progresses. If you can't remember if you took your pills or who called that morning, you can check your calendar.

Maintain a calm and stable home environment A calm and stable home environment reduces behavior problems. New situations, noise, large groups of people, being rushed or pressed to remember, or being asked to do complicated tasks can cause anxiety. When you have Alzheimer's disease or dementia, becoming upset reduces the ability to think clearly even more.

Establish a nighttime ritual Dementia behaviors may be worse at night when you're more tired, strained by the demands of the day, or perhaps confused because of the decrease in daylight. Try to establish going-to-bed rituals that are calming and away from the noise of television, meal cleanup and active family members. Leave night lights on to prevent disorientation. Limiting caffeine during the day, avoiding daytime napping and exercising during the day may help prevent nighttime restlessness.

Create a plan Develop a comprehensive plan that identifies goals for care as well as

the various support agencies, care centers, primary and specialty doctors, legal advisors and other family members that can help achieve these goals.

This process may or may not be something that a person with dementia can participate in. Some things for you and your caregiver to consider are:

What is the long-term prognosis and what is the plan for treatment? Is independent living possible? If not, will care be provided in a family home or a nursing home? Does support need to be provided for things such as meal preparation, daily hygiene and taking medications? If independent or semi-independent living isn't possible, who will be the primary caregiver? What about driving? Should it continue? Are there safety issues, such as installing bed and bathroom safety rails and removing or securing knives and other dangerous substances or objects, that need to be addressed? What assistance is available through adult care centers, in-home nursing care or other agencies? What about legal issues such as a living will and power of attorney for health care issues? What are your wishes? Keep in mind that the disease will evolve over time, and care needs to be adjusted as symptoms change and progress. People with dementia should be encouraged to continue their normal activities as long as they're safe and the activities don't cause frustration or confusion. Mental, social and physical activities help maintain a person's health and well-being.

Alternative medicine By Mayo Clinic staff Use caution when considering alternative remedies to ward off or slow the progression of dementia, especially if taking other medications. Dietary supplements, vitamins and herbal remedies aren't regulated, and claims about their benefits are often based on personal testimonials rather than scientific research. Some of the more popular alternative remedies for Alzheimer's disease and other forms of dementia are:

Vitamin E. Some studies have shown that vitamin E can slow the progression of Alzheimer's disease, while other studies have shown no benefit. Doctors warn against taking large dosages of vitamin E, especially if you're taking blood thinners, because of an increased risk of bleeding. Omega-3 fatty acids. Omega-3s are a type of polyunsaturated fatty acid (PUFA) found in fish and nuts. Research has linked certain types of omega-3s to a reduced risk of heart disease, stroke, dementia and cognitive decline. The Food and Drug Administration (FDA) permits supplements and foods to display labels with "a qualified health claim" for two omega-3s called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The FDA recommends taking no more than a combined total of 3 grams of DHA or EPA a day, with no more than 2 grams from supplements. Theories about why omega-3s might influence dementia risk include their benefit to the heart and blood vessels, anti-inflammatory effects, and support and protection of nerve cell membranes. Preliminary evidence also shows that omega-3s may help reduce symptoms of depression. It's thought this is because it's an essential nutrient for brain function. Coenzyme Q10. This antioxidant occurs naturally in your body and is needed for normal cell reactions. This compound hasn't been studied for its effectiveness in treating dementia. A synthetic version of this compound, called idebenone, was tested for Alzheimer's disease, but didn't show favorable results. Little is known about what dosage is considered safe, and too much may lower blood pressure, decrease blood sugar, or cause bruising or bleeding.

Ginkgo. Some people believe that extracts from the leaves of the ginkgo biloba tree have antioxidant and anti-inflammatory properties that may help slow the progression of memory problems associated with dementia. But a recent largescale study showed no benefit. Be aware that these preparations can interact with blood-thinning medications and cause bleeding. Huperzine A. Made from Chinese club moss, huperzine A appears to work in ways similar to prescription cholinesterase inhibitors. Because of an increased risk of toxic side effects, don't take huperzine A if you're also taking a prescription cholinesterase inhibitor. Coping and support By Mayo Clinic staff Receiving a diagnosis of dementia can be devastating to you and your loved ones. Many things need to be considered to ensure that you and those around you are as prepared as possible for dealing with a condition that's unpredictable and continually changing.

Take care of yourself emotionally As your disease progresses you may experience a wide range of feelings. Some things you can do to help yourself cope are:

Write in a journal about your feelings and experiences. Join a local support group. Get some counseling. Talk to a member of your church or another person who can help you with your spiritual needs. Maintain contact and share your feelings with friends and family. Participate in an online community of people who are having similar experiences. Helping someone with dementia You can help a person cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing

unconditional love, and doing your best to help the person retain dignity and selfrespect.

Caregiver support Providing care for a person with dementia is physically and emotionally demanding. Often, the primary caregiver is a spouse or other family member. Feelings of anger and guilt, frustration and discouragement, worry and grief, and social isolation are common. If you're a caregiver for someone with dementia, you can help yourself by:

Asking friends or other family members for help when you need it Taking care of your health Learning as much about the disease as you can Asking questions of doctors, social workers and others involved in the care of your loved one Joining a support group

Prevention By Mayo Clinic staff Although research is still ongoing, you can take steps to prevent or delay the onset of dementia.

Keep your mind active. Mentally stimulating activities may increase your ability to cope with or compensate for the changes associated with dementia. This includes such things as puzzles and word games, learning a language, playing an instrument, reading, writing, painting or drawing. Not only can these activities delay the onset of dementia but also can help decrease its effects the more frequent the activity, the more beneficial the effects. Be physically and socially active. Physical and social activities can delay the onset

of dementia and also reduce its symptoms. The more frequent the activities, the more significant their effects. Examples of physical activity are walking, swimming and dancing. Social activities include traveling, attending the theater and art exhibits, and playing cards or games. Lower your homocysteine levels. Early research has shown that high doses of three B vitamins folic acid, B-6 and B-12 help lower homocysteine levels and appear to slow the progression of Alzheimer's disease. Lower your cholesterol levels. The deposits that occur in the brains of people with high cholesterol are one of the causes of vascular dementia. So lowering your cholesterol levels can help prevent this condition. Statin drugs, which help lower cholesterol levels, also may help lower the risk of developing dementia. Control your diabetes. Controlling diabetes can reduce your risk of developing Alzheimer's disease and vascular dementia. Lower your blood pressure. Keeping blood pressure at normal levels can significantly reduce your risk of Alzheimer's disease and vascular dementia. Pursue education. People who've spent more time in formal education appear to have a lower incidence of mental decline, even when they have brain abnormalities. Researchers think that education may help your brain develop a strong nerve cell network that compensates for nerve cell damage caused by Alzheimer's disease. Maintain a healthy diet. Eating a healthy diet is important for many reasons, but studies show that a diet rich in fruits, vegetables and omega-3 fatty acids, commonly found in certain fish and nuts, can have a protective effect and decrease your risk of developing dementia. Get your vaccinations. Those who receive vaccinations for influenza, tetanus, diphtheria and polio appear to have a significantly reduced risk of Alzheimer's disease, so staying current on your vaccinations could have a protective effect against developing dementia.

Alzheimer's disease Definition By Mayo Clinic staff Alzheimer's disease is the most common cause of dementia the loss of intellectual and social abilities severe enough to interfere with daily functioning. In Alzheimer's disease, healthy brain tissue degenerates, causing a steady decline in memory and mental abilities. Alzheimer's disease is not a part of normal aging, but the risk of the disorder increases with age. About 5 percent of people between the ages of 65 and 74 have Alzheimer's disease, while nearly half the people over the age of 85 have Alzheimer's. Although there's no cure, treatments may improve the quality of life for people with Alzheimer's disease. Those with Alzheimer's as well as those who care for them need support and affection from friends and family to cope.

Symptoms By Mayo Clinic staff Alzheimer's disease may start with slight memory loss and confusion, but it eventually leads to irreversible mental impairment that destroys a person's ability to remember, reason, learn and imagine.

Memory loss Everyone has occasional lapses in memory. It's normal to forget where you put your car keys or to blank on the names of people whom you rarely see. But the memory problems associated with Alzheimer's disease persist and worsen. People with Alzheimer's may:

Repeat things Often forget conversations or appointments Routinely misplace things, often putting them in illogical locations

Eventually forget the names of family members and everyday objects Problems with abstract thinking People with Alzheimer's may initially have trouble balancing their checkbook, a problem that progresses to trouble recognizing and dealing with numbers.

Difficulty finding the right word It may be a challenge for those with Alzheimer's to find the right words to express thoughts or even follow conversations. Eventually, reading and writing also are affected.

Disorientation People with Alzheimer's disease often lose their sense of time and dates, and may find themselves lost in familiar surroundings.

Loss of judgment Solving everyday problems, such as knowing what to do if food on the stove is burning, becomes increasingly difficult, eventually impossible. Alzheimer's is characterized by greater difficulty in doing things that require planning, decision making and judgment.

Difficulty performing familiar tasks Once-routine tasks that require sequential steps, such as cooking, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to do even the most basic things.

Personality changes People with Alzheimer's may exhibit:

Mood swings Distrust in others Increased stubbornness Social withdrawal Depression

Anxiety Aggressiveness

Causes By Mayo Clinic staff No one factor appears to cause Alzheimer's disease. Instead, scientists believe that it may take a combination of genetic, lifestyle and environmental factors to trigger the onset of symptoms. While the causes of Alzheimer's are poorly understood, its effect on brain tissue is clear. Alzheimer's disease damages and kills brain cells.

Two types of brain cell (neuron) damage are common in people who have Alzheimer's:

Plaques. Clumps of a normally harmless protein called beta-amyloid may interfere with communication between brain cells. Although the ultimate cause of neuron death in Alzheimer's isn't known, mounting evidence suggests that the abnormal processing of beta-amyloid protein may be the culprit. Tangles. The internal support structure for brain cells depends on the normal functioning of a protein called tau. In people with Alzheimer's, threads of tau protein undergo alterations that cause them to become twisted. Many researchers believe this may seriously damage neurons, causing them to die.

Risk factors By Mayo Clinic staff Age Alzheimer's usually affects people older than 65, but can, rarely, affect those younger than 40. Less than 5 percent of people between 65 and 74 have Alzheimer's. For people 85 and older, that number jumps to nearly 50 percent.

Heredity Your risk of developing Alzheimer's appears to be slightly higher if a firstdegree relative parent, sister or brother has the disease. Although the genetic mechanisms of Alzheimer's among families remain largely unexplained, researchers have identified several genetic mutations that greatly increase risk in some families.

Sex Women are more likely than men are to develop the disease, in part because they live longer.

Mild cognitive impairment People who have mild cognitive impairment have memory problems that are worse than what might be expected for people of their age, yet not bad enough to be classified as dementia. Many of those who have this condition go on to develop Alzheimer's disease.

Lifestyle The same factors that put you at risk of heart disease may also increase the likelihood that you'll develop Alzheimer's disease. Examples include:

High blood pressure High cholesterol Poorly controlled diabetes And keeping your body fit isn't your only concern you've got to exercise your mind as well. Some studies have suggested that remaining mentally active throughout your life, especially in your later years, reduces the risk of Alzheimer's disease.

Education levels Studies have found an association between less education and the risk of Alzheimer's. But the precise reason why this occurs is unknown. Some researchers theorize that the more you use your brain, the more synapses you create, which provides a greater reserve as you age. But it may simply be harder to detect Alzheimer's in people who exercise their minds frequently or who have more education. Complications

By Mayo Clinic staff In advanced Alzheimer's disease, people may lose all ability to care for themselves. This can make them more prone to additional health problems such as:

Pneumonia. Difficulty swallowing food and liquids may cause people with Alzheimer's to inhale (aspirate) some of what they eat and drink into their airways and lungs, which can lead to pneumonia. Infections. Urinary incontinence may require the placement of a urinary catheter, which increases the risk of urinary tract infections. Untreated urinary tract infections can lead to more-serious, life-threatening infections. Injuries from falls. People with Alzheimer's may become disoriented, increasing their risk of falls. Falls can lead to fractures. In addition, falls are a common cause of serious head injuries, such as bleeding in the brain. Preparing for your appointment By Mayo Clinic staff People who have Alzheimer's often don't recognize that they have a problem. In many cases, family members are the ones who notice the symptoms and arrange for a doctor's appointment. Your family physician may refer you to a neurologist or psychologist for further evaluation.

What you can do Because you may not be aware of all your signs and symptoms, it's a good idea to take a family member or close friend along with you to the doctor's appointment. You may also want to write a list that includes:

Detailed descriptions of your symptoms Information about medical problems you've had in the past Information about the medical problems of your parents or siblings All the medications and dietary supplements you take

Questions you want to ask the doctor What to expect from your doctor In addition to a physical exam, your doctor may also check your neurological health by testing your:

Reflexes Muscle strength Muscle tone Senses of touch and sight Coordination Balance During the appointment, your doctor might also conduct a brief mental status evaluation, which may assess:

Memory Problem-solving abilities Attention spans Counting skills Language usage

Tests and diagnosis By Mayo Clinic staff Doctors can accurately diagnose 90 percent of Alzheimer's cases. Alzheimer's disease can be diagnosed with complete accuracy only after death, when microscopic examination of the brain reveals plaques and tangles.

To help distinguish Alzheimer's disease from other causes of memory loss, doctors typically rely on the following types of tests.

Lab tests Blood tests may be done to help doctors rule out other potential causes of the dementia, such as thyroid disorders or vitamin deficiencies.

Neuropsychological testing Sometimes doctors undertake a more extensive assessment of thinking and memory skills. This type of testing, which can take several hours to complete, is especially helpful in trying to detect Alzheimer's and other dementias at an early stage.

Brain scans By looking at images of the brain, doctors may be able to pinpoint any visible abnormalities such as clots, bleeding or tumors that may be causing signs and symptoms. Positron emission tomography (PET) can reveal areas of the brain that may be less active and the density of amyloid plaques.

Magnetic resonance imaging (MRI). An MRI machine uses radio waves and a strong magnetic field to produce detailed images of your brain. You lie on a narrow table that slides into the tube-shaped MRI machine, which makes loud banging noises during scans. The entire procedure can take an hour or more. MRIs are painless, but some people feel claustrophobic in the machine. Computerized tomography (CT). For a CT scan, you lie on a narrow table that slides into a small chamber. X-rays pass through your body from various angles, and a computer uses this information to create cross-sectional images, or slices, of your brain. The test is painless and takes about 20 minutes. Positron emission tomography (PET). During a PET scan, you'll be injected with a low-level radioactive material, which binds to chemicals that travel to the brain. You lie on a table while an overhead scanner tracks the radioactive material. This helps show which parts of your brain aren't functioning properly. The test is painless and can be particularly useful in distinguishing between different types of dementia.

Treatments and drugs By Mayo Clinic staff Currently, there's no cure for Alzheimer's disease. Doctors sometimes prescribe drugs to improve signs and symptoms that often accompany Alzheimer's, including sleeplessness, wandering, anxiety, agitation and depression. But only two varieties of medications have been proved to slow the cognitive decline associated with Alzheimer's.

Cholinesterase inhibitors This group of medications which includes donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) works by improving the levels of neurotransmitters in the brain. But cholinesterase inhibitors don't work for everyone. As many as half the people who take these drugs show no improvement. Other people may choose to stop taking the drugs because of the side effects, which include diarrhea, nausea and vomiting.

Memantine (Namenda) The first drug approved to treat moderate to severe stages of Alzheimer's, memantine protects brain cells from damage caused by the chemical messenger glutamate. It sometimes is used in combination with a cholinesterase inhibitor. Memantine's most common side effect is dizziness, although it also appears to increase agitation and delusional behavior in some people. Lifestyle and home remedies By Mayo Clinic staff A healthy lifestyle may help prevent or postpone the development of Alzheimer's disease. Because Alzheimer's is most common in people over the age of 80, delaying the onset of the disease would increase the probability that people will die of other causes before Alzheimer's has a chance to develop.

Eat your veggies Maintaining a healthy weight and eating a healthy diet appears to reduce the risk of developing Alzheimer's disease. Your doctor may suggest:

Lots of fruits and vegetables Fish or poultry, instead of red meat

Whole-grain breads and cereals Alternate sources of proteins, such as beans, nuts and seeds More olive oil and less saturated fat Exercise your body Higher levels of physical activity have been associated with a lower incidence of Alzheimer's disease.

Exercise your brain, too Maintaining mental fitness may delay onset of dementia. Some researchers believe that lifelong mental exercise and learning may promote the growth of additional synapses, the connections between neurons, and delay the onset of dementia.

Carry a reminder calendar. Record not just upcoming events, but things that happen and activities you need to complete on a daily basis. And check off those activities when done. If you can make this process a habit before your memory problems worsen, you'll be more likely to retain this skill as the disease progresses. If you can't remember if you took your pills or who called that morning, you can check your journal.

Alternative medicine By Mayo Clinic staff Vitamin E Some studies have shown that vitamin E can slow the progression of Alzheimer's disease, while other studies have shown no benefit. Doctors now warn people against taking large dosages of vitamin E, because it can increase your risk of cardiovascular death.

Ginkgo Some people believe that extracts from the leaves of the ginkgo biloba tree may help slow the progression of memory problems associated with Alzheimer's disease. But a recent large-scale study showed no benefit. Be aware that these preparations can interact with blood-thinning medications and cause bleeding.

Huperzine A Made from Chinese club moss, Huperzine A appears to work in ways similar to prescription cholinesterase inhibitors. Because of the increased risk of toxic side effects, you shouldn't take Huperzine A if you're also taking a drug like donepezil (Aricept).

Coping and support By Mayo Clinic staff People with Alzheimer's disease often experience a mixture of emotions confusion, frustration, anger, fear, uncertainty, grief and depression.

You can help a person cope with the disease by being there to listen, reassuring the person that life can still be enjoyed, providing unconditional love, and doing your best to help the person retain dignity and self-respect.

A calm and stable home environment reduces behavior problems. New situations, noise, large groups of people, being rushed or pressed to remember, or being asked to do complicated tasks can cause anxiety. As a person with Alzheimer's becomes upset, the ability to think clearly declines even more.

Caring for the caregiver Providing care for a person with Alzheimer's disease is physically and emotionally demanding. Feelings of anger and guilt, frustration and discouragement, worry and grief, and social isolation are common. If you're a caregiver for someone with Alzheimer's disease, you can help yourself by:

Asking friends or other family members for help when you need it Taking care of your health Learning as much about the disease as you can Asking questions of doctors, social workers and others involved in the care of your loved one

Joining a support group Many people with Alzheimer's and their families benefit from counseling or local support groups. Contact your local Alzheimer's Association affiliate to get connected with support groups, doctors, resources and referrals, home care agencies, supervised living facilities, a telephone help line, and educational seminars.

Prevention By Mayo Clinic staff Right now, there's no proven way to prevent the onset of Alzheimer's disease. Human trials of a promising vaccine against Alzheimer's had to be stopped several years ago because some of the people who received the vaccine developed a serious inflammation of the brain.

However, you may be able to reduce your risk of Alzheimer's disease by reducing your risk of heart disease. Many of the same factors that increase your risk of heart disease can also increase your risk of dementia. The main players appear to be blood pressure, cholesterol and blood glucose levels.

Keeping active physically, mentally and socially also seems to reduce the risk of Alzheimer's disease.

Alzheimer's disease and dementia are different By Angela Lunde

My sincere appreciation to all of you who have posted a comment or two on this new blog, I am elated by the rapid interest! Your exchange of stories, ideas, and challenges, along with the compassionate support you are giving one another, is

exactly what I hope this blog can provide. As one individual stated, "Your experiences will comfort me."

Know that I will weigh in from time to time on some of the issues that surface, but for this blog, the real experts will be all of you impacted in one way or another by Alzheimer's disease or a related dementia. Each of you can provide a depth of knowledge shaped by your own circumstances; when it comes to a devastating disease like AD, sometimes simply an exchange of experiences is what matters most. I will, however, comment on themes and general issues that emerge and provide links to resources that I think can be beneficial.

For this entry, let me just state that there is often confusion and misunderstanding with the terms Alzheimer's disease and dementia, but there is a distinct difference.

The term dementia refers to a set of symptoms, not the disease itself. These symptoms might include language difficulty, loss of recent memory or poor judgment. In other words, when an individual is said to have dementia they are exhibiting certain symptoms. With a thorough screening including blood tests (to rule out other causes of dementia such as vitamin deficiency), a mental status evaluation, neuropsychological testing, and sometimes a brain scan, doctors can accurately diagnose the cause of the dementia symptoms in 90 percent of the cases. (It is true however, that Alzheimer's can be diagnosed with complete accuracy only after death, using a microscopic examination of brain tissue, which checks for plaques and tangles).

Although Alzheimer's disease accounts for 60-70 percent of cases of dementia, other disorders that cause dementia include: Vascular dementia, Parkinson's disease, dementia with Lewy Bodies and Frontotemporal dementia.

In the early stages of a disease, there can be some clear differences between the diseases. For example, in dementia with Lewy Bodies (the second most common cause of dementia) early symptoms of the disease may not be so much forgetfulness, but lowered attention span, recurrent visual hallucinations, and a fluctuation between

periods of lucidity (or clear thinking) followed by periods of confusion. However, as the specific disease advances, more parts of the brain become affected, and the differences from one cause of dementia to another are subtle.

In concluding my entry today, I'd like to pose a question: You may have heard the saying, "When you've met one person with Alzheimer's, you've met one person with Alzheimer's disease." In other words, no two persons are similar in how the disease impacts them. This holds true for caregivers as well. If you have seen how Alzheimer's disease (or related dementia) impacts one caregiver, you have seen how it impacts one caregiver. If you are caring for someone with Alzheimer's disease or a similar dementia, how has it impacted you, more importantly, how do you cope?

http://yourtotalhealth.ivillage.com/alzheimers-dementia http://www.mayoclinic.com/health/dementia/DS01131 http://www.mayoclinic.com/health/alzheimers-disease/DS00161 http://www.mayoclinic.com/health/alzheimers-disease-and-dementia/AZ00053 http://news.bbc.co.uk/2/hi/health/1079432.stm http://www.rcpsych.ac.uk/default.aspx?page=1427 http://www.everydayhealth.com/specialists/senior_aging/butler/qa/Dementia-vsAlzheimers/index.aspx

Alzheimer's disease is a progressive, degenerative and irreversible brain disorder that causes intellectual impairment, disorientation and eventually death and the most common cause of dementia. There is no cure. It is estimated that 2-5% of people over 65 years of age and up to 20% of those over 85 years of age suffer from the disease.

There are many sorts of dementia such as Alzheimers disease. They all affect the brain. Gradually the person loses his memory. He cant do the things he used to. In the end he cannot speak. This doesnt happen overnight. It happens gradually, bit by bit. In the middle of it is a person who knows he is losing his mind, his independence, and his place in the world. Alongside him is his family, who know they are losing him. Just because he cannot speak, it does not mean he cannot understand

Dementia affects the brain. The person gradually loses his intelligence, his memory and his personality. Some go quietly, others rebel. They can shout or swear or even strike out. This is distressing for people close to them.

People with dementia become muddled. They forget where they are. They may act as if they are somewhere else. They may not know what time it is. They may mix up night and day. They can wander out of their houses in the small hours believing it is time to go shopping.

Dementia Vs. Alzheimer's Disease: Ways to Distinguish the Two


Introduction It is important to compare dementia vs. Alzheimer's disease to

realize the differences between the two conditions. Alzheimer's is the most common form of dementia marked by memory loss in older people. Dementia is the gradual loss of intellectual function. Alzheimer's statistics show that the disease can strike a person as early as 45, while dementia generally takes hold after age 70. The most confused form of dementia is MultiInfarct Dementia or MID. This condition also attacks the blood vessels in the brain. Both disorders require testing to determine the best course of treatment.

Dementia and Alzheimer's diseases are perhaps two of the most confusing diseases that exist in the realm of mental degradation in America today. There are a number of differences, however, that allow for those dealing with symptoms characteristic of these two diseases to become more informed. Comparing the Two Diseases When comparing dementia vs. Alzheimer's disease it is very important to discuss the differences between the two diseases. Although they have many similarities, there are a number of differences that must be noted. Alzheimer's disease is defined as a form of dementia characterized by the gradual loss of several important mental functions. It is perhaps the most common cause of dementia in older Americans, and goes beyond just normal forgetfulness, such as losing your car keys or forgetting where you parked. Signs of Alzheimer's disease include memory loss that is much more severe and more serious, such as forgetting the names of your children or perhaps where you've lived for the last decade or two. Another way to compare dementia vs. Alzheimer's disease is to realize that dementia is a medical term used to describe a number of conditions characterized by the gradual loss of

intellectual function. Certain symptoms, as defined by the American Medical Association, of dementia include memory impairment, increased language difficulties, decreased motor skills, failure to recognized or identify objects, and disturbance of the ability to plan or think abstractly. Yet another way to determine the differences of dementia vs. Alzheimer's disease is when the onset of the disease was first noticed. Of course, this is a very difficult thing since the progression of both is very gradual, and often there is no one point where someone can say, "Aha!" and know that the disease has taken hold. Often the onset of Alzheimer's can occur as early as 45 years of age. General dementia, however, usually is noted later in life, perhaps in the 70 to 80 year range. When looking at dementia vs. Alzheimer's disease, one type of dementia is often confused with Alzheimer's disease MultiInfarct Dementia or MID. MID is a common cause of dementia in the elderly and occurs when blood clots block small blood vessels in the brain and destroys brain tissue. Symptoms of MID, which are very similar to Alzheimer's disease, include confusion, problems with short term memory, wandering and getting lost in familiar places, loss of bladder and bowel control, and emotional problems such as laughing or crying during inappropriate times.

Dementia is a large category of neurodegenerative conditions that affect the brain; it includes Alzheimer's disease, vascular dementia, frontal temporal dementia dementia pugilistica (boxer's, or repeated traumatic, dementia), and alcoholic dementia, as well as a few other rare conditions. Memory loss, problems with processing information, and impaired executive and planning functions are prominent signs of dementia. The term "senility" is frequently used as well. The problem with this word is that it conveys the idea that dementia is an inevitable concomitant of aging ("senile" means old). While aging is the key risk factor for dementia, it is not the direct cause. Genetic factors play an important role, and environmental and behavioral factors are probably also connected

Dementia vs. Alzheimer's


Dementia: It's not always Alzheimer's
Many people are under the impression that dementia and Alzheimer's are one-in-the-same, but this is not the case. What is the difference between the two? When disussing dementia vs. Alzheimer's disease it is very important to discuss the differences between the two terms. Dementia is a medical term used to describe a number of conditions characterized by the gradual loss of intellectual functions. Dementia is a neurological disorder that affects your ability to

think, speak, reason, remember and move. While Alzheimer's disease is the most common cause of dementia, many other conditions also can cause similar symptoms.

Dementia vs. Alzheimer's / Comparing the Two Terms


Dementia is a large category of neurodegenerative conditions that affect the brain. It includes: Alzheimer's disease, vascular dementia, frontal temporal dementia dementia pugilistica (boxer's, or repeated traumatic, dementia), and alcoholic dementia, as well as a few other rare conditions. Memory loss, problems with processing information, and impaired executive and planning functions are prominent signs of dementia. The term "senility" is a term that is not used today. The problem with this word is that it conveys the idea that dementia is an inevitable concomitant of aging. While aging is the key risk factor for dementia, it is not the direct cause. Alzheimer's disease is defined as a form of dementia characterized by the gradual loss of several important mental functions. It is perhaps the most common cause of dementia in older people, and goes beyond just normal forgetfulness, such as losing your car keys or forgetting where you parked. Signs of Alzheimer's disease, include memory loss that is much more severe and more serious, such as forgetting the names of your children or perhaps where you've lived for the last decade or two. When looking at dementia vs. Alzheimer's disease, one type of dementia is often confused with Alzheimer's disease. MultiInfarct Dementia (MID) is a common cause of dementia in the elderly and occurs when blood clots block small blood vessels in the brain and destroy brain tissue. Symptoms of MID, which are very similar to Alzheimer's disease, include confusion, problems with short term memory, wandering and getting lost in familiar places, loss of bladder and bowel control, and

emotional problems such as laughing or crying during inappropriate times. http://www.dementiaguide.com/community/dementiaarticles/Dementia vs. Alzheimer's#ixzz0L9VlxrO6&D

Dementia vs. Alzheimers.Is there a Difference?


Dementia is a term that is frequently used to describe memory loss. There is a misconception among many people that dementia is a normal part of aging.

Dementia is a term that is frequently used to describe memory loss. There is a misconception among many people that dementia is a normal part of aging. Many of our healthy aging population retain normal cognition well into their elder years. Although we all feel the affects of aging which is demonstrated by diminished hearing and vision, mental processing may slow as well. However, the losses that occur with a diagnosis of dementia are more profound and are a result of a disease process. Dementia is a condition of progressive, global deterioration of memory and cognition that impairs thought and social functioning. There are many causes of dementia. The most common cause of dementia is Alzheimers disease. Other causes of reversible dementia are vitamin B-12 deficiency, thyroid disease and prolonged alcohol abuse.