Dementia: Difference between revisions
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[[File:Alzheimer's_disease_brain_comparison.jpg| | {{SI}} | ||
[[File:A woman diagnosed as suffering from chronic dementia. Colour Wellcome L0026688.jpg|thumb|A drawing of a woman diagnosed with dementia.]] | {{Infobox medical condition | ||
[[File:An old man diagnosed as suffering from senile dementia. Colo Wellcome L0026689.jpg|thumb|A drawing of an old man diagnosed with senile dementia]] | | name = Dementia | ||
| image = [[File:Alzheimer's_disease_brain_comparison.jpg|250px]] | |||
| caption = Comparison of a normal aged brain (left) and the brain of a person with [[Alzheimer's disease]] (right), a common cause of dementia. | |||
| field = [[Neurology]] | |||
| symptoms = [[Memory loss]], [[confusion]], [[disorientation]], [[language problems]], [[mood changes]] | |||
| onset = Usually [[elderly]] | |||
| duration = [[Chronic (medicine)|Chronic]] | |||
| causes = [[Alzheimer's disease]], [[vascular dementia]], [[Lewy body dementia]], [[frontotemporal dementia]] | |||
| risks = [[Ageing]], [[family history]], [[genetic factors]], [[smoking]], [[alcohol use disorder]] | |||
| diagnosis = [[Cognitive testing]], [[neuroimaging]] | |||
| differential = [[Delirium]], [[depression]], [[normal pressure hydrocephalus]] | |||
| treatment = [[Medications]], [[cognitive behavioral therapy]], [[supportive care]] | |||
| prognosis = [[Progressive disease|Progressive]] | |||
| frequency = 50 million worldwide (as of 2020) | |||
}} | |||
[[File:A woman diagnosed as suffering from chronic dementia. Colour Wellcome L0026688.jpg|left|thumb|A drawing of a woman diagnosed with dementia.]] | |||
[[File:An old man diagnosed as suffering from senile dementia. Colo Wellcome L0026689.jpg|left|thumb|A drawing of an old man diagnosed with senile dementia]] | |||
[[File:Alzheimers brain.jpg|thumb|Brain atrophy in severe Alzheimer's]] | [[File:Alzheimers brain.jpg|thumb|Brain atrophy in severe Alzheimer's]] | ||
[[File:Donepezil skeletal.svg|thumb|Donepezil]] | [[File:Donepezil skeletal.svg|thumb|Donepezil]] | ||
[[Image:Alzheimer and other dementias world map - DALY - WHO2004.svg|thumb]] | [[Image:Alzheimer and other dementias world map - DALY - WHO2004.svg|thumb]] | ||
[[File:Care at Home with Dementia, Tigray (8015180561).jpg|thumb|Old woman from [[Ethiopia]]]] | [[File:Care at Home with Dementia, Tigray (8015180561).jpg|thumb|Old woman from [[Ethiopia]]]] | ||
'''Dementia''' is a broad category of [[brain diseases]] that cause a long-term and often gradual decrease in the ability to think and remember, which is severe enough to affect daily functioning. Other common symptoms include emotional problems, difficulties with language, and a decrease in motivation. Consciousness is usually not affected. A diagnosis of dementia requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging. These diseases have a significant effect on [[caregivers]]. | '''Dementia''' is a broad category of [[brain diseases]] that cause a long-term and often gradual decrease in the ability to think and remember, which is severe enough to affect daily functioning. Other common symptoms include emotional problems, difficulties with language, and a decrease in motivation. Consciousness is usually not affected. A diagnosis of dementia requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging. These diseases have a significant effect on [[caregivers]]. | ||
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== Types of Dementia == | == Types of Dementia == | ||
The most common type of dementia is [[Alzheimer's disease]], which makes up 50% to 70% of cases. Other common types include: | The most common type of dementia is [[Alzheimer's disease]], which makes up 50% to 70% of cases. Other common types include: | ||
* [[Vascular dementia]] (25%) | * [[Vascular dementia]] (25%) | ||
* [[Dementia with Lewy bodies]] (15%) | * [[Dementia with Lewy bodies]] (15%) | ||
* [[Frontotemporal dementia]] | * [[Frontotemporal dementia]] | ||
Less common causes include: | Less common causes include: | ||
* [[Normal pressure hydrocephalus]] | * [[Normal pressure hydrocephalus]] | ||
* [[Parkinson's disease dementia]] | * [[Parkinson's disease dementia]] | ||
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* [[Creutzfeldt–Jakob disease]] | * [[Creutzfeldt–Jakob disease]] | ||
More than one type of dementia may exist in the same person. A small proportion of cases run in families. In the [[DSM-5]], dementia was reclassified as a neurocognitive disorder, with degrees of severity. | More than one type of dementia may exist in the same person. A small proportion of cases run in families. In the [[DSM-5]], dementia was reclassified as a neurocognitive disorder, with degrees of severity. | ||
== Diagnosis and Screening == | == Diagnosis and Screening == | ||
Diagnosis is usually based on history of the illness and cognitive testing, with medical imaging and blood tests used to rule out other possible causes. The [[Mini Mental State Examination]] (MMSE) is one commonly used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes, and obesity. Screening the general population for the disorder is not recommended. | Diagnosis is usually based on history of the illness and cognitive testing, with medical imaging and blood tests used to rule out other possible causes. The [[Mini Mental State Examination]] (MMSE) is one commonly used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes, and obesity. Screening the general population for the disorder is not recommended. | ||
== Treatment and Management == | == Treatment and Management == | ||
There is no known cure for dementia. Cholinesterase inhibitors such as [[donepezil]] are often used and may be beneficial in mild to moderate disorder. Overall benefit, however, may be minor. There are many measures that can improve the quality of life of people with dementia and their caregivers. Cognitive and behavioral interventions may be appropriate. Educating and providing emotional support to the caregiver is important. Exercise programs may be beneficial with respect to activities of daily living and potentially improve outcomes. Treatment of behavioral problems with antipsychotics is common but not usually recommended, due to the limited benefit and the side effects, including an increased risk of death. | There is no known cure for dementia. Cholinesterase inhibitors such as [[donepezil]] are often used and may be beneficial in mild to moderate disorder. Overall benefit, however, may be minor. There are many measures that can improve the quality of life of people with dementia and their caregivers. Cognitive and behavioral interventions may be appropriate. Educating and providing emotional support to the caregiver is important. Exercise programs may be beneficial with respect to activities of daily living and potentially improve outcomes. Treatment of behavioral problems with antipsychotics is common but not usually recommended, due to the limited benefit and the side effects, including an increased risk of death. | ||
== Global Impact == | == Global Impact == | ||
Globally, dementia affected about 46 million people in 2015. About 10% of people develop the disorder at some point in their lives. It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84, and nearly half of those over 85 years of age. In 2013 dementia resulted in about 1.7 million deaths, up from 0.8 million in 1990. As more people are living longer, dementia is becoming more common. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors. It is one of the most common causes of disability among the elderly. It is believed to result in economic costs of US$604 billion a year. People with dementia are often physically or chemically restrained to a greater degree than necessary, raising issues of human rights. Social stigma against those affected is common. | Globally, dementia affected about 46 million people in 2015. About 10% of people develop the disorder at some point in their lives. It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84, and nearly half of those over 85 years of age. In 2013 dementia resulted in about 1.7 million deaths, up from 0.8 million in 1990. As more people are living longer, dementia is becoming more common. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors. It is one of the most common causes of disability among the elderly. It is believed to result in economic costs of US$604 billion a year. People with dementia are often physically or chemically restrained to a greater degree than necessary, raising issues of human rights. Social stigma against those affected is common. | ||
== Signs and Symptoms == | == Signs and Symptoms == | ||
The symptoms of dementia vary across types and stages of the diagnosis. The most commonly affected areas include memory, visual-spatial, language, attention, and problem solving. Most types of dementia are slow and progressive. By the time signs of the disorder are apparent, deterioration in the brain has already been occurring for a long time. The course of dementia varies depending on the type, but generally progresses through three stages: mild (early-stage), moderate (middle-stage), and severe (late-stage). | The symptoms of dementia vary across types and stages of the diagnosis. The most commonly affected areas include memory, visual-spatial, language, attention, and problem solving. Most types of dementia are slow and progressive. By the time signs of the disorder are apparent, deterioration in the brain has already been occurring for a long time. The course of dementia varies depending on the type, but generally progresses through three stages: mild (early-stage), moderate (middle-stage), and severe (late-stage). | ||
=== Mild (Early-Stage) === | === Mild (Early-Stage) === | ||
In the early stage of dementia, the person may: | In the early stage of dementia, the person may: | ||
* Experience forgetfulness, particularly of recent events | * Experience forgetfulness, particularly of recent events | ||
* Have difficulty managing finances | * Have difficulty managing finances | ||
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* Show subtle changes in personality or behavior | * Show subtle changes in personality or behavior | ||
=== Moderate (Middle-Stage) === | === Moderate (Middle-Stage) === | ||
As dementia progresses to the moderate stage, the person may: | As dementia progresses to the moderate stage, the person may: | ||
* Require assistance with activities of daily living (ADLs), such as dressing, grooming, and eating | * Require assistance with activities of daily living (ADLs), such as dressing, grooming, and eating | ||
* Exhibit increased memory loss and confusion | * Exhibit increased memory loss and confusion | ||
| Line 71: | Line 68: | ||
* Display sleep disturbances, including insomnia or night wandering | * Display sleep disturbances, including insomnia or night wandering | ||
=== Severe (Late-Stage) === | === Severe (Late-Stage) === | ||
In the severe stage of dementia, the person may: | In the severe stage of dementia, the person may: | ||
* Lose the ability to communicate coherently or at all | * Lose the ability to communicate coherently or at all | ||
* Require full-time assistance with ADLs | * Require full-time assistance with ADLs | ||
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* Become more susceptible to infections, particularly pneumonia | * Become more susceptible to infections, particularly pneumonia | ||
== Risk Factors and Prevention == | == Risk Factors and Prevention == | ||
Several risk factors are associated with dementia, including age, family history, genetics, and lifestyle factors. Some of these factors, such as age and genetics, are non-modifiable. However, there are modifiable risk factors that can be addressed to reduce the risk of developing dementia: | Several risk factors are associated with dementia, including age, family history, genetics, and lifestyle factors. Some of these factors, such as age and genetics, are non-modifiable. However, there are modifiable risk factors that can be addressed to reduce the risk of developing dementia: | ||
* Maintain a healthy diet, such as the [[Mediterranean diet]] | * Maintain a healthy diet, such as the [[Mediterranean diet]] | ||
* Engage in regular physical activity | * Engage in regular physical activity | ||
| Line 90: | Line 83: | ||
* Stay mentally and socially active | * Stay mentally and socially active | ||
== Research and Future Directions == | == Research and Future Directions == | ||
Research on dementia is ongoing, with scientists striving to better understand the causes, develop effective treatments, and ultimately find a cure. Current research areas include: | Research on dementia is ongoing, with scientists striving to better understand the causes, develop effective treatments, and ultimately find a cure. Current research areas include: | ||
* Investigating the role of genetics in the development and progression of dementia | * Investigating the role of genetics in the development and progression of dementia | ||
* Studying the effectiveness of various drug therapies | * Studying the effectiveness of various drug therapies | ||
Latest revision as of 01:01, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Dementia | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Memory loss, confusion, disorientation, language problems, mood changes |
| Complications | N/A |
| Onset | Usually elderly |
| Duration | Chronic |
| Types | N/A |
| Causes | Alzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia |
| Risks | Ageing, family history, genetic factors, smoking, alcohol use disorder |
| Diagnosis | Cognitive testing, neuroimaging |
| Differential diagnosis | Delirium, depression, normal pressure hydrocephalus |
| Prevention | N/A |
| Treatment | Medications, cognitive behavioral therapy, supportive care |
| Medication | N/A |
| Prognosis | Progressive |
| Frequency | 50 million worldwide (as of 2020) |
| Deaths | N/A |
Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember, which is severe enough to affect daily functioning. Other common symptoms include emotional problems, difficulties with language, and a decrease in motivation. Consciousness is usually not affected. A diagnosis of dementia requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging. These diseases have a significant effect on caregivers.
Types of Dementia[edit]
The most common type of dementia is Alzheimer's disease, which makes up 50% to 70% of cases. Other common types include:
Less common causes include:
More than one type of dementia may exist in the same person. A small proportion of cases run in families. In the DSM-5, dementia was reclassified as a neurocognitive disorder, with degrees of severity.
Diagnosis and Screening[edit]
Diagnosis is usually based on history of the illness and cognitive testing, with medical imaging and blood tests used to rule out other possible causes. The Mini Mental State Examination (MMSE) is one commonly used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes, and obesity. Screening the general population for the disorder is not recommended.
Treatment and Management[edit]
There is no known cure for dementia. Cholinesterase inhibitors such as donepezil are often used and may be beneficial in mild to moderate disorder. Overall benefit, however, may be minor. There are many measures that can improve the quality of life of people with dementia and their caregivers. Cognitive and behavioral interventions may be appropriate. Educating and providing emotional support to the caregiver is important. Exercise programs may be beneficial with respect to activities of daily living and potentially improve outcomes. Treatment of behavioral problems with antipsychotics is common but not usually recommended, due to the limited benefit and the side effects, including an increased risk of death.
Global Impact[edit]
Globally, dementia affected about 46 million people in 2015. About 10% of people develop the disorder at some point in their lives. It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84, and nearly half of those over 85 years of age. In 2013 dementia resulted in about 1.7 million deaths, up from 0.8 million in 1990. As more people are living longer, dementia is becoming more common. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors. It is one of the most common causes of disability among the elderly. It is believed to result in economic costs of US$604 billion a year. People with dementia are often physically or chemically restrained to a greater degree than necessary, raising issues of human rights. Social stigma against those affected is common.
Signs and Symptoms[edit]
The symptoms of dementia vary across types and stages of the diagnosis. The most commonly affected areas include memory, visual-spatial, language, attention, and problem solving. Most types of dementia are slow and progressive. By the time signs of the disorder are apparent, deterioration in the brain has already been occurring for a long time. The course of dementia varies depending on the type, but generally progresses through three stages: mild (early-stage), moderate (middle-stage), and severe (late-stage).
Mild (Early-Stage)[edit]
In the early stage of dementia, the person may:
- Experience forgetfulness, particularly of recent events
- Have difficulty managing finances
- Struggle with planning and organizing
- Become disoriented, especially in unfamiliar environments
- Show subtle changes in personality or behavior
Moderate (Middle-Stage)[edit]
As dementia progresses to the moderate stage, the person may:
- Require assistance with activities of daily living (ADLs), such as dressing, grooming, and eating
- Exhibit increased memory loss and confusion
- Struggle with recognizing familiar faces and places
- Experience mood and behavioral changes, such as agitation, depression, or paranoia
- Display sleep disturbances, including insomnia or night wandering
Severe (Late-Stage)[edit]
In the severe stage of dementia, the person may:
- Lose the ability to communicate coherently or at all
- Require full-time assistance with ADLs
- Exhibit severe physical decline, including difficulty walking, sitting, and swallowing
- Experience incontinence
- Become more susceptible to infections, particularly pneumonia
Risk Factors and Prevention[edit]
Several risk factors are associated with dementia, including age, family history, genetics, and lifestyle factors. Some of these factors, such as age and genetics, are non-modifiable. However, there are modifiable risk factors that can be addressed to reduce the risk of developing dementia:
- Maintain a healthy diet, such as the Mediterranean diet
- Engage in regular physical activity
- Manage chronic health conditions, such as diabetes, hypertension, and high cholesterol
- Maintain a healthy weight
- Avoid smoking and limit alcohol consumption
- Stay mentally and socially active
Research and Future Directions[edit]
Research on dementia is ongoing, with scientists striving to better understand the causes, develop effective treatments, and ultimately find a cure. Current research areas include:
- Investigating the role of genetics in the development and progression of dementia
- Studying the effectiveness of various drug therapies
- Developing new diagnostic tools and techniques for early detection
- Exploring the potential benefits of non-pharmacological interventions, such as cognitive stimulation therapy and physical exercise
- Investigating the potential of stem cell therapy and other novel treatments
- As our understanding of dementia improves, it is hoped that new therapies and preventive strategies will be developed to help reduce the global burden of this debilitating condition.
External links[edit]
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| Diseases of the nervous system, primarily CNS (G04–G47, 323–349) | ||||||||||||||||||||
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