Causes, symptoms, diagnosis, treatment and prevention of dementia.
Dementia is a condition in which nerve cells are damaged by various causes, leading to acquired brain dysfunction. Cognitive functions such as memory, language and visuospatial ability decline, and this interferes with daily life.
There are many possible causes of dementia in later life. The most common are Alzheimer's disease and vascular dementia. Less common causes include other degenerative brain diseases such as dementia with Lewy bodies, frontotemporal degeneration and Parkinson's disease, as well as normal pressure hydrocephalus, head injury, brain tumors, metabolic disorders, deficiency disorders and toxic disorders.
Memory loss
Problems using language
Personality changes
Disorientation
Disruptive or inappropriate behavior
An accurate medical history, reported by a family member or caregiver who knows the patient well, is important. We check whether cognitive functions, including memory, have changed compared with before, and if so, when and how the changes began. Diagnosis is then made through various tests such as a physical examination, neurological examination, mental status examination and blood tests.
Evaluates cognitive functions such as memory, and checks for disorders of consciousness such as delirium or confusion, and for behavioral and psychological symptoms such as depression, delusions or hallucinations.
Evaluates the patient's level of daily functioning through basic activities such as eating, dressing, washing and toileting, and more complex activities such as making phone calls and cooking.
Divided into structural brain imaging such as MRI and CT, and functional brain imaging such as PET and SPECT. These tests look at the structure and shape of the brain and are very important for identifying the cause of dementia in older adults.
Checks for signs of physical illness or neurological disease that may affect the patient's cognitive function.
Tests for anemia, liver function, kidney function, diabetes and vitamins are performed to find physical illnesses that may cause or worsen dementia in older adults.
Objectively evaluates various cognitive functions related to brain function. It includes a broad assessment of cognitive areas such as language, attention, memory, calculation and executive function.
Once an accurate diagnosis finds the cause, treatment is tailored to it, and about 10-15% of cases can be cured with appropriate treatment. However, even curable dementia becomes difficult to cure if left untreated. If you suspect dementia symptoms in later life, it is important to visit a medical institution that offers dementia testing and get an accurate diagnosis.
A cure for Alzheimer's disease has not yet been developed, but it is treated with medications that relieve symptoms and slow its progression. These cannot completely stop the disease, but they can delay its progression by about 6 months to 2 years.
The most important treatment for vascular dementia is preventing recurrence or worsening of cerebrovascular disease with antiplatelet agents such as aspirin or anticoagulants such as warfarin. Treating vascular risk factors such as high blood pressure, diabetes, smoking and obesity is also very important.
Non-drug treatments aimed at improving cognitive function are also provided. These include memory training, reality orientation training and occupational therapy, which train impaired cognitive areas or make the most of unimpaired areas to compensate. Music therapy, art therapy and horticultural therapy are also used to improve cognitive function and emotional stability.
