My own research into many sites, information is pieced together

Dementia is a group of symptoms involving progressive impairment of all aspects of brain function. Disorders that cause dementia are usually disorders that impair the vascular (blood vessel) or neurologic structures of the brain (organic brain syndrome). A few causes of dementia are treatable. Treatable causes include normal pressure hydrocephalus, brain tumors, and dementia due to metabolic causes. However, many of the disorders associated with dementia are progressive, irreversible, degenerative conditions.

Dementia may be diagnosed when there is impairment of two or more brain functions, including language, memory, visual-spatial perception, emotional behavior or personality, and cognitive skills (such as calculation, abstraction, or judgment). Dementia usually appears first as forgetfulness. Other symptoms may be apparent only on neurologic examination or cognitive testing. Loss of functioning progresses slowly from decreased problem solving and language skills, to difficulty with ordinary daily activities, to severe memory loss and complete disorientation with withdrawal from social interaction.


  • Progressive loss of memory
  • Inability to concentrate
  • Decrease in problem solving skills and judgment capability
  • Fluctuating mental status, hyperactive to limited alertness
  • Confusion
  • Hallucination, delusions
  • Altered sensation or perception
  • Impaired recognition (agnosia)

  • Altered sleep patterns
  • Insomnia
  • Need for increased sleep
  • Disturbance or change of sleep-wake cycle

  • Motor system impairment
  • Impaired skilled motor function (apraxia)
  • Gait changes
  • Inappropriate movements

  • Disorientation
  • Person, place, time
  • Visual-spatial disorientation
  • Inability to interpret environmental cues

  • Specific disorders of problem solving or learning
  • Inability to generalize
  • Loss of abstract thinking
  • Impaired calculating ability
  • Inability to learn

  • Memory deficit

  • Absent or impaired language ability (aphasia)
  • Inability to comprehend speech
  • Inability to read (alexia)
  • Inability to write (agraphia)
  • Inability to speak, without muscle paralysis
  • Inability to form words
  • Inability to name objects (anomia)
  • Poor enunciation
  • Inappropriate speech, use of jargon or wrong words
  • Inability to repeat a phrase
  • Persistent repetition of phrases

  • Personality changes
  • Irritable
  • Poor temper control
  • Anxiety
  • Depression
  • Indecision
  • Self centered
  • Inflexible
  • No observable mood (flat affect)
  • Inappropriate mood or behavior
  • Withdrawal from social interaction
  • Inability to function or interact in social or personal situations
  • Inability to maintain employment
  • Decreased ability to care for oneself
  • Decreased interest in daily living activities


    The goal of treatment is to control the symptoms of dementia. Treatment varies with the specific disorder. Hospitalization may be required for a short time. The underlying causes should be identified and treated, including treatment for reversible organic lesions (such as tumors).

    Stopping or changing medications that worsen confusion, or that are not essential to the care of the person, may improve cognitive function. Medications that contribute to confusion include anticholinergics, analgesics, cimetidine, central nervous system depressants, lidocaine, and other medications.

    Disorders that contribute to confusion should be treated. These include heart failure, decreased oxygen (hypoxia), thyroid disorders, anemia, nutritional disorders, infections, and psychiatric conditions such as depression. Correction of coexisting medical and psychiatric disorders often greatly improves mental functioning.

    Medications may be required to control aggressive or agitated behaviors or behaviors that are dangerous to the person or to others. These are usually given in very low doses, with adjustment as required.

    Medications that may be considered for use include:

  • Anti-psychotics, given at night
  • Beta blockers if dementia is related to central nervous system lesions
  • Serotonin-affecting drugs (lithium, trazodone, buspirone, clonazepam)
  • Dopamine blockers (such as haloperidol)
  • Carbamazepine, particularly in senile dementia, Alzheimer's type
  • Fluoxetine, imipramine, may help to stabilize mood
  • Cerebral vasodilators (variable results reported)
  • Stimulant drugs (such as methylphenidate), may improve mood
  • Ergotoxine alkaloids, may improve mood and self care without altering cognitive function

    The provision of a safe environment, control of aggressive or agitated behavior, and the ability to meet physiologic needs may require monitoring and assistance in the home or in an institutionalized setting. This may include in-home care, boarding homes, adult day care, or convalescent homes.

    In any care setting, there should be familiar objects and people. Lights that are left on at night may reduce disorientation. The schedule of activities should be simple. Behavior modification may be helpful for some people in controlling unacceptable or dangerous behaviors. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (within the bounds of safety). Reality orientation, with repeated reinforcement of environmental and other cues, may help reduce disorientation.

    The outcome varies. Acute disorders that cause delirium may coexist with chronic disorders causing dementia. Chronic brain syndromes are often progressive and usually result in decreased quality of life and decreased life span.

  • The most common cause of dementia worldwide is Alzheimer's Disease. This is probably followed by multi-infarct dementia, which is caused by multiple strokes.

    Basically, anything which causes damage to the cerebral cortex can cause dementia. Head trauma, toxins, poisons and encephalitis may cause dementia-like symptoms.

    The important thing to remember when faced with someone who has apparent dementia is to exclude delirium in that patient.

    Just one of many psychiatric disorders.

    De*men"ti*a (?), n. [L., fr. demens. See Dement.]

    Insanity; madness; esp. that form which consists in weakness or total loss of thought and reason; mental imbecility; idiocy.


    © Webster 1913.

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