The Spectrum of Dementias

Say dementia and the average American and most think "Alzheimer's Disease". To physicians such as those in the neurological specialties, Dementia is a broad category, with most being Alzheimer's Disease, many others being due to vascular conditions and a multitude of others from metabolic diseases, traumatic brain injuries, nutritional deficiencies and others due to poorly understood neurologic diseases comprising the rest. Progress is being made in the diagnosis and therapy of Alzheimer's disease and vascular induced dementia. The other dementias are rarer and harder to study.

Dementia is a decline in cognitive functions, such as reasoning, memory and other functions of thinking. These may be termed "Activities of Daily Living". Most dementias have a progressive course. Neurologists may separate dementias into reversible and irreversible and cortical (brain cells being involved) and subcortical (connections between brain cells being involved).

Diagnosis is not always a straight forward matter; family history, personal history and physical exam along with a review of medications and some laboratory testing may help diagnose a dementia and classify it; perhaps the most powerful tools are the new radiological techniques = CAT scans, MRI scans and PET scans with new techniques on line. Ask your physician is there any chance it is a reversible process. And specific diagnostic tests for Alzheimer's are in the works.

There is hope and help on the way; our understanding of the basic processes in Alzheimer's Disease has progressed exponentially and not only are better drugs becoming available, but hope for a vaccine against the beta amyloid tangles central to the pathology of this dementia is in the works. Additionally, the passive attitude of letting the dementia progress is giving way to keeping the patient stimulated and mentally active. And an understanding has evolved that vascular diseases contribute to this dementia.

Ministrokes, the basis for vascular dementia (along with hypertension) are open to intervention - but need early identification.

Although these are by their very nature tragic diseases, progress is truly being made. If a loved one suffers from one of these illnesses, consider enrolling him or her in a clinical study after familiarizing yourself with the potential risks and benefits, try to find a compassionate physician who can make time for you and your loved one, engage your family in the care process, give yourself time off and join a support network - on line or otherwise. A good book, dealing with amyotrophic laterial sclerosis, but full of insight is: Tuesdays with Morrie.

The articles below are well worth reading for understanding dementia: Just a note on statistics: 60% Alzheimer's, 20% Vascular Diseases and 20% others.

http://www.emedicinehealth.com/dementia_overview/article_em.htm
Good review article
http://neurology.health-cares.net/dementia.php
Excellent review article with many subtopics
http://www.about-dementia.com/
An easy to read and understandable review of Dementia
http://en.wikipedia.org/wiki/Alzheimer's_disease
http://en.wikipedia.org/wiki/Dementia
Two good Wiki articles on Alzheimer's and dementia