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- Dementia is characterized by a slow deterioration of memory and mental function, usually worsening slowly over months and years. An individual suffering dementia typically has a clear sensorium (i.e., he is alert and not drowsy, sleepy, or in a stupor). A rapid onset of confusion or memory loss is not dementia, and needs immediate medical evaluation.
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- Memory loss
- Loss of impulse control (may start using profane language)
- Decreased level of function
- A decrease in the ability to perform the activities of daily living
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- Mini-mental status examination
- MRI or CT scan of head to check for Strokes or other causes
- Basic blood tests to check for other conditions, such as underactive thyroid
- Lumbar puncture (spinal tap) may be necessary if there is a concern about tertiary Syphilis or Chronic Meningitis
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- Alzheimer's disease -- treatments that may have some benefit:
- Donepezil (Aricept)
- Selegiline
- Ginkgo Bilboa
- Vitamin E
- Antidepressants are prescribed if underlying Depression is present
- Anti-anxiety and anti-psychotic medications may be needed for some individuals
- Multi-infarct dementia
- The goal is to prevent further stokes. Treatments may include an aspirin per day, Plavix, Coumadin, or cholesterol-lowering medications.
The medications currently available somewhat improve mental
function, while slowing the progression of the
dementia. It is important to keep the individual with
Alzheimer's disease in a stable, predictable,
environment. In addition, support from spouses, family
members, and caregivers are extremely important.
Generally, there are support organizations in most areas in
the United States.
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- Primary degenerative dementia
- Alzheimer's disease is the most common type and, in general, is a steady, degenerating dementia.
- Huntington dementia is associated with chorea, a movement disorder (see chorea).
- Pick's disease is characterized by personality changes
- Slow viruses such as Creutzfeld-Jakob syndrome or "Mad Cow" disease
- Multi-infarct dementia is caused by multiple small Strokes
- Mixed -- both Alzheimer's disease and multi-infarct dementia are present
- HIV dementia
- Normal pressure hydrocephalus -- excess cerebral spinal fluid in the brain
- Parkinson's Disease (occurs in some individuals)
- Multiple Sclerosis (occurs in some individuals
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