At the Center for Brain and Neuro Care, we diagnosis and treat memory disorders. This includes programs that focus on Alzheimer’s disease, frontotemporal dementia, and normal pressure hydrocephalus, as well as stroke and related vascular dementia. We take a multidisciplinary approach to reducing the progression of the disease, both to improve a patient’s quality of life and reduce their caregiver’s burden.

Alzheimer’s disease is the commonest type of dementia that commonly affects those between ages 60-85. Patients can have problems with memory, thinking, language and behavior. It progresses slowly, increasing a caregiver’s burden over time.

However, the disease is medically manageable. If you are experiencing memory loss, you need to seek your doctor’s attention right away for early intervention.This is the best way to slow the progression of the disease.

Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

The risk of dementia increases as a person gets older. Most types of dementia are nonreversible (degenerative), which means the changes in the brain are progressive and cannot be reversed.

Alzheimer’s disease is the most common type of dementia. Other types of dementia are:

+ Vascular dementia— caused by many small strokes.
+ Lewis body dementia
+ Brain injury
+ Multiple sclerosis
+ Infections such as HIV/AIDS
+ Syphilis
+ Lyme disease
+ Parkinson disease

Some causes of dementia may be stopped or reversed if they are found soon enough, including:

+ Brain injury
+ Brain tumors
+ Chronic alcohol abuse
+ Changes in blood sugar, sodium, and calcium levels (dementia due to metabolic causes)
+ Low vitamin B12 level
+ Normal pressure hydrocephalus
+ Use of certain medicines, including cimetidine and some cholesterol drugs

Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory.

They may also have mild problems with:

+ Emotional behavior or personality
+ Thinking and judgment (cognitive skills)
+ Language
+ Perception

Symptoms of MCI can include:

+ Difficulty doing more than one task at a time
+ Difficulty solving problems or making decisions
+ Forgetting recent events or conversations
+ Taking longer to do more difficult mental activities

Early symptoms of dementia can include:

+ Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines
+ Getting lost on familiar routes
+ Language problems, such as trouble with the names of familiar objects
+ Losing interest in things previously enjoyed, having a flat mood
+ Misplacing items
+ Personality changes and loss of social skills, which can lead to inappropriate behaviors

As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. These worsening symptoms may include:

+ Change in sleep patterns, often waking up at night
+ Difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving
+ Forgetting details about current events
+ Forgetting events in one’s own life history, losing self-awareness
+ Having hallucinations, arguments, striking out, and violent behavior
+ Having delusions
+ Becoming depressed or agitated
+ More difficulty reading or writing
+ Poor judgment and loss of ability to recognize danger
+ Using the wrong word, not pronouncing words correctly, speaking in confusing sentences
+ Withdrawing from social contact

People with severe dementia can no longer:

+ Perform basic activities of daily living, such as eating, dressing, and bathing
+ Recognize family members
+ Understand language

Other symptoms may include problems controlling bowel movements or urine and difficulty swallowing.

Exams and Tests

<h6>A skilled health care provider can often diagnose dementia by:</h6>

+ Doing a complete physical exam, including nervous system exam
+ Asking about the person’s medical history and symptoms
+ Doing mental function tests (mental status examination)

Other tests may be ordered to find out if other problems may be making the dementia worse, such as:

+ Anemia
+ Brain tumor
+ Chronic infection
+ Intoxication from medications
+ Severe depression
+ Thyroid disease
+ Vitamin deficiency
+ The following tests and procedures may be done:
+ B12 level
+ Bloodammonia levels
+ Blood chemistry (chem-20)
+ Blood gas analysis
+ Cerebrospinal fluid (CSF) analysis
+ Drug or alcohol levels (toxicology screen)
+ Electroencephalograph(EEG)
+ Head CT
+ Mental status test
+ MRI of head
+ Thyroid function tests, including thyroid stimulating hormone
+ Thyroid stimulating hormonelevel
+ Urinalysis

Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time. Sometimes dementia medicine can make a patient’s confusion worse. Stopping or changing these medicines is part of the treatment. Certain mental exercises can help with dementia.

Treating conditions that sometimes lead to confusion often greatly improves mental function. Such conditions include:

+ Anemia
+ Congestive heart failure
+ Decreased blood oxygen (hypoxia)
+ Depression
+ Heart failure
+ Infections
+ Nutritional disorders
+ Thyroid disorders

Medicines that may be prescribed include:

Aricept, which can help slow the decline in memory and improve mental function (such as thinking) by increasing the amount of a certain natural substance in the brain. Patients who continued taking Aricept were better able to remember, understand, communicate and perform daily tasks for at least a year longer than those who stopped taking the drugs.

Namenda, either alone or in combination with Aricept, helps slow the clinical progression in Alzheimer’s dementia. Starting treatment early may improve the patient’s chances. The benefits of Namenda increase over time, allowing patients to remain independent for longer, alleviating caregiver burden, and delaying the possible need to be institutionalized.

Namzaric, a combination of Namenda and Aricept, is approved for the treatment of moderate to severe Alzheimer’s disease. We find that patents are more likely to take this drug as prescribed since it is only taken once a day.

Exelon transdermal patch is applied to the skin once a day. It’s used to treat people with:

Dementia, a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality

Alzheimer’s disease, a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities,

dementia related to Parkinson’s disease, a brain system disease with symptoms of slowing of movement, muscle weakness, shuffling walk, and loss of memory.