| The term dementia is used broadly to describe a | | | | long-term dialysis and long-term diuretic therapy |
| condition which is characterized by cognitive | | | | (used to treat congestive heart failure). The |
| decline, but there are many different types of | | | | symptoms of dementia caused by |
| dementia. Although it is usually progressive, | | | | Wernicke-Korsakoff syndrome include confusion, |
| properly diagnosing dementia can reverse the | | | | permanent gaps in memory, and impaired |
| effects and be treated and even cured | | | | short-term memory. Hallucinations may also occur. |
| completely by addressing the underlying cause. | | | | Mild Cognitive Impairment (MCI) |
| However, dementia caused by incurable conditions | | | | Dementia can be due to medical illness, |
| such as Alzheimer’s disease, are irreversible. | | | | medications and a host of other treatable causes. |
| What are the different types of dementia? | | | | With mild cognitive impairment, an individual will |
| Experts estimate that Alzheimer’s disease is | | | | experience memory loss, and sometimes impaired |
| the underlying cause of 60–80% of all | | | | judgment and speech, but is usually aware of the |
| dementia cases. However, there are many other | | | | decline. These problems usually don’t interfere |
| conditions which can also cause dementia, which | | | | with the normal activities of daily living. Individuals |
| makes it vital for the patient to obtain accurate | | | | with mild cognitive impairment may also |
| diagnosing of dementia early on in order to get | | | | experience behavioral changes that involve |
| proper treatment. Following are some of the | | | | depression, anxiety, aggression and emotional |
| most common types of dementia and their | | | | apathy; these can be due to the awareness of |
| causes.. | | | | and frustration related to his or her condition. |
| Vascular Dementia | | | | What can I expect when the doctor is diagnosing |
| The second most common form of dementia, | | | | dementia? |
| vascular dementia is caused by poor blood flow to | | | | The health care professional you meet with will |
| the brain, which deprives brain cells of the | | | | need to know the symptoms the patient is |
| nutrients and oxygen they need to function | | | | experiencing, their duration, frequency and rate of |
| normally. One of the ten dementia types, vascular | | | | progression. The doctor will do everything he or |
| dementia can result from any number of | | | | she can to make the patient comfortable while |
| conditions which narrow the blood vessels, | | | | diagnosing dementia, which includes addressing the |
| including stroke, diabetes and hypertension. | | | | patient’s fears regarding the types of |
| Mixed Dementia | | | | dementia and condition. Diagnosing dementia |
| Sometimes dementia is caused by more than one | | | | requires a full review of the patient’s health |
| medical condition. This is called mixed dementia. | | | | care, family history and medication history. This |
| The most common form of mixed dementia is | | | | includes evaluating the patient for depression, |
| caused by both Alzheimer’s and vascular | | | | substance abuse and nutrition, and other |
| disease. | | | | conditions that can cause memory loss, including |
| Dementia with Lewy Bodies (DLB) | | | | anemia, vitamin deficiency, diabetes, kidney or |
| Sometimes referred to as Lewy Body Disease, | | | | liver disease, thyroid disease, infections, |
| this type of dementia is characterized by | | | | cardiovascular and pulmonary problems. The |
| abnormal protein deposits called Lewy bodies | | | | patient must also undergo a physical exam and |
| which appear in nerve cells in the brain stem. | | | | blood tests in order to determine which types of |
| These deposits disrupt the brain’s normal | | | | dementia the patient may be suffering from. |
| functioning, impairing cognition and behavior and | | | | Not every doctor is familiar with the complexities |
| can also cause tremors. DLB is not reversible and | | | | of dementia diagnosis, so you will need to find a |
| has no known cure. | | | | doctor who is experienced at diagnosing dementia |
| Parkinson’s Disease Dementia (PDD) | | | | types. Currently, there is no single test that |
| Parkinson’s disease is a chronic, progressive | | | | proves Alzheimer’s, although it is possible to |
| neurological condition, and in its advanced stages, | | | | achieve 90% accuracy. However, we may have |
| the disease can affect cognitive functioning. Not all | | | | difficulty in discovering the true underlying cause. |
| people with Parkinson’s disease will develop | | | | In patients with advanced findings of brain |
| dementia, however. Dementia due to | | | | dysfunction, diagnosing dementia is fairly |
| Parkinson’s is also a Lewy body dementia. | | | | straightforward. But in patients with some early |
| Symptoms include tremors, muscle stiffness and | | | | findings of diminished brain function, the diagnosis |
| speech problems. Reasoning, memory, speech, | | | | and its type is seldom clear. Following are some of |
| and judgment are usually affected. | | | | the approaches that are commonly used in |
| Frontotemporal Dementia | | | | determining types of dementia. |
| Pick’s disease, the most common of the | | | | Mini Mental State Evaluation (MMSE) |
| frontotemporal dementia types, is a rare disorder | | | | The mini-mental status exam is a very brief |
| which causes damage to brain cells in the frontal | | | | evaluation of the patient’s cognitive status |
| and temporal lobes. Pick’s disease affects the | | | | used in diagnosing dementia types. The patient is |
| individual’s personality significantly, usually | | | | required to identify the time, date and place |
| resulting in a decline in social skills, coupled with | | | | (including street, city and state) where the test is |
| emotional apathy. Unlike other types of dementia, | | | | taking place, be able to count backwards, identify |
| Pick’s disease typically results in behavior and | | | | objects previously known to him or her, be able |
| personality changes manifesting before memory | | | | to repeat common phrases, perform basic skills |
| loss and speech problems. | | | | involving math, language use and comprehension, |
| Creutzfeldt-Jacob Dementia (CJD) | | | | and demonstrate basic motor skills. |
| CJD is a degenerative neurological disorder, which | | | | Mini-Cog |
| is also known as mad cow disease. The incidence | | | | Another test for diagnosing dementia, the |
| is very low, occurring in about one in one million | | | | mini-cog takes only a few minutes to administer |
| people. There is no cure. Caused by viruses that | | | | and is used as an initial screening for various |
| interfere with the brain’s normal functioning, | | | | types of dementia. The patient is required to |
| dementia due to CJD progresses rapidly, usually | | | | identify three objects in the office, then draw the |
| over a period of several months. Symptoms | | | | face of a clock in its entirety from memory, and |
| include memory loss, speech impairment, | | | | finally, recall the three items identified earlier. |
| confusion, muscle stiffness and twitching, and | | | | Imaging Tests: CTs, MRIs & Pet Scans |
| general lack of coordination, making the individual | | | | Physicians diagnosing dementia may study the |
| susceptible to falls. Occasionally, blurred vision and | | | | structure of the patient’s brain by CT or MRI |
| hallucinations are also associated with the condition. | | | | to see if there are any growths, abnormalities or |
| Normal Pressure Hydrocephalus (NPH) | | | | general shrinkage (as seen in cases of |
| Normal pressure hydrocephalus involves an | | | | Alzheimer’s). Studies of brain function, using a |
| accumulation of cerebrospinal fluid in the | | | | PET scan and a special form of MRI can more |
| brain’s cavities. Impaired drainage of this fluid | | | | definitively confirm the diagnosis of various types |
| leads to the build-up and results in added pressure | | | | of dementia and raise the accuracy of the |
| on the brain, interfering with the brain’s ability | | | | diagnosis to 90%. A PET scan administered and |
| to function normally. Individuals with dementia | | | | reviewed by an expert delivers the most |
| caused by normal pressure hydrocephalus often | | | | accurate and suggestive results while diagnosing |
| experience problems with ambulation, balance and | | | | dementia. The most accurate form of PET |
| bladder control, in addition to cognitive | | | | scanning for types of dementia is called |
| impairments involving speech, problem-solving | | | | Stereotactic Surface Projection, which involves an |
| abilities and memory. | | | | advanced statistical analysis of the data. |
| Huntington’s Disease | | | | In 2007, led by Dr. Norman Foster, head of the |
| Huntington’s disease is an inherited | | | | Alzheimer’s Center at the University of Utah, |
| progressive dementia that affects the | | | | a group of elite PET scientists and dementia |
| individual’s cognition, behavior and movement. | | | | experts conducted a study in which they |
| The cognitive and behavioral symptoms of | | | | performed PET scans and clinical tests on multiple |
| dementia due to Huntington’s include memory | | | | patients. The accuracy with the tests was 90% |
| problems, impaired judgment, mood swings, | | | | for both Alzheimer’s and frontotemporal |
| depression and speech problems (especially slurred | | | | dementia types. They stated that scans increased |
| speech). Delusions and hallucinations may occur. In | | | | the experts’ confidence in diagnosing |
| addition, the individual may experience difficulty | | | | dementia types and made them question and |
| ambulating, and uncontrollable jerking movements | | | | sometimes change the diagnosis in 42% of cases. |
| of the face and body. | | | | They stated that early and accurate diagnosing of |
| Wernicke-Korsakoff Syndrome | | | | dementia is critical to avoid misdiagnosis and |
| Wernicke-Korsakoff syndrome is caused by a | | | | mistreatment. The results of this study show that |
| deficiency in thiamine (Vitamin B1) and often | | | | PET scanning is highly predictive of the |
| occurs in alcoholics, although it can also result from | | | | patient’s clinical course and essential to |
| malnutrition, cancer which have spread in the | | | | properly diagnosing dementia. |
| body, abnormally high thyroid hormone levels, | | | | |