Dementia

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Central nervous system

Overview

Symptoms

Treatment

Prevention

Dementia

Alternative Names:

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia

Symptoms:

Progressive memory loss
Inability to concentrate
Decrease in problem-solving skills and judgment capability
Confusion, severe
Hallucinations and delusions
Altered sensation or perception
Impaired recognition (agnosia)
- Impaired recognition of familiar objects or persons
- Impaired recognition through the senses
Altered sleep patterns
- Insomnia
- Need for increased sleep
- Disturbance or change in sleep-wake cycle
Motor system impairment
- Impaired skilled motor function (apraxia)
  - Inability to reproduce geometric figures
  - Inability to mimic hand positions
  - Inability to dress self
- Gait changes
- Inappropriate movements
- Other motor system impairment
Disorientation
- Person, place, time disorientation
- 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
- Short-term memory problems (can't remember new things)
- Long-term memory problems (can't remember past)
Absent or impaired language ability (aphasia)
- Inability to comprehend speech
- Inability to read
- Inability to write
- Inability to speak, without muscle paralysis
- Inability to form words
- Inability to name objects
- Poor enunciation
- Inappropriate speech; use of jargon or wrong words
- Inability to repeat a phrase
- Persistent repetition of phrases
- Other language impairment
Personality changes
- Irritability
- Poor temper control
- Anxiety
- Depression
- Indecisiveness
- Self-centeredness
- Inflexibility
- 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
Lack of spontaneity

Additional symptoms that may be associated with this disease are as follows:

Swallowing problems
Incontinence

Signs and tests:

The following tests and procedures may be done to determine the severity of dementia and its cause:

Serum electrolytes
Blood chemistry (chem-20)
Serum calcium
Glucose test
Thyroid stimulating hormone level
Thyroid function tests
Liver function tests
Blood ammonia levels
B-12 level
Drug or alcohol levels (toxicology screen)
Urinalysis
Blood gas analysis
EEG (electroencephalograph)
Head CT
MRI of head
CSF (cerebrospinal fluid) analysis

References:

Alva G. Alzheimer disease and other dementias. Clin Geriatr Med. 2003; 19(4): 763-76.

American Academy of Neurology. About Dementia. Neurology. 2004; 63(10); E20.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004:283-286.

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003: 705-708.

Review Date: 5/10/2006
Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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