What is Dementia?

Dementia is a term used to identify different brain disorders that have in common memory loss, confusion, and problems with language and understanding. They are normally progressive and eventually prevent the sufferer from caring for him/herself. There are over 100 diverse types of dementia, some of which do react to intervention, so it is important to look for a reason for these symptoms. Could they be caused by something treatable like thyroid disease, or anemia, or even be created by medicines? Such treatable conditions can be established by a good physical and mental evaluation, plus carefully chosen lab tests.

Isn't dementia just old age or senility?

Aging exclusively does not cause substantial retention problems or stop us taking care of ourselves. As we get older, it might take longer to remember names or find the right word to say. This is different from the loss of memory and other mental problems associated with conditions like Alzheimer's disease (AD). Those suffering from Alzheimer's can get lost in familiar places like home or close to home, fail to acknowledge family members, fail to recognize familiar objects such as a pen or a watch, and cannot recompense for these deficiencies.

While various varieties of "dementia" are more common the longer we live, they are not part of typical aging. All memory alterations should be thoroughly assessed.

What are the unique kinds of "dementia"?

The most commonplace dementias are Alzheimer's disease (AD), vascular dementia and Lewy Body dementia. But, there are many other causes of impaired brain function such as strokes, low vitamin B12 levels, thyroid gland conditions, depression, AIDS, other infections and illnesses. In addition, medicinal drugs, either prescribed or bought without prescription, or alternative and herbal remedies can affect memory and induce mental confusion in elderly individuals.

What is Alzheimer's disease?

In this condition, certain cells in the brain stop functioning and eventually die. These cells produce fundamental chemical substances [acetylcholine, serotonin, dopamine and others] needed for memory, speech and other thought functions. As the chemicals decrease, so do the person's abilities to remember and think distinctly. AD usually sneaks up on the person and family. It can get worse slowly and silently over several years before changes are noticed. Over time (usually 2-8 years), it advances to a point where the person can no longer handle simple tasks like eating or bathing.

How do you get Alzheimer's Disease?

As we get older our chances of developing AD increase. Between the ages of 65 and 70, approximately one in 20 people has the disease. By the age of 85 and older, between 1 in 2 or 3 has this disease. We also recognize that some families pass along genes that increase the chance for getting AD. Some factors in our surroundings can increase the risk also, such as head trauma with unconsciousness. When we say "increases the risk" of getting AD, this does not mean we will get it for certain. It just means the odds of our getting it are enhanced.

Is there any point to visiting my health care provider?

It is very critical to get a thorough medical evaluation. First, the psychological changes could be a result of a treatable condition such as thyroid disease, or medication affiliated, and second, there are now treatments accessible for AD that can improve the symptoms and slow the progression of the disease. Third, the doctor's office should be able to help you in finding community resources for information, support groups and help at home.

What can we expect from the health care provider?

Your health care provider should take your concerns earnestly. He or she should carry out a careful medical examination and medicines inspection. There should be tests of memory, temper, day-to-day routine, lab tests, and sometimes a scan of the brain. A referral for thorough mental screening may be given. If the diagnosis is clear, the physician should continue to render care throughout the illness.

What treatments are there for Alzheimer's disease?

Medicines approved for handling Alzheimer's disease are donepezil [Aricept], galantamine [Razadyne, formerly Reminyl] and rivastigmine [Exelon]. They function by increasing the levels of acetylcholine in the brain. Memantine (Namenda) influences glutamate, another brain courier chemical, and might help AD symptoms. Vitamin E might slow the advancement of Alzheimer's disease. Nevertheless, since it can increase hemorrhaging, it should be employed with care, especially in individuals taking blood thinners. None of these drugs cures or contains the disease but might slow advancement.

Several herbal cures and other dietary supplementations are advertised as effective treatments for AD and associated disorders. However complete scientific evidence of this is inadequate as yet, though tests are being conducted on substances such as Ginko Biloba. Your physician or the Alzheimer's Association may be able to help you find a research study website if you wish to participate in one of these trials.

How can I convince my loved one to go to the doctor?

Often, your family member already acknowledges there is something wrong and is scared. It is facilitative to focus on the accessible treatment alternatives, and to remind your family member that early detection allows decisions to be made about treatment, and will permit him or her to put matters in order.

How do I recognize when my loved one should cease working, banking, driving or living alone?

These are difficult questions that your health care provider should assist you in answering. In general, if there is potential for harm to your family member or to others, it may be time to consider stopping certain activities. Health care providers rely on your accounts when making recommendations about major life changes. They can be supportive in reinforcing your concerns.

What else can I do as a caregiver?

Above all else, the person with dementia needs your care and reinforcement. You can't supply that care if you don't look after your own health. Caregiving can be rewarding, but can also be strenuous, sad and demoralizing. You can become sick if you ignore your own health needs. You need intermissions from caregiving; you need assistance at home; you need to eat, sleep and exercise regularly; you need to forgive yourself for feelings of angriness and guilt. A support group can help you through some tough times you may face.

Is a nursing home truly needed?

This is an personal issue. Oftentimes households feel ashamed about putting a loved-one permanently in a nursing home. Some nursing homes can provide part-time respite care, to give the main health care provider a break. A good nursing home can supply care, safety and societal interactions that can give your family member pleasure and security. It can likewise give you a chance to slumber unworried and do your everyday tasks with some peace of mind. With good help at home, safety measures (such as removing the knobs from stoves) and day care alternatives, the individual can stay at home for a prolonged time.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

The Interdisciplinary Team; The Role of the Psychiatrist

by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication