Dementia

Dementia refers to a group of diseases that cause confusion with memory loss. Types of dementia include Alzheimer’s, vascular dementia (caused by small strokes), Parkinson’s-associated dementia, and many others such as Lewy-Body Dementia. Dementia is progressive and incurable. Progressive means the symptoms get worse over time. Incurable means that the memory loss is permanent. Memory loss makes it difficult to remember names and places, how to do the usual activities of daily living, etc. People with dementia eventually require complete care; over half of all nursing home residents have some type of dementia.

There are two general ways to treat dementia. Treat not cure.

1. Try to reverse or slow down the disease progress. Drugs such as Aricept (donepezil), Exelon (rivastigmine), Reminyl (galantamine), Namenda (memantine), intended to slow down the disease progress can sometimes keep a person functioning longer at home, but unfortunately they have not been as helpful as initially hoped and have shown little benefit over the long term. [if !supportLineBreakNewLine] [endif]

2. Control symptoms such as pain, depression, hallucinations (seeing or hearing things not really present) and sleeplessness. For symptom management, there are many drugs to help. Since most seniors have some pain, Tylenol or even small doses of morphine help calm those who can’t (or won’t) tell us they have pain; sleeping pills and occasionally antidepressants may benefit. The latest studies show that keeping the number of medications to a minimum, using behavioral approaches (a calming attitude, avoiding confrontations, etc.) as well as reducing “unnecessary” tests, procedures, and relocations works better.

Keeping mentally and physically active, eating a healthy diet, avoiding obesity, and controlling blood pressure have been shown to be the most beneficial to prevent the disease: for example, walking daily, doing crosswords or other puzzles, learning new hobbies, eating lots of fruits and vegetables. Forcing your brain to ‘make new connections’ helps – as in using your left hand to do things you normally use your right hand for.

Dementia can also affect the decision to have surgery or a test done. Dementia is made worse by anything which disrupts daily routine: being hospitalized, having surgery, taking additional drugs or major tests – all these can, and often do, make the patient more confused, sometimes permanently.

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