Dementia

Diagnosis

Diagnosing dementia and identifying its specific form can be challenging. Healthcare providers need to observe the pattern of lost abilities and functions in order to determine the underlying cause of dementia. They also need to assess the remaining capabilities of the patient. In recent times, the availability of biomarkers has improved the accuracy of diagnosing Alzheimer’s disease.

• Physical examination: A medical professional will examine the patient physically and review the patient’s medical history and symptoms. They will probably also inquire about the symptoms from a person close to the patient.

The ability of thinking will be assessed by the healthcare provider. Tests are used to examine a variety of thinking abilities, including memory, orientation, reasoning and judgment, language proficiency, and attention.

To accurately assess memory, language, visual perception, attention, problem-solving, mobility, senses, balance, reflexes, and other areas, healthcare professionals will perform neurological evaluations.

Healthcare providers will likely do a series of tests that can assist them identify the issue because there is not a single test that can diagnose dementia.

• Imaging test:
  • CT or MRI: A computer and X-rays are used in CT to produce precise images of the brain. A computer, radio waves, and magnets are used in MRI to provide precise images of the brain. These imaging examinations search for signs of hydrocephalus, bleeding, tumors, hemorrhage, and stroke.
  • PET scans: This unique kind of brain scan can reveal patterns of brain activity as well as whether or not the amyloid or tau protein, signs of Alzheimer’s disease, has built up in the brain.
• Laboratory tests: Simple blood tests can identify bodily issues like a thyroid gland that is not functioning properly or a vitamin B-12 shortage that can impair brain function. The spinal fluid may occasionally be checked for signs of infection, inflammation, or certain degenerative illnesses.

To assess autoimmune disorders and neurodegenerative diseases, healthcare providers occasionally request cerebrospinal fluid studies.

• Psychiatric evaluation: An expert in mental health can assess whether depression, mood changes, or another mental illness is causing the memory loss.
• Neurocognitive test: The healthcare provider will utilize written and automated tests to assess the mental faculties during neurocognitive testing, including problem-solving, learning, judgment, memory, planning, reasoning, and language.

Treatment

Most types of dementia can be managed and treated using medications and various other approaches to alleviate and control the symptoms. However, it’s important to note that the majority of dementia types cannot be cured or reversed, and available therapies typically have modestly positive effects.

• Medications: The following approaches are used to temporarily alleviate dementia symptoms.
  • Cholinesterase inhibitors: The effectiveness of these drugs, such as donepezil, rivastigmine, and galantamine, is attributed to an increase in levels of a chemical messenger that is important in memory and judgment.

These drugs may be administered for different dementias, such as vascular dementia, Parkinson’s disease dementia, and Lewy body dementia, even though they are typically used to treat Alzheimer’s disease.

Nausea, vomiting, and diarrhea are possible side effects. Additional negative effects include decreased heart rate, fainting, and disturbed sleep.

• • Memantine: Memantine functions by controlling glutamate activity, another chemical messenger involved in cognitive processes including learning and memory. Sometimes a cholinesterase inhibitor is prescribed along with memantine. Memantine frequently causes dizziness as a side effect.
  • Aducanumab: It aims to address amyloid proteins, which accumulate and form plaques in the brains of individuals with Alzheimer’s disease.
  • Lecanemab: A different Alzheimer’s drug, has demonstrated potential in treating mild Alzheimer’s disease and mild cognitive impairment brought on by Alzheimer’s disease.

A phase 3 clinical trial discovered that the drug reduced cognitive deterioration in persons with early Alzheimer’s disease by 27%. The mechanism of action of lecanemab is to stop the clumping of amyloid plaques in the brain. The question of whether removing amyloid plaque clusters from the brain can halt the disease has received just a small amount of research up to this point.

• • Other medications: Medication may be prescribed by the healthcare provider to address additional symptoms or conditions such as depression, sleep issues, hallucinations, parkinsonism, or agitation, based on the individual patient’s needs.
• Therapies: Several behavioral issues and symptoms of dementia may be initially managed without the use of drugs:
  • Occupational therapy: An occupational therapist can provide safety tips for the home and educate coping mechanisms. The goal is to avoid mishaps like falls, control behavior, and get the patient ready for the progression of dementia.
  • Modifying the environment: Someone with dementia may find it simpler to focus and function if there is less clutter and noise. Knives and car keys are two examples of things someone would need to conceal. In the event that a person with dementia wanders, monitoring systems can alarm.
  • Simplifying tasks: It is beneficial to break tasks down into simpler steps, prioritize achieving success, and establish structure and routine to reduce confusion in individuals with dementia.