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Dementia   

Overview | Symptoms | Treatment | Prevention

Alternative names:

Chronic brain syndrome

Symptoms

• progressive loss of memory
• inability to concentrate
• decrease in problem solving skills and judgment capability
• confusion, severe
• hallucination, delusions
• altered sensation or perception
• impaired recognition (agnosia)
  • impaired recognition of familiar objects or persons
  • impaired recognition through stimuli of any or all senses
• altered sleep patterns
  • insomnia
  • need for increased sleep
  • disturbance or change of 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 impairment of motor system
• disorientation
  • person, place, time
  • 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
  • long-term memory
• absent or impaired language ability (aphasia)
  • inability to comprehend speech
  • inability to read (alexia)
  • inability to write (agraphia)
  • inability to speak, without muscle paralysis
  • inability to form words
  • inability to name objects (anomia)
  • poor enunciation
  • inappropriate speech, use of jargon or wrong words
  • inability to repeat a phrase
  • persistent repetition of phrases
  • other language impairment
• personality changes
  • irritable
  • poor temper control
  • anxiety
  • depression
  • indecision
  • self centered
  • inflexible
  • 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:

• swallowing problems
• incontinence

Signs and Tests

A neurologic examination may reveal abnormalities. Early on, there may be only mild memory or attentional deficits. As time progresses, there may be evidence of other cognitive difficulties. These include language problems,disorientation, changes in personality, visuo-spatial problems, slowness of thinking, apraxia (impaired ability to carry out motor activities despite normal motor function), agnosia (failure to identify objects despite intact sensory function), and difficulty with planning and organizing.

Eventually there may also be symptoms of weakness, incontinence, falling and other abnormal neurological function.

The work up includes identifying reversible causes. These are usually rare. The extent of damage and cause of dementia may be indicated by tests and procedures that include, but are not limited to:

• 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, alcohol levels (toxicology screen)
• urinalysis
• blood gas analysis
• EEG, electroencephalograph
• head CT
• MRI of head
• CSF (cerebrospinal fluid) analysis

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