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Alzheimer's Disease and Dementia
To understand Alzheimer's disease, it is crucial to first understand the major manifestation of this disease: dementia. Dementia is the universal slowing of the thought processes. This may be demonstrated by poor short term memory, poor judgment, and an inability to perform simple mathematical calculations.
Dementia can be caused by a number of conditions (multiplestrokes, alcohol abuse, B-complex vitamin deficiencies). Alzheimer's is of particular interest due to its prevalence, unrelenting downhill course, and its, as yet, unknown cause. Although Alzheimer's disease can occur in younger age groups (50's), it most commonly occurs in those over 65. Let's review some of the causes of dementia.
CAUSES OF DEMENTIA
1. B-COMPLEX VITAMIN DEFICIENCIES (thiamine, B6, B12, niacin)
2. CHRONIC ALCOHOL ABUSE
3. ALZHEIMER'S DISEASE
4. SENILE DEMENTIA (old age)
5. MULTI-INFARCT DEMENTIA (secondary to multiple strokes)
6. DIABETES
7. HYPOTHYROIDISM
8. LIVER DISEASE
9. KIDNEY FAILURE
Severe dementia may progress to the complete inability to care for one's self, poor bladder and bowel control, wandering (frequently getting lost), mood swings, and occasional violent outbursts.
Evaluation of Dementia
The evaluation of the patient with dementia is complex. Both CT-scanning and MRI scanning of the brain can reveal changes consistent with the diagnosis of Alzheimer's disease. Spinal tap, blood tests, and EEG may all be part of the battery of exams necessary to evaluate this difficult problem. Emphasis will first be given to ruling out treatable and reversible causes. Some medications can make these patients worse, so a complete evaluation of the patient's medications must be undertaken. The Neurologist is expert in the evaluation of this patient.
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