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JAMA Patient Page
September 22/29, 2004

Dementia

JAMA. 2004;292(12):1514. doi:10.1001/jama.292.12.1514

Dementia is the loss of intellectual ability, which is also known as cognitive (thinking) function. Persons with dementia may be confused, not able to remember things, or lose skills they once had, including performing normal daily activities. Eventually, they may not recognize family members or friends and may display agitated behavior. Although dementia is more common in older adults, it is not a normal consequence of aging. The September 22/29, 2004, issue of JAMA includes an article reporting that regular walking is associated with a reduced risk of developing dementia and an article reporting that physical activity is associated with slower cognitive decline.

SIGNS AND SYMPTOMS OF DEMENTIA

  • Gradually increasing memory loss

  • Confusion

  • Unclear thinking, including losing problem-solving skills

  • Agitated behavior or delusions

  • Becoming lost in formerly familiar circumstances

  • Loss of interest in daily or usual activities

ALZHEIMER DISEASE

Alzheimer disease is the most common cause of dementia. Persons with Alzheimer disease lose functioning neurons (nerve cells) in areas of the brain dealing with cognitive function and memory. They also experience buildup of abnormal proteins in some brain cells. Alzheimer disease affects mostly older adults but can sometimes begin in younger individuals. The cause of Alzheimer disease is not known, but risk factors for Alzheimer disease include family history and advanced age.

OTHER CAUSES OF DEMENTIA

Vascular dementia is usually caused by very small strokes over a period of time that affect blood flow to areas of the brain related to memory and thinking. Some neurological diseases, such as Parkinson disease (a brain disease that causes tremors and muscle stiffness) and Huntington disease (an inherited disease that causes abnormal movements and dementia), can cause dementia because of their effects on brain tissue. These are less common causes of dementia than Alzheimer disease or vascular dementia. Infections that can cause dementia include human immunodeficiency virus (HIV, the virus that causes AIDS), tuberculosis, syphilis, meningitis (infection of the covering of the brain), and encephalitis (infection of brain tissue).

TREATMENT

A careful history of the illness, a physical examination, and blood tests are important to identify reversible causes of dementia, such as infection. Diagnosing dementia can help the person and his or her family members seek help from many available resources. There is no cure for Alzheimer disease or vascular dementia. However, there are prescription medications that may help slow the progression of dementia during treatment. Your doctor can help you decide if medication may be helpful. Medical research into Alzheimer disease and the other dementias may someday help in prevention, early recognition, and more effective treatments.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on Alzheimer disease was published in the November 7, 2001, issue; and one on psychiatric illness in older adults was published in the June 7, 2000, issue.

Sources: National Institute on Aging, National Institute of Neurological Disorders and Stroke, Alzheimer's Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

TOPIC: MENTAL HEALTH

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