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Dementia is the loss of intellectual ability, which is also known as cognitive (thinking) function, that interferes with daily activities. 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 November 19, 2008, issue of JAMA includes a study finding that the herbal product Ginkgo biloba did not decrease the development of dementia in either normal elderly persons or those with mild cognitive impairment. This Patient Page is based on one previously published in the June 6, 2007, issue of JAMA.
Signs and symptoms of dementia
Gradually increasing memory loss
Unclear thinking, including losing problem-solving skills
Agitated behavior or delusions
Becoming lost in formerly familiar circumstances
Loss of interest in and inability to perform daily or usual activities
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, a specific gene, and advanced age.
Other causes of dementia
Vascular dementia is usually caused by 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. Symptoms like those of dementia may be caused by many other factors, including medications and some illnesses. A careful evaluation by a doctor is important to look for treatable causes.
Diagnosing dementia can help the person and his or her family members seek help from available resources. There is no cure for Alzheimer disease or vascular dementia. Some prescription medications may help slow the progression of dementia during treatment. Your doctor can help you decide if medication may be worthwhile. Medical research on Alzheimer disease and the other dementias may someday help in prevention, early recognition, and more effective treatments.
For more information
National Institute on Aginghttp://www.nia.nih.gov
National Institute of Neurological Disorders and Strokehttp://www.ninds.nih.gov
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 mild cognitive impairment was published in the October 1, 2008, 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. To purchase bulk reprints, call 312/464-0776.
TOPIC: MENTAL HEALTH
Torpy JM, Lynm C, Glass RM. Dementia. JAMA. 2008;300(19):2330. doi:10.1001/jama.300.19.2330
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