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.
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 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 and advanced age.
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).
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.
National Institute on Aging 800/438-4380 http://www.nia.nih.gov
Alzheimer's Association 800/272-3900 http://www.alz.org
National Institute of Neurological Disorders and Stroke http://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 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
Torpy JM, Lynm C, Glass RM. Dementia. JAMA. 2004;292(12):1514. doi:10.1001/jama.292.12.1514