Dementia

Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several different diseases may cause dementia.

Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia.

Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms may be reversible.

Dementia symptoms vary depending on the cause, but common signs and symptoms include:

Cognitive changes

• Memory loss, which is usually noticed by a spouse or someone else
• Difficulty communicating or finding words
• Difficulty with visual and spatial abilities, such as getting lost while driving
• Difficulty reasoning or problem-solving
• Difficulty handling complex tasks
• Difficulty with planning and organizing
• Difficulty with coordination and motor functions
• Confusion and disorientation

Psychological changes

• Personality changes
• Depression
• Anxiety
• Inappropriate behavior
• Paranoia
• Agitation
• Hallucinations

See a doctor if you or a loved one has memory problems or other dementia symptoms. Some treatable medical conditions can cause dementia symptoms, so it's important to determine the underlying cause.

Dementia is caused by damage to or loss of nerve cells and their connections in the brain. Depending on the area of the brain that's affected by the damage, dementia can affect people differently and cause different symptoms.

Dementias are often grouped by what they have in common, such as the protein or proteins deposited in the brain or the part of the brain that's affected. Some diseases look like dementias, such as those caused by a reaction to medications or vitamin deficiencies, and they might improve with treatment.

Types of dementias that progress and aren't reversible include:

• Alzheimer's disease. Alzheimer's disease is the most common cause of dementia.
  Although not all causes of Alzheimer's disease are known, experts do know that a small percentage are related to mutations of three genes, which can be passed down from parent to child. While several different genes are probably involved in Alzheimer's disease, one important gene that increases risk is apolipoprotein E4 (APOE).
  Alzheimer's disease patients have plaques and tangles in their brains. Plaques are clumps of a protein called beta-amyloid, and tangles are fibrous tangles made up of tau protein. It's thought that these clumps damage healthy neurons and the fibers connecting them.
  Other genetic factors might make it more likely that people will develop Alzheimer's.
• Vascular dementia. This second most common type of dementia is caused by damage to the vessels that supply blood to your brain. Blood vessel problems can cause strokes or damage the brain in other ways, such as by damaging the fibers in the white matter of the brain. The most common symptoms of vascular dementia include difficulties with problem-solving, slowed thinking, focus and organization. These tend to be more noticeable than memory loss.
• Lewy body dementia. Lewy bodies are abnormal balloonlike clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease. This is one of the more common types of progressive dementia. Common signs and symptoms include acting out one's dreams in sleep, seeing things that aren't there (visual hallucinations), and problems with focus and attention. Other signs include uncoordinated or slow movement, tremors, and rigidity (parkinsonism).
• Frontotemporal dementia. This is a group of diseases characterized by the breakdown (degeneration) of nerve cells and their connections in the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior and language. Common symptoms affect behavior, personality, thinking, judgment, and language and movement.
• Mixed dementia. Autopsy studies of the brains of people 80 and older who had dementia indicate that many had a combination of several causes, such as Alzheimer's disease, vascular dementia and Lewy body dementia. Studies are ongoing to determine how having mixed dementia affects symptoms and treatments.

Other disorders linked to dementia

• Huntington's disease. Caused by a genetic mutation, this disease causes certain nerve cells in your brain and spinal cord to waste away. Signs and symptoms, including a severe decline in thinking (cognitive) skills, usually appear around age 30 or 40.
• Traumatic brain injury (TBI). This condition is most often caused by repetitive head trauma. People such as boxers, football players or soldiers might experience TBI.
  Depending on the part of the brain that's injured, this condition can cause dementia signs and symptoms such as depression, explosiveness, memory loss and impaired speech. TBI may also cause parkinsonism. Symptoms might not appear until years after the trauma.
• Creutzfeldt-Jakob disease. This rare brain disorder usually occurs in people without known risk factors. This condition might be due to deposits of infectious proteins called prions. Creutzfeldt-Jakob disease usually has no known cause but can be inherited. It may also be caused by exposure to diseased brain or nervous system tissue, such as from a cornea transplant. Signs and symptoms of this fatal condition usually appear after age 60.
• Parkinson's disease. Many people with Parkinson's disease eventually develop dementia symptoms (Parkinson's disease dementia).

Dementia-like conditions that can be reversed

Some causes of dementia or dementia-like symptoms can be reversed with treatment. They include:

• Infections and immune disorders. Dementia-like symptoms can result from fever or other side effects of your body's attempt to fight off an infection. Multiple sclerosis and other conditions caused by the body's immune system attacking nerve cells also can cause dementia.
• Metabolic problems and endocrine abnormalities. People with thyroid problems, low blood sugar (hypoglycemia), too little or too much sodium or calcium, or problems absorbing vitamin B-12 can develop dementia-like symptoms or other personality changes.
• Nutritional deficiencies. Not drinking enough liquids (dehydration); not getting enough thiamin (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms. Copper and vitamin E deficiencies also can cause dementia symptoms.
• Medication side effects. Side effects of medications, a reaction to a medication or an interaction of several medications can cause dementia-like symptoms.
• Subdural hematomas. Bleeding between the surface of the brain and the covering over the brain, which is common in the elderly after a fall, can cause symptoms similar to those of dementia.
• Poisoning. Exposure to heavy metals, such as lead, and other poisons, such as pesticides, as well as recreational drug or heavy alcohol use can lead to symptoms of dementia. Symptoms might resolve with treatment.
• Brain tumors. Rarely, dementia can result from damage caused by a brain tumor.
• Anoxia. This condition, also called hypoxia, occurs when organ tissues aren't getting enough oxygen. Anoxia can occur due to severe sleep apneas, asthma, heart attack, carbon monoxide poisoning or other causes.
• Normal-pressure hydrocephalus. This condition, which is caused by enlarged ventricles in the brain, can cause walking problems, urinary difficulty and memory loss.