Dementia is a decrease of mental functions developping over months to years. This might cause a memory impairment aside difficulties with other mental functions. Attention, recognition, language, planning, abstraction and the capability of running tasks, can be affected. Eventually this might impair daily activities. Emotional and behavioural changes might also occur, such as depression, fear, hallucinations… 1% of the population aged > 65j develops dementia and the percentage raises with age.
Several different conditions might cause dementia. Often a neurodegenerative disease with loss of neurons in the brain results in dementia, such as Alzheimer’s disease. Although the precise cause of this disease is not yet fully known, loss of neurons is noticed, starting in the hippocampus (a brain region essential for memory) and expanding to the rest of the brain. Also precipitation of tau and amyloid proteins in neurons is seen.
Other neurodegenerative diseases also might cause dementia such as dementia with lewy bodies, parkinson’s dementia and frontemporal dementia.
Structural changes in the brain due to stroke, tumours, inflammation … or intoxication with alcohol or drugs can also cause dementia.
The evaluation on consultation comprises a profound talk with the patient and family, a neurogical examination and evaluation of the mental functions.
Quite often a neuropsychological testing is planned, a blood test, an EEG, a brain scan (MRI) or even a lumbar puncture.
Sometimes after all examinations the criteria for dementia are not met, but there might be an isolated memory problem. This is called mild cognitive impairment. Often this MCI might evolve to Alzheimer’s disease, so follow up is necessary.
Depending on the results of the above mentioned examinations, certain drugs are prescribed or psychological care is provided.