Breaking News
March 21, 2019 - Mutations in noncoding genes could play big role in regulating cancer, study finds
March 21, 2019 - A medical student’s thoughts on Match Day
March 21, 2019 - Are eggs good or bad for you?
March 21, 2019 - New analysis reveals precision oncology insights for colorectal cancer
March 21, 2019 - Pollutants appear to weaken immune system and increase pathogen virulence
March 21, 2019 - Researchers develop and validate scale for rating severity of mononucleosis
March 21, 2019 - Scientists identify generation of key immune response in mice on introducing solid food
March 21, 2019 - New nanomaterial could restore internal structure of damaged bones
March 21, 2019 - Selective destruction of prostate tumor as effective as complete prostate removal
March 21, 2019 - 2011 to 2015 Saw Increase in Psychiatric ED Visits for Youth
March 21, 2019 - Tapeworm drug targets common vulnerability in tumor cells
March 21, 2019 - Off the beaten path for global health residency
March 21, 2019 - European Parliament’s report calls on EU to develop policies to regulate endocrine-disrupting chemicals
March 21, 2019 - Women with undiagnosed diabetes in pregnancy more likely to experience stillbirths
March 21, 2019 - Fish consumption can help prevent asthma, study reveals
March 21, 2019 - Royal Holloway professors to lead new to research into curing Neurofibromatosis type 1
March 21, 2019 - NSF offers grant to improve treatment approaches for pelvic organ prolapse
March 21, 2019 - Your Apple Watch Might Help Spot a Dangerous Irregular Heartbeat
March 21, 2019 - Research team uncovers critical new clues about what goes awry in autistic brains
March 21, 2019 - From March Madness to medicine with help from mentors
March 21, 2019 - Mental health disorders among young adults may be on the increase
March 21, 2019 - New study examines smarter automatic defibrillator
March 21, 2019 - UC Riverside research shows how natural selection favors cheaters
March 21, 2019 - Mother’s diet during pregnancy can impact lung-specific genes of her offspring
March 21, 2019 - AeroForm Tissue Expanders makes breast reconstruction after mastectomy more comfortable
March 21, 2019 - New project focuses on creating more responsive, intuitive prosthetics
March 21, 2019 - New case study describes adolescent patient with rapid-onset schizophrenia and Bartonella infection
March 21, 2019 - Umass Amherst food scientist honored with 2019 Young Scientist Research Award
March 21, 2019 - Smell of skin could lead to early diagnosis for Parkinson’s
March 21, 2019 - Difference in brain connectivity may explain autism spectrum disorder
March 21, 2019 - Untangling the microbiome — with statistics
March 21, 2019 - Human microbiome metabolites enhance colon injury by enterohemorrhagic E. coli, study shows
March 21, 2019 - Written media can improve citizens’ understanding of palliative care
March 21, 2019 - New research aims to find how asthma symptoms are aggravated
March 21, 2019 - New $9.7 million NIH grant project seeks to improve hearing restoration
March 21, 2019 - Researchers measure brain metabolite levels in people with mild memory problems
March 21, 2019 - FDA approves first drug for treatment of postpartum depression in adult women
March 20, 2019 - Gene editing and designer babies experiments face global moratorium
March 20, 2019 - Major scientific study of wound care dressings wins ‘Best Clinical or Preclinical Research Award’
March 20, 2019 - Biohaven Enrolls First Patient In Phase 3 Generalized Anxiety Disorder (GAD) Trial Of Troriluzole
March 20, 2019 - Big data study identifies drugs that increase risk of psychosis in youth with ADHD
March 20, 2019 - Mystery novel and dream spur key scientific insight into heart defect | News Center
March 20, 2019 - Study measures impact of policies designed to reduce air pollution in two mega-cities
March 20, 2019 - Mild sleep apnea during pregnancy changes sugar levels and may affect infant growth patterns
March 20, 2019 - SSB and Novasep collaborate to develop new membrane chromatography systems
March 20, 2019 - Leaky valve repair improves quality of life in heart failure patients
March 20, 2019 - Diattenuation Imaging offers structural information of difficult to access brain regions
March 20, 2019 - Early sports specialization linked to increased injury rates during athletic career
March 20, 2019 - Study brings clarity about milk intake for children with Duarte galactosemia
March 20, 2019 - Allergan Announces FDA Acceptance of New Drug Application for Ubrogepant for the Acute Treatment of Migraine
March 20, 2019 - Maternal smoking during pregnancy increases risk of ADHD among offspring up to three-fold
March 20, 2019 - Pioneering pediatric kidney transplant surgeon Oscar Salvatierra dies at 83 | News Center
March 20, 2019 - F.D.A. Approves First Drug for Postpartum Depression
March 20, 2019 - TB remains a major public health challenge in the European region
March 20, 2019 - Most pills contain common allergens, warn experts
March 20, 2019 - Researchers discover previously unknown mechanism by which cells can sense oxygen
March 20, 2019 - World’s leading source of data on diagnosis, treatments for aortic dissection
March 20, 2019 - Breast cancer relapse predictor may soon be a reality
March 20, 2019 - Researchers identify origin of chronic pain in humans
March 20, 2019 - Two-drug combinations containing calcium channel blocker significantly lowers BP
March 20, 2019 - King’s scientists to monitor air quality exposure of 250 children
March 20, 2019 - Active substance from plant could turn into a ray of hope against eye tumors
March 20, 2019 - Preventative cardioverter defibrillator implantation is of little benefit to kidney dialysis patients
March 20, 2019 - New method based on neurofeedback may reduce anxiety
March 20, 2019 - Study explores whether alcohol consumption can have an effect on arthritis
March 20, 2019 - Merck to collaborate with GenScript for plasmid and virus manufacturing in China
March 20, 2019 - FDA Approves Zulresso (brexanolone) for the Treatment of Postpartum Depression
March 20, 2019 - Study examines long-term opioid use in patients with severe osteoarthritis
March 20, 2019 - Retired Stanford professor Edward Rubenstein, pioneer in intensive care medicine, dies at 94 | News Center
March 20, 2019 - Aaron Diamond AIDS Research Center to Join Columbia University
March 20, 2019 - Call for halt to human gene editing and designer babies experiments
March 20, 2019 - Study illuminates how hot spots of genetic variation evolved in the human genome
March 20, 2019 - Roundworm study suggests alternatives for treatment of schizophrenia
March 20, 2019 - Sphingotec reports new applications of bio-ADM at 39th ISICEM
March 20, 2019 - Preventing falls through free community-based screenings for older adults
March 20, 2019 - AAOS: Supplement Use Low in Patients With Osteoporosis, Hip Fracture
March 20, 2019 - Does intensive blood pressure control reduce dementia?
March 20, 2019 - Nut consumption could be key to better cognitive health in older people
March 20, 2019 - Drinking hot tea associated with increased risk of esophageal cancer
March 20, 2019 - Androgen receptor plays vital role in regulating multiple mitochondrial processes
Dealing with Dementia | NIH News in Health

Dealing with Dementia | NIH News in Health

image_pdfDownload PDFimage_print

Special Issue: Seniors

Print this issue

When Thinking and Behavior Decline

Forgetfulness, temporary confusion, or having trouble remembering a name or word can be a normal part of life. But when thinking problems or unusual behavior starts to interfere with everyday activities—such as working, preparing meals, or handling finances—it’s time to see a doctor. These could be signs of a condition known as dementia.

Dementia is a brain disorder that most often affects the elderly. It’s caused by the failure or death of nerve cells in the brain. Alzheimer’s disease is the most common cause. By some estimates, about one-third of people ages 85 and older may have Alzheimer’s. Although age is the greatest risk factor for dementia, it isn’t a normal part of aging. Some people live into their 90s and beyond with no signs of dementia at all.

“Dementia really isn’t a disease itself. Instead, dementia is a group of symptoms that can be caused by many different diseases,” says Dr. Sanjay Asthana, who heads an NIH-supported Alzheimer’s disease center at the University of Wisconsin. “Symptoms of dementia can include problems with memory, thinking, and language, along with impairments to social skills and some behavioral symptoms.”

Several factors can raise your risk for developing dementia. These include aging, smoking, uncontrolled diabetes, high blood pressure, and drinking too much alcohol. Risk also increases if close family members have had dementia.

Symptoms of dementia might be reversed when they’re caused by dehydration or other treatable conditions. But most forms of dementia worsen gradually over time, and there is no treatment. Scientists are searching for ways to slow down this process or prevent it from starting in the first place.

The two most common causes of dementia in older people are Alzheimer’s disease and vascular dementia, a condition that involves changes to the brain’s blood supply. Vascular dementia often arises from strokeWhen normal blood flow to the brain fails, often due to blocked or broken blood vessels. or arteriosclerosis (hardening of the arteries) in the brain. Other causes of dementia include Parkinson’s disease, HIV, head injury, and Lewy body disease. (Lewy bodies are a type of abnormal protein clump in brain cells.)

Dementia in people under age 60 is often caused by a group of brain diseases called frontotemporal disorders. These conditions begin in the front or sides of the brain and gradually spread. A rare, inherited form of Alzheimer’s disease can also occur in people in their 30s, 40s, and 50s.

The symptoms of dementia can vary, depending on which brain regions are damaged. “In general, the left side of the brain is involved in language, and the right side is very involved in social behavior,” says Dr. Bruce L. Miller, who directs an NIH-funded dementia center at the University of California, San Francisco.

In the case of a frontotemporal disorder, “if it begins in the left side of the brain, you tend to have worsening language problems; if it starts on the right, it affects behavior and might be mistaken for a psychiatric condition,” Miller explains. Damage to specific brain regions can cause people to become apathetic, lose their inhibitions, or show no consideration for the feelings of others.

With Alzheimer’s disease, memory-related areas in the lower and back parts of the brain tend to be affected first. Other types of dementia can affect regions that control movement.

“The treatment for all of these disorders is slightly different,” Miller says. That’s why it’s important to get an accurate diagnosis.

Because different types of dementia can have overlapping symptoms, and some people have more than one underlying condition, it’s best to see a clinician who has expertise in diagnosing dementia. “NIH has specialized centers across the country that have clinics that can diagnose and evaluate patients with Alzheimer’s disease and dementia,” Asthana says. (See NIH’s Alzheimer’s Disease Research Centers for more information at www.nia.nih.gov/health/alzheimers-disease-research-centers.)

To make a diagnosis, physicians usually ask about a person’s medical history and do a physical exam including blood tests. They also check for thinking, memory and language abilities, and sometimes order brain scans. This evaluation will determine if the symptoms are related to a treatable condition—such as depression, an infection, or medication side effects.

With some types of dementia, a clear diagnosis can’t be made until the brain is examined after death. “There’s no single blood test or brain scan that can diagnose Alzheimer’s disease or some other types of dementia with certainty,” Asthana says. “In these cases, a definite diagnosis can be made only at autopsy.”

More than a decade ago, NIH-supported scientists found a way to detect signs of Alzheimer’s disease in the brains of living people. All people with Alzheimer’s disease have abnormal protein clumps known as amyloid plaques. These plaques can be seen in Positron Emission Tomography (PET) scans using special tracers that bind specifically to amyloid. But extensive plaque buildup can also be found in some people who have no signs of dementia. Because of this uncertainty, amyloid imaging isn’t considered a definitive tool for diagnosing Alzheimer’s disease. NIH supported researchers have been working on other techniques, but none of these have proven definitive.

“Right now, a lot of research is focusing on the pre-symptomatic stages of the disease, where we can see evidence of amyloid protein before a person has any symptoms. We can test to see if medications can slow or prevent buildup of this amyloid protein,” Asthana says. “So far, no studies have shown that clearing the brain of amyloid protein can actually translate into significantly improved symptoms.”

Different approaches are now being studied as treatments for Alzheimer’s disease, Parkinson’s dementia, and certain other forms of dementia. Currently approved medications may improve symptoms, but none can halt or reverse progressive damage to the brain.

“In contrast, if the dementia is due to vascular disease, there are many things we can do to prevent it from progressing. It’s the same things we do to prevent cardiovascular disease,” says Dr. Helena Chui, director of an NIH-funded Alzheimer’s center at the University of Southern California. “Some people with vascular dementia are given anticlotting medications. Others are given medications to keep blood pressure, cholesterol, and diabetes under control.”

Chui notes that a healthy lifestyle can help protect the aging brain. “Regular exercise, a heart-healthy diet, and avoiding smoking can reduce your risk for heart disease as well as dementia,” she says. Engaging in social and intellectually stimulating activities might also help to protect brain function. “You can change your trajectory toward a healthier brain by making healthy choices,” Chui says.

Article Review. This special issue is a collection of previously published articles. However, articles were updated and re-reviewed by NIH experts prior to inclusion. Published December 2017.

Tagged with:

About author

Related Articles