1. The Brain

5. Problems with the Brain… Dementia – group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. Caused by conditions or changes in the brain. Different types exist – Alzheimer’s is the most common. Dementia indicates problems with at least two brain functions, such as memory loss with impaired judgment or language. Some causes are treatable and even reversible.

6. Symptoms of Dementia Memory loss Difficulty communicating Inability to learn or remember new information Difficulty with planning and organizing Difficulty with coordination and motor functions Personality changes Inability to learn Inappropriate behavior Paranoia Agitation Hallucinations

7. When to See the Doctor… See the doctor when you see memory problems or other symptoms in yourself or a loved one. Some medical conditions can cause dementia and are treatable. Early diagnosis is important.

8. Causes It is not always from the same disease. Some occur on their own – like Alzheimer’s. Much is still unknown. May be caused by a reaction to medication or an infection, but are reversible.

9. Progressive Dementias Alzheimer’s – caused by destruction of brain cells. Two types of brain cell damage are common – protein clumps (plaques) and protein strands (tangles). It progresses slowly with a decline in cognitive abilities. It can also be seen early as a result of a defective gene. It may also be genetic (FAD).

10. Progressive Dementias cont. Lewy body dementia – abnormal clumps of protein in the brain. Also found in people with Parkinson’s disease. Symptoms are similar to Alzheimer’s, but people will fluctuate between clear and foggy thinking, visual hallucinations, and tremors or rigidity. They may thrash out or kick in their sleep due to the development of a sleep disorder (RBD – REM sleep behavior disorder).

11. Progressive Dementias cont. Vascular dementia – damage to the brain as a result of a problem with arteries serving the brain and the heart. Symptoms are sudden, usually after a stroke, and may occur in people with high blood pressure, or previous strokes and heart attacks. May also be caused by an infection in the heart valve, or a build up of protein in the brain’s blood vessels (causing bleeding strokes).

12. Progressive Dementias cont. Frontotemporal dementia – caused by the degeneration of nerve cells in the frontal and temporal lobes of the brain. Symptoms will include problems with personality, behavior, and language. They may be seen between the ages of 40 and 65. The cause is really not known, but there is a link to certain genetic mutations. Sufferers usually do not have a family history of dementia. There is a protein link with ALS.

13. Disorders Linked to Dementia Huntington’s disease – inherited disease causing nerve cells in brain and spinal cord to waste away. Dementia pugilistica – caused by repetitive head trauma. HIV-associated dementia – HIV destroys brain cells. Creutzfeldt-Jakob disease – rare, fatal brain disorder that occurs sporadically with no known causes. May see problems with language, coordination, personality, and memory. Secondary dementias – associated with disorders that affect movement (ex. – Parkinson’s)

14. Dementia Causes That Can Be Reversed Infections and immune disorders Metabolic problems and endocrine abnormalities Nutritional deficiencies Reactions to medications Subdural hematomas Poisoning Brain tumors Anoxia (not enough oxygen to the tissues in the body) Heart and lung problems

15. Risk Factors That Cannot Be Changed Age Family History

16. Risk Factors That Can Be Changed Alcohol use Atherosclerosis Blood pressure Cholesterol Depression Diabetes High estrogen levels Homocysteine blood vessels (elevated level of an amino acid) Smoking

17. Problems Resulting from Dementia Inadequate nutrition Reduced hygiene Difficulty taking medications Deterioration of emotional health Difficulty communicating Delirium Problems sleeping Personal safety challenges

18. Tests Medical history and physical exam Cognitive tests Neurological evaluation Brain scans (CT, MRI, EEG – Electroencephalogram) Lab tests (blood and urine) Psychiatric evaluation

19. Common Medications Cholinesterase inhibitors (Aricept, Exelon, Razadyne) – help with memory and judgment. (Side effects – nausea, vomiting, diarrhea.) Memantine (Namenda) – help with learning and memory. (Main side effect – dizziness)

20. Lifestyle and Home Remedies Carry a reminder calendar/keep a journal Maintain a calm and stable home environment Establish a nighttime ritual Create a plan (for the future)

21. Alternative Medicine Vitamin E – theory that it slows Alzheimer’s. May cause bleeding. Omega-3 fatty acids – essential nutrient for brain function. Coenzyme Q10 – little testing has been performed. Ginkgo – some believe that it helps with memory. No real benefit. May react with blood-thinning medication. Huperzine A – has increased risk of toxic side effects.

22. Prevention Keep your mind active Be physically and socially active Lower your homocysteine levels Lower your cholesterol levels Control your diabetes Lower your blood pressure Pursue education Maintain a health diet Get your vaccinations.