Dementia

The most common type of dementia is Alzheimer's disease. Dementia disorders also include Creutzfeldt-Jakob disease, vascular dementia, and dementia with Lewy bodies, as well as frontotemporal dementia—the type that action star Bruce Willis announced he has been diagnosed with, according to a family announcement in 2023.

The terms “senility” or “senile dementia” were commonly used to describe dementia disorders in the past, and memory loss was once believed to be an inevitable part of aging. Now we can provide specific, individualized medical diagnoses to give patients with the care and respect they deserve.

Dementia interferes with executive function—everything our brains need to do beyond keeping us alive. People with dementia may struggle with their attention span, short-term memory, problem solving skills, and ability to keep track of time and space.

Apathy is often an early symptom. For example, a golfer who loved the game suddenly gives it up, saying they just don’t feel like playing anymore. Other common personality changes include irritability, combativeness, resistance to eating or bathing, and loss of inhibition—saying whatever is on their mind, even when inappropriate. We often see increased paranoia as the disease progresses; patients may be convinced that a misplaced object was stolen.

Risk factors

While the exact cause remains unknown, there are several risk factors that increase the likelihood of developing dementia, including:

• Age: This is the most common risk factor. After age 65, the likelihood of developing dementia doubles every five years.
• Genetics and family history: Dementia tends to run in families. If multiple relatives have developed dementia or Alzheimer's, your risk increases. The occurrence or likelihood of dementia within one's family also may be caused by a certain gene.

How is dementia diagnosed?

First steps are to rule out and address any possible masquerading diseases, such as depression, thyroid problems, anemia, and vitamin deficiencies, as well as other neurological conditions such as Parkinson’s disease. An MRI can uncover physical abnormalities. Though rare, the disease can be associated with malformations, tumors, inflammation, or abnormal fluid pressure in the brain.

Cognitive tests help us evaluate skills such as visualization, recall, calculation and interpretation.

Dementia is undeniably a frightening diagnosis, and there are options for symptom management. The specialists at MedStar Health collaborate closely to create a comprehensive treatment plan customized for each patient. You’ll work with experts including neurologists, geriatricians, and behavioral health specialists.

Family members and caregivers will be involved at every stage. Our dedicated Center for Successful Aging team will help you coordinate appointments, medications, and home safety.

Medications

Researchers are making significant advancements in the quest to one day prevent and cure dementia. Today, specialists can prescribe existing medications to treat specific symptoms or behaviors:

• Memory, learning and other cognitive skills: Cholinesterase inhibitors like donepezil, rivastigmine, galantamine) help increase brain activity. A glutamate regulator called memantine can help slow the decline in learning and memory. These can be combined for some patients.
• Insomnia: Suvorexant can help regulate sleep/wake cycles.
• Mood swings and irritability: Antidepressants, especially selective serotonin reuptake inhibitors such as fluoxetine (Prozac®) and sertraline (Zoloft®).
• Severe agitation, aggression, or delusions: Low doses of antipsychotic drugs like quetiapine or clozapine might be recommended for emotional outbursts or disruptive episodes.

If you’re a caregiver, keeping track of a complex medication regimen can be confusing or even intimidating. MedStar Health’s Home Care services include Medication Management support. A registered nurse can teach you how to organize prescriptions and set up reminders.

Supportive therapies

MedStar Health offers extensive services for patients and families:

• Neurorehabilitation

• Physical therapy

• Occupational therapy

• Speech-language pathology

• Home health care

• House call program

There is solid evidence that taking good care of your health can reduce the risk of developing dementia. That means staying active, eating well, avoiding tobacco and excessive alcohol consumption, getting enough sleep, and protecting yourself from head injuries.

Education, socialization, and mental stimulation are important—these activities keep important brain pathways open. Exercise is another incredibly important factor. Movement increases blood flow and releases endorphins that create a sense of well-being and improves metabolism. Aim for 30 minutes to an hour of moderate exercise most days of the week.

MedStar Health patients may have access to clinical trials, which offer the latest dementia therapies before they are widely available elsewhere.