Fymat AL.
Abstract
According to the World Health Organization (WHO), dementia is “an umbrella term for several diseases affecting memory, other cognitive abilities and behavior that interfere significantly with a person's ability to maintain their daily living activities. It is not a normal part of aging”. Many different diseases can cause dementia; these will be reviewed below. Not being a specific disease, these contributors do not reach to the primary cause of the disease. Unable to pinpoint the root cause of the disease, we are powerless in treating it. While drugs are available to alleviate some of the symptoms, they do not cure it. Indeed, there is presently no cure for dementia. The reason stems from our incomplete understanding of the deep biology of the contributing diseases and associated epigenetic/ ecogenetic influences. After a brief history of the disease, I will elaborate on the following factors: epidemiology, three phases of signs and symptoms (early, middle and late), risk factors, and four progressive stages (mild cognitive impairment, early, middle, and late dementia). I will also review the classification of the disease (both within the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders), the approach followed to reaching a diagnosis (preliminary and cognitive testings, imaging scans). I will further discuss the main contributors to dementia (Alzheimer disease; the various dementias: vascular, Lewy body, Parkinson, frontotemporal, and senility; normal pressure hydrocephalus; and Creutzfeldt-Jacobs disease) and other contributors. Still further, the various cognitive impairments (mild, fixed), neurodegenerative dementia as well as the variations of dementia with age of occurrence are succinctly described. Management of the disease and the associated psychopharmacotherapy are also detailed, although the medications used have little or no effect on the underlying disease process. Lastly complementary and preventive measures are outlined.