Receiving a dementia diagnosis is undeniably difficult, especially since most cases are irreversible and lack a cure. Some forms of dementia, however, can be the result of other serious illnesses or conditions that, if treated, are fully reversible. For this reason, a thorough evaluation by a healthcare team, including a neurologist, geriatric psychiatrist, or geriatrician, along with tests like blood work and brain imaging, is crucial in distinguishing between these scenarios.
Scientifically, "dementia" is a broad term that does not refer to a specific disease but rather describes a decline in mental function from a previously normal state. In most cases, this decline is progressive, ultimately interfering with daily activities. Dementia can impact memory, language, mood, and behavior. The condition arises when areas of the brain involved in these functions become damaged or dysfunctional, often for reasons that remain "unknown."
Age is the strongest risk factor for dementia, as it primarily affects older individuals. Studies show that dementia affects 5% to 8% of people over 65, with the prevalence doubling approximately every five years. By age 85, nearly half of all individuals are expected to have some form of dementia.
Alzheimer’s disease is the most common cause of dementia, accounting for around 70% of cases. Other less common causes include vascular dementia, dementia with Lewy bodies, frontotemporal dementia, and dementia due to Parkinson’s disease.
Conversely, certain conditions can mimic dementia but are reversible. These include side effects from medications, vitamin deficiencies, or thyroid problems. Addressing these issues or discontinuing the problematic medication can fully reverse the cognitive impairment.
Medications for irreversible dementias like Alzheimer’s are typically aimed at slowing cognitive decline, with the goal of preserving an acceptable quality of life. Some individuals with Alzheimer’s can live for 15-20 years post-diagnosis, though the course of the disease varies greatly depending on individual factors that are still not fully understood.
Importantly, researchers around the world continue to investigate the mechanisms behind dementia and explore novel drugs and treatments in the hopes of one day slowing—and ultimately curing—this condition.
Domenico Praticò, MD, holds the position of the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor and the Founding Director at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.
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