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dementia

Dementia

What is dementia?

Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:

It is normal to become a bit more forgetful as you age. But dementia is not a normal part of aging. It is a serious disorder which interferes with your daily life.

What are the types of dementia?

The most common types of dementia are known as neurodegenerative disorders. These are diseases in which the cells of the brain stop working or die. They include:

Other conditions can cause dementia or dementia-like symptoms, including:

Who is at risk for dementia?

Certain factors can raise your risk for developing dementia, including:

What are the symptoms of dementia?

The symptoms of dementia can vary, depending on which parts of the brain are affected. Often, forgetfulness is the first symptom. Dementia also causes problems with the ability to think, problem solve, and reason. For example, people with dementia may:

Some people with dementia cannot control their emotions and their personalities may change. They may become apathetic, meaning that they are no longer interested in normal daily activities or events. They may lose their inhibitions and stop caring about other peoples' feelings.

Certain types of dementia can also cause problems with balance and movement.

The stages of dementia range from mild to severe. In the mildest stage, it is just beginning to affect a person's functioning. In the most severe stage, the person is completely dependent on others for care.

How is dementia diagnosed?

Your health care provider may use many tools to make a diagnosis:

What are the treatments for dementia?

There is no cure for most types of dementia, including Alzheimer's disease and Lewy body dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease. They may include:

Can dementia be prevented?

Researchers have not found a proven way to prevent dementia. Living a healthy lifestyle might influence some of your risk factors for dementia.

Lewy Body Dementia

What is Lewy body dementia (LBD)?

Lewy body dementia (LBD) is one of the most common types of dementia in older adults. Dementia is a loss of mental functions that is severe enough to affect your daily life and activities. These functions include:

What are the types of Lewy body dementia (LBD)?

There are two types of LBD: dementia with Lewy bodies and Parkinson's disease dementia.

Both types cause the same changes in the brain. And, over time, they can cause similar symptoms. The main difference is in when the cognitive (thinking) and movement symptoms start.

Dementia with Lewy bodies causes problems with thinking ability that seem similar to Alzheimer's disease. Later, it also causes other symptoms, such as movement symptoms, visual hallucinations, and certain sleep disorders. It also causes more trouble with mental activities than with memory.

Parkinson's disease dementia starts as a movement disorder. It first causes the symptoms of Parkinson's disease: slowed movement, muscle stiffness, tremor, and a shuffling walk. Later on, it causes dementia.

What causes Lewy body dementia (LBD)?

LBD happens when Lewy bodies build up in parts of the brain that control memory, thinking, and movement. Lewy bodies are abnormal deposits of a protein called alpha-synuclein. Researchers don't know exactly why these deposits form. But they do know that other diseases, such as Parkinson's disease, also involve a build-up of that protein.

Who is at risk for Lewy body dementia (LBD)?

The biggest risk factor for LBD is age; most people who get it are over age 50. People who have a family history of LBD are also at higher risk.

What are the symptoms of Lewy body dementia (LBD)?

LBD is a progressive disease. This means that the symptoms start slowly and get worse over time. The most common symptoms include changes in cognition, movement, sleep, and behavior:

In the early stages of LBD, symptoms can be mild, and people can function fairly normally. As the disease gets worse, people with LBD need more help due to problems with thinking and movement. In the later stages of the disease, they often cannot care for themselves.

How is Lewy body dementia (LBD) diagnosed?

There isn't one test that can diagnose LBD. It is important to see an experienced doctor to get a diagnosis. This would usually be specialist such as a neurologist. The doctor will:

LBD can be hard to diagnose, because Parkinson's disease and Alzheimer's disease cause similar symptoms. Scientists think that Lewy body disease might be related to these diseases, or that they sometimes happen together.

It's also important to know which type of LBD a person has, so the doctor can treat that type's particular symptoms. It also helps the doctor understand how the disease will affect the person over time. The doctor makes a diagnosis based on when certain symptoms start:

What are the treatments for Lewy body dementia (LBD)?

There is no cure for LBD, but treatments can help with the symptoms:

Support groups can also be helpful for people with LBD and their caregivers. Support groups can give emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.

NIH: National Institute of Neurological Disorders and Stroke

Alzheimer's Caregivers

A caregiver gives care to someone who needs help taking care of themselves. It can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But sometimes caregiving can be stressful and even overwhelming. This can be especially true when caring for someone with Alzheimer's disease (AD).

AD is an illness that changes the brain. It causes people to lose the ability to remember, think, and use good judgment. They also have trouble taking care of themselves. Over time, as the disease gets worse, they will need more and more help. As a caregiver, it is important for you to learn about AD. You will want to know what happens to the person during the different stages of the disease. This can help you plan for the future, so that you will have all of the resources you will need to be able to take care of your loved one.

As a caregiver for someone with AD, your responsibilities can include:

As you care for your loved one with AD, don't ignore your own needs. Caregiving can be stressful, and you need to take care of your own physical and mental health.

At some point, you will not be able to do everything on your own. Make sure that you get help when you need it. There are many different services available, including:

You might consider hiring a geriatric care manager. They are specially trained professionals who can help you to find the right services for your needs.

NIH: National Institute on Aging

Alzheimer's Disease

Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities.

AD begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. A related problem, mild cognitive impairment (MCI), causes more memory problems than normal for people of the same age. Many, but not all, people with MCI will develop AD.

In AD, over time, symptoms get worse. People may not recognize family members. They may have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. This can cause great stress for family members who must care for them.

AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease.

No treatment can stop the disease. However, some drugs may help keep symptoms from getting worse for a limited time.

NIH: National Institute on Aging

Delirium

What is delirium?

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

What causes delirium?

There are many different problems that can cause delirium. Some of the more common causes include:

Who is more likely to get delirium?

Certain factors put you at risk for delirium, including:

What are the symptoms of delirium?

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

How is delirium diagnosed?

Your health care provider may use many tools to make a diagnosis:

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

What are the treatments for delirium?

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

Can delirium be prevented?

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Memory

Every day, you have different experiences and you learn new things. Your brain cannot store all of that information, so it has to decide what is worth remembering. Memory is the process of storing and then remembering this information. There are different types of memory. Short-term memory stores information for a few seconds or minutes. Long-term memory stores it for a longer period of time.

Memory doesn't always work perfectly. As you grow older, it may take longer to remember things.

It's normal to forget things once in a while. We've all forgotten a name, where we put our keys, or if we locked the front door. If you are an older adult who forget things more often than others your age, you may have mild cognitive impairment. Forgetting how to use your phone or find your way home may be signs of a more serious problem, such as:

If you're worried about your forgetfulness, see your health care provider.

NIH: National Institute on Aging

Progressive Supranuclear Palsy

What is progressive supranuclear palsy (PSP)?

Progressive supranuclear palsy (PSP) is a rare brain disease. It happens because of damage to nerve cells in the brain. PSP affects your movement, including control of your walking and balance. It also affects your thinking and eye movement.

PSP is progressive, which means that it gets worse over time.

What causes progressive supranuclear palsy (PSP)?

The cause of PSP is unknown. In rare cases, the cause is a mutation in a certain gene.

One sign of PSP is abnormal clumps of tau in nerve cells in the brain. Tau is a protein in your nervous system, including in nerve cells. Some other diseases also cause a buildup of tau in the brain, including Alzheimer's disease.

Who is at risk for progressive supranuclear palsy (PSP)?

PSP usually affects people over 60, but in some cases it can start earlier. It is more common in men.

What are the symptoms of progressive supranuclear palsy (PSP)?

Symptoms are very different in each person, but they may include:

How is progressive supranuclear palsy (PSP0 diagnosed?

There is no specific test for PSP. It can be difficult to diagnose, because the symptoms are similar to other diseases such as Parkinson's disease and Alzheimer's disease.

To make a diagnosis, your health care provider will take your medical history and do physical and neurological exams. You may have an MRI or other imaging tests.

What are the treatments for progressive supranuclear palsy (PSP)?

There is currently no effective treatment for PSP. Medicines may reduce some symptoms. Some non-drug treatments, such as walking aids and special glasses, may also help. People with severe swallowing problems may need gastrostomy. This is a surgery to insert a feeding tube into the stomach.

PSP gets worse over time. Many people become severely disabled within three to five years after getting it. PSP isn't life-threatening on its own. It can still be be dangerous, because it increases your risk of pneumonia, choking from swallowing problems, and injuries from falling. But with good attention to medical and nutritional needs, many people with PSP can live 10 or more years after the first symptoms of the disease.

NIH: National Institute of Neurological Disorders and Stroke

Clinical Trials

Clinical trials are research studies that test how well new medical approaches work in people. Each study answers scientific questions and tries to find better ways to prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a treatment that is already available.

Every clinical trial has a protocol, or action plan, for conducting the trial. The plan describes what will be done in the study, how it will be conducted, and why each part of the study is necessary. Each study has its own rules about who can take part. Some studies need volunteers with a certain disease. Some need healthy people. Others want just men or just women.

An Institutional Review Board (IRB) reviews, monitors, and approves many clinical trials. It is an independent committee of physicians, statisticians, and members of the community. Its role is to:

In the United States, a clinical trial must have an IRB if it is studying a drug, biological product, or medical device that the Food and Drug Administration (FDA) regulates, or it is funded or carried out by the federal government.

NIH: National Institutes of Health

Down Syndrome

What is Down syndrome?

Down syndrome is a condition in which a person has an extra chromosome or an extra piece of a chromosome. This extra copy changes how a baby's body and brain develop. It can cause both mental and physical challenges during their lifetime. Even though people with Down syndrome might act and look similar, each person has different abilities.

What causes Down syndrome?

Chromosomes are tiny "packages" in your cells that contain your genes. Genes carry information, called DNA, that controls what you look like and how your body works. People with Down syndrome have an extra copy of chromosome 21. In some cases, they may have an extra copy of part of the chromosome. Having an extra copy of a chromosome is called trisomy. So sometimes Down syndrome is also called trisomy 21.

Down syndrome is usually not inherited. It happens by chance, as an error when cells are dividing during early development of the fetus. It is not known for sure why Down syndrome occurs or how many different factors play a role.

One factor that increases the risk of having a baby with Down syndrome is the age of the mother. Women ages 35 and older are more likely to have a baby with Down syndrome.

What are the symptoms of Down syndrome?

The symptoms of Down syndrome are different in each person. And people with Down syndrome may have different problems at different times of their lives. They usually have mild to moderate intellectual disabilities. Their development is often delayed. For example, they may start talking later than other children.

Some of the common physical signs of Down syndrome include:

What other problems does Down syndrome cause?

Many people with Down syndrome have the common physical signs and have healthy lives. But some people with Down syndrome might have one or more birth defects or other health problems. Some of the more common ones include:

How is Down syndrome diagnosed?

Health care providers can check for Down syndrome during pregnancy or after a child is born.

There are two basic types of tests that help find Down syndrome during pregnancy:

These tests have a small risk of causing a miscarriage, so they're often done after a screening test shows that an unborn baby could have Down syndrome.

After a baby is born, the provider may make an initial diagnosis of Down syndrome based on the physical signs of the syndrome. The provider can use a karyotype genetic test to confirm the diagnosis. The test can check for extra chromosomes in a sample of the baby's blood.

What are the treatments for Down syndrome?

There is no single, standard treatment for Down syndrome. Treatments are based on each person's physical and intellectual needs, strengths, and limitations.

Services early in life focus on helping children with Down syndrome develop to their full potential. These services include speech, occupational, and physical therapies. They are typically offered through early intervention programs in each state. Children with Down syndrome may also need extra help or attention in school, although many children are included in regular classes.

Since people with Down syndrome can have birth defects and other health problems, they will need regular medical care. They may need to have certain extra health screenings to check for problems that happen more often in people with Down syndrome.

Centers for Disease Control and Prevention

Impaired Driving

Impaired driving is dangerous. It's the cause of more than half of all car crashes. It means operating a motor vehicle while you are affected by:

For your safety and the safety of others, do not drive while impaired. Have someone else drive you or take public transportation when you cannot drive. If you need to take a call or send a text message, pull over.

National Highway Traffic Safety Administration

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