Dementia & Alzheimer's

Dementia

Dementia is a condition in which cognitive function—the ability to think, concentrate, and remember—is impaired. Dementia occurs in many forms, some more severe than others. Neurologists classify dementias into categories based on characteristics, progression, or the affected part of the brain. These classifications are:

Cortical dementia—Cortical dementias usually cause problems with memory, language, thinking, and social behavior. This form of dementia originates from damage to the brain's cortex, or outer layer.

Subcortical dementia—Subcortical dementia often causes changes in emotions and movement as well as memory. This form of dementia that affects parts of the brain below the cortex.

Progressive dementia—Progressive dementia worsens over time and interferes with more cognitive abilities as it progresses.

Primary dementia— Dementia such as Alzheimer’s disease, that does not result from any other condition.

Secondary dementia— When a physical disease or injury causes dementia, it is said to be a secondary dementia.

We provide geriatric neurology services to diagnose and treat all classifications and forms of dementia, including:

  • Alzheimer’s Disease
  • Corticobasal Degeneration
  • Dementia Puglilistca
  • Creutzfeldt-Jakob Disease
  • Frontotemporal Dementia
  • Hereditary Dementias
  • HIV Associated Dementia
  • Huntington’s Disease
  • Lewy Body Dementia
  • Vascular Dementia

In addition to advanced clinical care, we provide comprehensive support for patients and families affected by dementia and Alzheimer’s Disease.


Alzheimer's Disease

According to the National Institute of Neurological Disorders and Stroke, Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die. The disease often results in the following behaviors:

  • Impaired memory, thinking, and behavior
  • Confusion
  • Restlessness
  • Personality and behavior changes
  • Impaired judgment
  • Impaired communication
  • Inability to follow directions
  • Language deterioration
  • Impaired thought processes that involve visual and spatial awareness
  • Emotional apathy

With Alzheimer's disease, motor function is often preserved.

There is not a single, comprehensive test for diagnosing Alzheimer's disease. By ruling out other conditions through a process of elimination, doctors, or other specialists, can obtain a diagnosis of probable Alzheimer's disease with approximately 90 percent accuracy. Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In order to evaluate a patient, a doctor will take a complete medical history, give a neurological motor and sensory exam, and perform other diagnostic procedures.

Alzheimer's disease has no cure, but some medications can help to slow the damage it does to the brain and the progression of symptoms.


Mild Cognitive Impairment

The development of Alzheimer’s dementia is a gradual process (or transition) and not a sudden event. Most affected patients transition through a phase called mild cognitive impairment(MCI), an intermediate stage between the normal expected cognitive decline of aging and the more serious decline of Alzheimer’s dementia. MCI patients have problems with memory, language and judgment that are greater than normal age-related changes, but they do not have dementia. Affected patients might forget important events such as appointments or social engagements, lose their train of thought in conversations, feel overwhelmed making decisions, or have trouble finding their way around familiar environments. Family members may notice that their memory has “slipped”. Although they might need to use written notes or other reminders to cope at home or at work, MCI does not prevent them from performing their day-to-day life activities.

MCI is a risk factor for developing Alzheimer’s in the future, just as high cholesterol is a risk factor for developing heart disease. MCI patients will develop Alzheimer’s disease at a rate of about 12%/yr, more than ten times the rate of the general population. If you start out with 100 patients, 12 will have developed Alzheimer’s by the end of the first year, 24 by the end of the second year, 36 by the end of the third year and so on and so forth. The onset of Alzheimer’s is defined when the memory and behavioral problems of MCI get bad enough to affect daily activities. Cognitive screening for MCI and Alzheimer’s dementia is one component of Medicare’s new annual wellness visit, and healthcare providers will be required to administer a brief screening test such as the Mini-Cog, the Memory Impairment Screen (MIS), or the General Practitioner Assessment of Cognition (GPCOG) during that visit. An abnormal result on the screening test will identify patients with MCI, at risk for developing dementia, who can then be sent for further testing.

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