Dementia

A certain amount of forgetfulness does accompany the stresses and physiological changes of aging. Most of us experience some frustration over lost car keys, misplaced eyeglasses, forgotten names. If we are over 50 we often wonder about the dreaded specter of a dementing illness. For most of us, the charge will be to devise means to circumvent our normal forgetful ways. The National Institute on Aging has published an "Age Page" on forgetfulness.

Serious, progressive memory loss is not a normal symptom of old age, but may well be a sign of severe depression, stress, unresolved grieving, medical problems, including adverse interactions of medications, infections, malnutrition, substance abuse. It may also be a symptom of a progressive dementia. When significant memory loss and confusion are evident, a thorough medical and neurological assessment is essential to rule out treatable causes as well as to become informed and plan for the course of those diagnoses for which there is currently no treatment.

Some of the more common causes of dementia (in reverse order of occurrence) include:

• Picks disease: a degenerative disease of the brain with symptoms of difficulty in reasoning and irrational behavior. The National Institutes of Health has an information page on Pick's disease.

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• Huntington's disease: a degenerative disease of the brain with symptoms of choreiforrn (dance like) movements and dementia. The Huntington's Disease Society of America has a web site you may want to visit.

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• Parkinson's dementia: a degenerative disease of the brain with primary symptoms of uncontrolled tremors, especially of the extremities. The National Parkinson's Foundation has a web site of information about this disease.

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• Vascular dementia (also referred to as multi-infarct dementia): caused by repeated mini-strokes. The National Institutes of Health has an information page on multi-infarct dementia.

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• Alzheimer' disease: perhaps the best known and most devastating of the dementias. Indications that point to Alzheimer's disease include a gradual onset of symptoms, usually after age 65, the absence of any physical illness or impairment, and a genetic history of the illness. The onset can be very gradual and often the person with this disease can "cover" with other ways of coping. It may be difficult for close family members to recognize. Alzheimer's is diagnosed following extensive neurological testing to rule out all other organic brain diseases or causes. Check out the National Alzheimer's Association's web site for more information.