Dementia – The Reversible Causes
Dementia is a term that describes a wide range of symptoms associated with a decline in memory severe enough to reduce a person’s ability to perform daily activities. Alzheimer’s disease accounts for 60 to 80 percent of all cases. The second most common type is the overall cognitive decline following a stroke, termed vascular dementia. However, there are quite a few medically reversible dementias which occur secondary to vitamin deficiencies and thyroid disorders.
At Hannah Joseph Hospital, we specialize in diagnosing and treating both reversible and irreversible causes of dementia, providing comprehensive care and advanced treatment options to improve patient outcomes.
Understanding Dementia
Memory deficit is the cardinal feature of dementia, but this disorder requires impairment in one more domain: language, perception, visuospatial function, calculation, judgment, abstraction, or problem-solving skills. Dementia affects 3-11% of adults over 65 years of age, with a greater presence among institutionalized residents. The risk factors include advancing age, family history of dementia, and the presence of the apolipoprotein E-4 allele.
Reversible Causes of Dementia
There is a substantial subset of patients who have underlying reversible causes for dementia. These cases may be misdiagnosed as depressive illness or ignored and attributed to advancing age. Conditions like chronic subdural hematomas, normal pressure hydrocephalus, frontal lobe tumors (low-grade astrocytoma), gliomatosis cerebri, metastatic brain tumors, lymphoma (brain), and benign cranial tumors like basifrontal meningioma can lead to memory and cognitive decline. In these patients, dementia may be the first warning symptom without any other feature of raised intracranial pressure. Cases related to head trauma, encephalomeningitis (brain fever), and stroke (occlusive and hemorrhagic) also present with a general decline in cognition and are correctable to a great extent if presented to the clinician early.
Diagnosis
Anyone who has a recent onset of progressive decline in memory coupled with slowing of activities in daily living, even in old age, should be investigated. At Hannah Joseph Hospital, our comprehensive diagnostic approach includes:
– Thyroid Function Tests and Vitamin Levels: Screening serum levels for vitamins and thyroid function tests to rule out other causes of medically treatable dementias.
– Basic Blood Tests: To identify any underlying conditions contributing to cognitive decline.
– Biochemical Markers and EEGs: Used to determine dementias due to aging of brain cells, like Alzheimer’s.
– MRI Brain with MR-Angiography: Helpful to diagnose all other causes of dementia. Sometimes, a dynamic CSF flow study using MRI is needed if normal pressure hydrocephalus is suspected.
(An example of a Chronic Subdural Hematoma presenting with cognitive decline of recent onset)
Treatment
At Hannah Joseph Hospital, we offer advanced treatment options tailored to the specific cause of dementia:
– Medical Management: For dementia due to degeneration of brain cells, medications like Donepezil and Memantine can help control the decline in memory.
– Replacement Therapies: Appropriate treatments for thyroid disorders and vitamin deficiencies can reverse cognitive decline and maintain patient well-being.
– Surgical Interventions: A programmable ventriculoperitoneal (VP) shunt surgery is useful in cases of normal pressure hydrocephalus. Simple cranial surgeries using burr holes can drain chronic subdural hematomas. Microsurgical procedures can excise benign tumors, where dementia symptoms are completely reversible.
– Radiation and Chemotherapy: For malignant brain tumors, these treatments, in addition to surgery, can provide temporary symptom relief.
Dementias with an underlying cause must be aggressively treated, regardless of advanced age, as they are medically and surgically correctable in most cases.
Comprehensive Care at Hannah Joseph Hospital
At Hannah Joseph Hospital, we are committed to providing expert care for patients with dementia. Our multidisciplinary team of specialists offers personalized treatment plans to meet each patient’s unique needs, ensuring the best possible outcomes.
Trust Hannah Joseph Hospital for Expert Dementia Care
Dementia can have a profound impact on patients and their families, but with prompt and appropriate treatment, significant recovery is possible. At Hannah Joseph Hospital, we are dedicated to providing compassionate and comprehensive care, from diagnosis to treatment and follow-up.
If you or a loved one is experiencing symptoms of dementia, trust Hannah Joseph Hospital for expert care. Our team of specialists is here to support you every step of the way, helping to improve quality of life and cognitive function. Contact us today to learn more about our services and how we can assist you on your journey to better health.
Author:
Dr. M. J. Arunkumar, M. Ch., DNB
Senior Consultant Neurosurgeon
Hannah Joseph Hospital
Madurai