Dementia is defined as a sustained decline in cognitive function including memory and at least one additional area of cognitive function, sufficient in degree to interfere with social or occupational functioning.
Alzheimer’s disease, sometimes known as Alzheimers, is the single most common form of dementia but a number of other cases are also known.
Evaluation for the brain disease dementia includes a search for alternative causes, some of which may be at least partially reversible. Among these would be chemical or metabolic disorders such as hypothyroidism or vitamin B12 deficiency, effects of chemical substances including tranquilizers and alcohol, depression, and structural processes such as tumors, strokes, Normal Pressure Hydrocephauls, or enlargement of the ventricles (fluid sacs) within the brain.
The assessment for suspected dementia and/or Alzheimers would include a thorough, detailed history and a comprehensive general and neurological examination, with emphasis on thinking or cognitive function. A number of studies are generally recommended, including blood count, chemical survey, thyroid screen, vitamin B12 level, and usually a serologic test for syphilis. Other blood and urine studies may be indicated in specific situations. Usually, a scan of the brain is carried out, either computed tomography (CT) or magnetic resonance imaging (MRI). Other studies may be recommended, again in certain circumstances, including EEG, spinal puncture, and occasionally radionuclide studies such as SPECT or PET scans.
If the diagnosis of probable or possible Alzheimer’s disease can be made (by specific criteria which have been established), there are medications available that may have a positive impact on the level of memory function and behavior. If an alternative diagnosis besides Alzheimers is identified, appropriate further studies or treatment for brain diseases may be recommended.
