Is dementia treatable?

One should differentiate the terms treatable and reversible or curable. All or almost all forms of dementia are treatable, in that medication and supportive measures are available to help with management of the demented patient. However, most types of dementia remain incurable or irreversible and only modest benefits from treatment are realized. Some disorders which may be successfully treated with return to a normal or pre-morbid state might include:

  • Impairment from toxic side effects of medications or drugs
  • Tumors that can be removed
  • Subdural hematoma, an accumulation of blood beneath the outer covering of the brain that results from a broken blood vessel, usually as a result of a head injury (which can be minor and even unrecognized)
  • Normal pressure hydrocephalus
  • Metabolic disorders, such as a vitamin B12 deficiency
  • Hypothyroidism, a condition that results from low levels of thyroid secretion
  • Hypoglycemia, a condition that results from low blood sugar, assuming absence of extensive cell injury

Dementias that are largely irreversible, but may still be at least partially responsive to medications currently available for memory loss or modification of behavior include:

  • Alzheimer's disease
  • Multi-infarct (vascular) dementia
  • Dementias associated with Parkinson's disease and similar disorders
  • AIDS dementia complex
  • Creutzfeldt-Jakob disease (CJD), a quickly progressing and fatal disease that is characterized by dementia and myoclonus — muscle twitching and spasm

What medications are available?

Memory-enhancing drugs, including the cholinesterase inhibitors (e.g., donepezil, rivastigmine, and galantamine) along with memantine, a medication that acts on another neurotransmitter system have all been shown to have some benefit in improving memory function in some patients. None of these drugs appear to stop the progression of the underlying disease however.

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