You can remember the reversible causes of dementia by using the mnemonic dementia. Alzheimers disease, with 89 cases 26%, followed by vascular dementia with 39 cases 11. The frequency of treatable causes of dementia is believed to be about 20 percent. There are many potentially reversible causes of dementia, which may. Few common causes of reversible dementias are vitamin b12 deficiency, normal pressure hydrocephalus, thyroid dysfunction, anticholinergic medications, depression, etc. There are many conditions that can result in symptoms of dementia. Other causes of reversible and nonreversible dementia. This dementia is caused by atherosclerosis, caused by, for example, deposits of. Drugs, including any new medications, increased dosages, drug interactions, overthecounter drugs, alcohol, etc.
A neurological condition known as idiopathic normal pressure hydrocephalus inph causes symptoms that are often confused with other forms of dementia. Jan 15, 2019 on an average, about 9% of the total cases of mild cognitive impairment being diagnosed are potentially reversible. There are, however, inaccuracies that have crept into it, especially in the table entitled reversible causes of mental impairment on p 261. Laboratory evaluation of dementia test intended diagnosis use comments psychometric testing all dementias, especially mci, ftd in appropriate clinical context virtually required for mci, mild ad, and. There are several clearly reversible causes of dementia that are remembered by the mnemonic dementia. Research open access differentiating between visual. Few common causes of reversible dementias are vitamin b12. Its neccessary for proper neurological function and the formation of red blood cells. A key goal for the healthcare provider is to identify as many causes as possible and correct those that are reversible. Actually, it rather depends on the cause of the mild cognitive impairment. Irreversible dementia is brought on by an incurable cause, so as it progresses the patients ability to care for themselves becomes largely diminished. Subdural hematomas, blood clots beneath the outer covering of the brain.
Dementia is irreversible when caused by degenerative disease or trauma, but might be reversible in some cases when caused by drugs, alcohol, hormone or vitamin imbalances, or depression, explains the cleveland clinic. Many causes of dementia and dementialike symptoms are treatable. Potentially reversible causes of dementia article pdf available in international journal of collaborative research on internal medicine and public health 28 august 2010 with 111 reads. Traditional causes of reversible dementias structural brain lesions. Dementias mnemonic for potentially reversible causes of dementia. May 16, 2019 the womans case of reversible dementia highlights just how much vitamin b12 does for the body. With the right course of treatment, these types of dementia can be controlled and possibly cured. Drugs any drug with anticholinergic activity, emotional depression, metabolic hypothyroid, eyes and ears declining, normal pressure hydrocephalus tumor or other spaceoccupying lesion, infection syphilis, aids, anemia vitamin b12 or folate deficiency. However, dementia can be temporary in certain cases. Reversible dementias journal of neurology, neurosurgery. Reversible dementia refers to types of dementia that can be partially or completely cured through treatment and proper management by targeting the underlying cause. List two irreversible causes of dementia and two reversible causes. See evaluation of cognitive impairment and dementia.
In general, it appears that the frequency of potentially reversible dementia syndromes identified has decreased. Laboratory evaluation of dementia test intended diagnosis use comments psychometric testing all dementias, especially mci, ftd in appropriate clinical context virtually required for mci, mild ad, and ftd. Pdf on jan 1, 2014, manish modi and others published reversible. When the underlying problem causing dementia symptoms is identified and treated, the dementia symptoms clear. In the past, a rudimentary, and nearly always negative, workup was conducted to rule out a reversible cause of dementia, leaving senile dementia as a default diagnosis. Mean dementia severity as assessed on the cdr scale did not however vary significantly between the groups. On the other hand, there is a group of conditions among elderly, where dementia follow a reversible course provided these conditions are picked and managed early. Some conditions that cause dementia, such as normal pressure hydrocephalus, thyroid problems or a vitamin deficiency, are treatable or reversible. A practical guide for caregivers is written primarily for family members caring for a loved one. The report does not, however, cover temporary and reversible forms of damage to the brain.
Could changes in thinking skills be reversible dementia. Conditions that may cause dementia are listed by frequency in table 1. So, before a diagnosis is made, its crucial to rule out whether the causes for dementia are actually reversible conditions. Prevalence of treatable and reversible dementias scielo. In a minority of cases, a reversible cause of a persons dementia can be identified and treated. Dementia evaluation and treatment dementia evaluation. These include, among others, head injury, brain tumours. Several methodologic flaws were found in many studies that recommended extensive screening of the demented elderly, limiting their usefulness as resources.
Describe behavioral symptoms that are typically seen as dementia progresses the five as of dementia. Most studies have reported a range somewhere between 0 and 20% of patients who are found to have a potentially reversible etiology. Initial evaluation of the patient with suspected dementia. It is one of the reversible causes of dementia where surgical intervention. In these cases, dementia cannot be reversed as the changes contributing to dementia. Before the physician recommends a treatment plan for your senior loved ones dementia, the cause will need to be identified.
Consequently, there are substantial benefits in choosing mri over ct in the firstline assessment of progres. Ad is caused by abnormal deposits of protein in the brain that destroy cells in the areas of the brain that control memory and mental functions. Alzheimers disease ad is the most common irreversible cause of dementia, accounting for 50% to 70% of all dementia cases2. More carefully designed studies are needed to understand better the frequency and etiology of reversible causes of dementia. Mar 30, 2017 reversible dementias are conditions that may well be associated with cognitive or behavioral symptoms that can be resolved once the primary etiology is treated confusion over the term reversible dementia as many metabolic causes of dementia overlap with delirium treatable dementias may be untreatable after a delay in.
The diagnosis will help determine whether or not the dementia symptoms can be reversed. In this case, dementia is caused by a condition that is treatable. Some of the reversible causes of dementia include depression, thyroid problems, heart disease and head injuries. Dementia is a growing medical, social and public health problem, which is becoming a global priority due to increasing number of new cases. Alzheimers disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia.
The approach to diagnosing ncds should include a thorough medical examination targeting potentially reversible causes of impairment, as well as screening for cognitive impairment in the outpatient. This allows the subtyping of dementia that is important for prognosis and treatment, particularly given that some physicians. Initial evaluation of the patient with suspected dementia aafp. As was mentioned by the authors, one of us amc has previously described the prevalence of reversible dementias, with. These series in general did not analyse presenile dementia in. Taking steps now to ensure a happier, healthier future, a small percentage of dementia cases may be reversible dementia if. Some reversible or partly reversible causes drugs depression metabolic causes thyroid disease vitamin b12 deficiency hypercalcaemia liver disease normal pressure hydrocephalus subdural haematoma neoplasm. Primary care evaluation of dementia 6 dementia syndromes alzheimers disease insidious onset and gradual progression. A wellinformed staff that communicates easily and effectively is a major asset in the detection, prevention, and treatment of the reversible causes of dementia. Other causes like drug and alcohol use, side effects from medication or vitamin deficiencies could be reversible as well. Understanding and caring for the person with dementia. In this report we use the term dementia to refer to the effects of all these different causes of damage to the brain. Learn who gets dementia, its symptoms, causes, treatment and more from experts at cleveland clinic.
The first step in management is an accurate diagnosis of the type of dementia. Thats why it is important to get a diagnosis as early as possible. Dementia is usually caused by degeneration in the cerebral cortex, the part of the brain responsible for thoughts, memories, actions, and personality. Of the 24 patients with reversible causes for dementia. Reversible causes of mental impairment jama jama network. Epidemiologists estimate that every 7 seconds, there is a new patient diagnosed with dementia across the globe 1 dementia. Presenting symptoms can be subtle and clinical acumen dictates that all patients should be thoroughly investigated to rule out such possibilities. In some cases, this damage or disruption isnt permanent, causing reversible dementia.
Aug 29, 2017 dementia is irreversible when caused by degenerative disease or trauma, but might be reversible in some cases when caused by drugs, alcohol, hormone or vitamin imbalances, or depression, explains the cleveland clinic. The first one is cushings syndrome, which is denoted as a cause of dementia. Reversible and irreversible cognitive disorders gulf bend. Recent findings substantial variability exists in the presenting features and clinical course of patients with common neurodegenerative causes of dementia, but the response to available therapies and eventual outcomes are often poor. Vitamin b12 deficiencies can cause reversible dementia. It is a group of symptoms that can affect thinking, memory, reasoning, personality, mood and behavior. Various causes exists for dementia among which alzheimers disease accounts for more than 60% of cases. Some conditions can cause dementia or dementia like symptoms. Reversible causes of delirium are outlined by the following acronym delirium. Dementia is generally caused by damage to or disruptions of brain cells, particularly in the cerebral cortex the part of the brain which controls memory, perception, consciousness, and language. Nov 04, 2016 these conditions leading to reversible dementia can be treated, and even cured in some cases, and that would reverse either partially or completely the effects of dementia. Such stories and case reports remind us of the importance in considering reversible causes of dementia.
About 20% of the causes of dementia are reversible. The possibility of revealing a reversible cause is higher and the differential diagnosis and workup are broadened. The diagnosis of reversible dementia in the elderly. Like, there are some causes of mci which can be reversed. Once the causes are taken care of, mci can get better.
Of the 24 patients with reversible causes for dementia, 11 had neuroinfections, eight patients had normal. However, the cost of investigating for a few causes that might be reversible has to be balanced against the benefit that would accrue to the patient in whom such a cause is identified and treated. Presentation usually related to primary deficits in recent ficits in recent memory. Irreversible dementia is often caused by damage to the brain that is irreversible. Reversible dementias clinics in geriatric medicine. Screening for these reversible causes is part of the diagnostic evaluation for anyone with changes in memory or thinking. This realization has influenced the evaluation of patients with dementia. According to the harvard special health report living better, living longer. Some of these causes can be treated while others are beyond treatment.
Not all dementia is alzheimer disease and many dementing illnesses are reversible to. What is my residentpatient with dementia trying to tell me. Identify and discuss the characteristics of two common types of dementia. Table 3 causes of potentially reversible cognitive impairment or dementia. It is also useful for training staff and volunteers. As changes occur, memory loss becomes more prevalent. Reversible dementia causes reversible conditions include. Reversible dementias, chronic subdural hematoma, meningioma, depression. When inph is misdiagnosed, its particularly troubling because the symptoms caused by this conditionunlike other forms of dementia are reversible. This packet describes possible causes of and solutions for addressing 12 behaviors you may witness in the people who are living with dementia. Dementia is a decline or cognitive impairment with memory, verbal skills, recognition, and executive functioning. This realization has influenced the evaluation of patients with dementia, with diagnostic approaches emphasizing routine screening for a short list of. Death of brain cells in this region leads to the cognitive impairments that characterise dementia.
Depression is by far the most common of the potentially reversible conditions. Dementia treatment includes therapy for reversible or curable dementias and nonspecific interventions that may improve the condition of patients with progressive dementia syndromes. They may be reversible if theyre caught early enough and if appropriate treatment is given. Reversible and irreversible cognitive disorders rudolph c. The combination of alzheimers disease and vascular dementia or other dementing disorders is termed mixed dementias. Vascular dementia is the second most common cause of dementia, accounting for about 20% of cases6. Depending on the cause, some dementia symptoms may be reversible.