Dementia 101

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Based on the various interpretations I read in the press, there seems to be some confusion about the term dementia. The DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, American Psychiatric Association) provides the most commonly used criteria and defines dementia in this way:

Dementia is a clinical state characterized by loss of function in multiple cognitive domains. Diagnostic features include : memory impairment and at least one of the following: aphasia, apraxia, agnosia, disturbances in executive functioning. In addition, the cognitive impairments must be severe enough to cause impairment in social and occupational functioning.

So, in even simpler terms, being demented means that one's mental faculties are impaired to a degree that interferes with their social and occupational function. For the purpose of most discussions, it really is as simple as that.

The confusion begins when people talk about "being diagnosed with dementia" or "treating dementia". In a world of clarity, those same people would speak instead about "being diagnosed with Parkinson's Disease or with Alzheimer's Disease" which may have led to a clinical state of dementia. No one would "treat dementia", they would treat the underlying medical condition causing the impairment that we describe as dementia. It is a simple concept but I hear it confused (or read about it being confused) on a daily basis.

We don't need to detect dementia, we need to detect medical conditions that lead to dementia. We cannot treat dementia, we must treat medical conditions that cause dementia. The word dementia merely describes the extent of some person's cognitive impairment.

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What Causes Memory Loss?

Contributed by: Dennis Fortier, President, Medical Care Corporation
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This is a common question that all too many people answer incorrectly. The comprehensive answer is that there are many causes of memory loss, most of which are completely treatable, and all of which are manageable to some degree. Many, however, assume that all recall deficits are due to Alzheimer's Disease and therefore, such symptoms must indicate a dire medical condition. While it is true that Alzheimer's Disease is one of the leading contributors to memory loss, there are many other, more benign conditions such as depression, thyroid disease, and anxiety to name just a few, that commonly impair memory and can be easily treated by a physician.

There is a good summary of medical conditions that cause memory loss and their respective treatments at www.PreventAD.com (which is an educational website, supported by Medical Care Corporation).

AD Treatment Perspective #1

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Current treatments do not cure AD but they can slow disease progression. This is an important difference. If you are expecting treatment to help the patient regain their former cognitive abilities, you will almost surely be disappointed. If you are expecting some stabilization or slowing of their decline, you may well be satisfied.

Remember: Slowing the advance of the disease can add precious months or even years to a patient’s independence and should not be marginalized as meaningless simply because a cure would be better.