• Dementia: Diagnosis and Treatments

Brain scans showing white matter damage linked to dementia (Gottesman lab)

Diagnosis

There is no certain way to be able to predict the possibility of dementia in a person. Attempting to diagnose the types of dementia that may occur within a person is also just as challenging until the symptoms itself becomes prominent. However, with the combined help from physicians, psychiatrist, counselors and the use of brain scans - researchers are one step closer to ensuring a safe and proper procedure of determining a patient's probability of developing dementia or having dementia and its types.

The assessments that doctors will conduct typically involves five key assessments which are: 

1. Medical history check
• Family background and if they are any members who have dementia
• Patient's background check
• Determine if any current prescribed medications contribute to the symptoms of dementia
• When and how did the symptoms appear
2. Physical examination
• Blood pressure check to detect any form of signs
• Certain conditions may be treatable with medications
3. Cognitive and Neuropsychological tests
• Sensory and reflex response 
• Balance assessment
• Cognitive skills tests such as problem-solving, memory, language and other abilities related to mental functioning
• Determine any other form of cognitive conditions that may be treatable with the appropriate medications
• Computed tomography (CT) scans: X-rays for a complete picture of the brain
• Magnetic resonance imaging (MRI) scans: Magnets and radio waves to have a detailed image of the brain (including nerves and tissues around it)
• Positron emission tomography (PET) scans: To check for the level of activity in the brain and to determine a certain type of protein that may determine the type of dementia
4. Laboratory tests
• Hormones and vitamins tests
• Blood testing 
• Checking levels of various chemicals in the patient's body to omit any possible cause of symptoms
5. Psychiatric evaluation
• To determine if any mental health conditions are contributing to the symptom or causing it

Treatments

There is no cure for dementia and Alzheimer's but there are medications that can help slow the progression of dementia and its symptoms. Dementia is a type of disease in the brain that eventually leads to the death of brain cells and tissues loss that affects the patient's memory, behavior, and other bodily functions.

Medications

1. Cholinesterase inhibitors
• Boost levels of chemical messengers that involve judgment and memory
• Such as donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne)
• Side effects - nausea, vomiting, and diarrhea



Examples of Aricept and Exelon with Cholinesterase Inhibitors




2. Memantine
• Prescribed with a cholinesterase inhibitor
• Regulating the activity of glutamate (another chemical messenger)
• Such as learning and memory
• Side effect - dizziness



Memantine Hydrochloride - Oral Intake




3. Other medications 
• Prescribed accordingly to other factors
• Such as depression, hallucinations, agitations and so on

Alternative Treatments

At times, medications can be overwhelming to some patients and their families. There may be some who are also allergic to certain types of medications. However, there is always an alternative source of treatment available as long as it is approved by the Food and Drug Administration (FDA). 

Although alternative methods and diets are supposed to be healthy and safer, the amount of legitimized proofs and research can be quite underwhelming and are mostly based out of testimonies.

Happy Healing (Credit: BESE)

1. Multi-sensory program
• Stimulate past memories and senses
• To increase socialization 
2. Therapies
• Occupational therapy enables patients to prepare for the progression of dementia and to prevent accidents 
• Reminiscence therapy allows the patient to ground their memories such as by recalling work life, family life
• Cognitive stimulation therapy (CST) assists a group of patients with mild to moderate dementia and carries out mentally engaging activities together such as singing, talking or cooking
3. Diet
• Nuts
• Mediterranean diet 
• Berries
• Coffee 

Learn more at https://www.webmd.com/alzheimers/dementia-treatments-overview#2

References

The Memory Center. (2018). Dementia: Can You Recover from Alzheimer’s or Dementia? Retrieved from https://www.thememorycenter.com/can-you-recover-from-alzheimers-or-dementia/

Mayo Clinic. (2019). Dementia: Alternative medicine. Retrieved from  https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019

WebMD. (2019). Dementia: What Are the Treatments for Dementia? Retrieved from https://www.webmd.com/alzheimers/dementia-treatments-overview#2

Heerema, E. (2018). Complementary and Alternative Treatments for Dementia. Retrieved from https://www.verywellhealth.com/complementary-and-alternative-therapies-for-dementia-98671

WebMD. (2019). What Other Therapies Help Someone with Dementia? Retrieved from https://www.webmd.com/alzheimers/guide/other-therapies-help-dementia#2
Alzheimer's Association. (2019). What is Dementia? Dementia Treatment and Care. Retrieved from https://www.alz.org/alzheimers-dementia/what-is-dementia
WebMD. (2019). How do Doctors Diagnose Dementia: Tests. Retrieved from https://www.webmd.com/alzheimers/diagnose-dementia#1
National Institute of Alzheimer. (2019). Basics of Alzheimer's Disease and Dementia: What Tests are Used to Diagnose Dementia? Retrieved from https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis
MedicalXpress. (2018). Mid to Late-Life Increases in Marker of Chronic Inflammation tied to Dementia. Hopkins University School of Medicine. Retrieved from https://medicalxpress.com/news/2018-07-mid-late-life-marker-chronic-inflammation.html