Dementia

Dementia (cognitive impairment causing memory loss, confusion, difficulty with daily tasks) is a symptom of a number of disorders. Some of them are treatable or reversible. Some are progressive and not treatable; management of the situation to support maximal function can help families cope.

Reversible causes of dementia that are common in later life include: dehydration, malnutrition, excessive numbers/doses of medications (a problem because older adults are often taking multiple medications for multiple conditions, and older adults do not metabolize medications as well as younger individuals making inadvertent overdose a problem), substance abuse, and depression.

Irreversible causes include: multi-infarct dementia (a series of small strokes-this condition can be stabilized but not reversed), Pick's Disease (the cause of which is not known, but is believed to be the result of a slow virus), Huntington's Chorea (a genetic disorder that occurs only in families where the genetic trait is present); and the most common of all dementing illnesses, Alzheimer's Disease.

To mange dementia, careful diagnosis is important. An older adult may have several sources of dementia. Treating depression or medication overdose in someone with Alzheimer's Disease can improve memory and function even though over the long term there is no cure.

For individuals with Alzheimer's Disease, management through behavioral and environmental strategies can maximize remaining function. Several new medications seem to slow the progress of the disease, although the effects of these medications is modest.

To learn more about behavioral and environmental strategies for managing Alzheimer's Disease, go to: www.dementiacarespecialists.com/assistedliving.pdf

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Depression

Older adults typically experience many losses: loss of family, friends, and spouse; loss of physical capacity; loss of financial resources, loss of functional independence. It is normal for them to experience grief as a result of these losses.

However, grief differs from depression. It is usually time-limited (although in the case of a very significant loss it can persist for a considerable period) and associated with a specific situation. Depression is a more pervasive sense of sadness, guilt, and hopelessness. In older adults, depression may present as dementia, or as depression. It is highly treatable through a combination of medication, psychotherapy, and activity interventions. Because depression can have profound consequences for quality of life, it is important for every health professional to screen for it and to make sure that it is treated appropriately.

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