Some studies have indicated that as many as 40 percent of Alzheimer’s patients have a family history of Alzheimer’s type of dementia; therefore, genetic factors are presumed to play a part in the development of the disorder, at least in some cases. Alzheimer’s type dementia has shown linkage to chromosomes 1, 14, and 21.
“Pseudodementia” occurs in depressed people who complain of impaired memory but, in fact, have a depressive disorder. When depression is treated, the cognitive defects disappear.
Pseudodementia typically involves three cognitive components: memory issues, deficits in executive functioning, and deficits in speech and language. Specific cognitive symptoms might include trouble recalling words or remembering things in general, decreased attention and concentration, difficulty completing tasks or making decisions, decreased speed and fluency of speech, and impaired processing speed.
Most types of dementia cannot be cured, but there are ways to manage symptoms and slow down the progression of dementia.
Doneprezil (Aricept), rivastigmine (Excelon), and galantamine (Reminyl) are cholinesterase inhibitors used to treat mild to moderate cognitive impairment in Alzheimer’s disease. Memantine (Namenda)protects neurons from excessive amounts of glutamate, which may be neurotoxic. The drug is sometimes combined with donepezil. It has been known to improve dementia.
Other drugs being tested for cognitive-enhancing activity include general cerebral metabolic enhancers, calcium channel inhibitors, and serotonergic agents. Some studies have shown that selegiline (Elderpryl), a selective type B monoamine oxidase inhibitor, may slow the advance of dementia.
Estrogen replacement therapy may reduce the risk of cognitive decline in postmenopausal women; however, more studies are needed to confirm this effect. Several epidemiological studies indicate a reduced risk of dementia in persons taking antihypertensive medications, cholesterol-lowering drugs, antioxidants, and anti-inflammatory drugs. However, no randomized controlled trials verify these data.
Patients facing a progression of dementia often benefit from supportive and educational psychotherapy in which the nature and course of their illness are clearly explained. They may also benefit from assistance in grieving and accepting the extent of their disability.
Psychotherapy and counseling for family members of patients with dementia may also be of great value. A common problem that develops among caregivers involves their self-sacrifice in caring for a patient. A gradually developing resentment is often suppressed because of the feelings of guilt produces. Therapists can help caregivers understand the complex mixture of feelings associated with seeing a loved one decline and can provide caregivers permission to express these feelings.
Preventive Lifestyle Factors
Exercise is reported to delay the onset of cognitive deterioration in general. Other factors associated with a reduced risk of cognitive impairment and dementia later in life include high education and socioeconomic status in early life, high work complexity, rich social network, social engagement, mentally stimulating activity, nonsmoking, and living with a partner during mid-life. Following a healthy diet, such as adherence to a Mediterranean diet, and intake of antioxidants and polyunsaturated fatty acids are also associated with a decreased dementia risk.
Risk factors for dementia include high blood pressure, obesity, high cholesterol, diabetes, and smoking.
Mental Health Library Sources:
Information included in all topics of the Mental Health Library comes from the Desk Reference to the Diagnostic Criteria From DSM-5 and Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Complete diagnostic and treatment information may be found within these publications.
Information within the Mental Health Library is not intended to be used for self-diagnosis purposes. Rather, it is provided as a public educational service to make people aware of mental health conditions. Please consult a qualified mental health professional for a diagnosis of any suspected mental health illness.
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