Almost everyone has watched the mental decline of an aging friend or family member. Dementia is caused by changes in the brain, which impair memory, thinking ability, personality and behavior. Alzheimer's disease is the most common cause of dementia, affecting about 10 percent of adults over age 65, and about 50 percent of adults over age 85.

There are other types of dementia that tend to be less severe than Alzheimer's disease.

This week's column will cover the symptoms and diagnosis of dementia. Next week, read about how to reduce your chances of developing dementia and keep your brain healthy.

Dementia is a general term for mental deterioration, or a decline in intellectual functioning. Dementia happens when brain cells are damaged or destroyed. People with dementia have significant memory problems, and especially cannot recall recent events. They become confused easily, and are overwhelmed if given too many things to think about at once.

People with dementia have difficulty learning new information. They may become disoriented, even in familiar places. They tend to have poor judgment, which can put them into dangerous situations. They can have language problems, forgetting words or using the wrong words.

The two most common types of dementia are Alzheimer's disease and vascular dementia. There are many other less-common causes of dementia. Some come on gradually, but others appear suddenly. Some types of dementia get progressively worse as time goes on, while other types are more stable.

Alzheimer's disease usually begins after age 60. It causes a gradual decline over seven to 10 years. Nearly all brain functions are affected. The cause is not fully understood, but it is known that the brains of Alzheimer's disease patients have abnormalities called amyloid plaques and neurofibrillary tangles.

People with Alzheimer's disease can eventually develop personality changes; aggression, paranoia and depression can occur. Life expectancy is about 10 years after diagnosis. In late stages of the disease, people begin to lose motor control. Difficulty swallowing can lead to aspiration pneumonia (an infection caused by inhaling food, drink or vomit into the lungs), which is a common cause of death for people with Alzheimer's disease.

Vascular dementia is the second most common cause of dementia. It usually affects people between ages 60 and 75. Symptoms of vascular dementia usually begin suddenly after a stroke. People with vascular dementia often have a history of high blood pressure, vascular disease, heart attack or previous stroke. Not everyone who has a stroke develops vascular dementia, but it can occur if nerve cells in the brain are damaged or destroyed.

To diagnose Alzheimer's disease or other types of dementia, thorough physical, neurological and psychiatric exams are done. Tests of memory, language and problem solving are an important part of the workup. Blood and urine tests can help rule out a curable problem causing dementia symptoms. Sometimes, a MRI or CT scan of the brain is done to help with the diagnosis.

Anyone with dementia symptoms should be evaluated by a health care provider. The reversible causes of mental decline include physical illness,=

depression, nutritional deficiencies (especially deficiencies of vitamins B-1, B-6 or B-12) and adverse reactions to medications. Although there is no cure for Alzheimer's disease, some types of dementia can be stopped or reversed with proper treatment.

Early diagnosis of dementia is important, to help the individual and family to plan for the future. Finding a safe living situation is important. Naming a durable power of attorney who can help the patient deal with financial and medical matters is also crucial.

Dementia is common, but it is not a normal and inevitable consequence of aging.

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Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to kbbrown@eastoregonian.com. You can find more local health news and information in the Health section at www.eastoregonian.info.

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