Memory Loss: Not Always Dementia

Dementia is an acquired progressive loss of cognitive function that interferes with daily work or social activities. It is not synonymous with memory loss. Memory loss is one of the common symptom of dementia. Other symptoms of dementia are:

• Behavioural changes such as depression or Anger.
• Disorientation to time, place and person.
• Difficulty in eating, dressing, walking and speaking.
• Difficulty in finding ways/going in different directions.
• Difficulty in naming family members, relatives and Objects.
• Difficulty in remembering important dates like birthday or anniversary.
• No personal care/ not aware of problems.
• Repetition of same things.

What are the common causes of Dementia?

• Alzheimer’s disease (Most common).
• Depression with Pseudo dementia.
• Multi-infarct or vascular dementia.
• Frontotemporal dementia.

Other Causes:-

• Vitamin Deficiencies (B12, B1, B6)
• Toxins (Drugs/ Alcohol).
• Endocrine disorder like Hypothyriodism.
• Metabolic like low sodium, High Ca+2
• Liver & Renal failure
• Vascular:- Stroke, Vasculitis.
• Structural cause :- Subdural hematomas, Normal pressure hydrocephalus, slow growing brain tumors
• Brain Infections (HIV, TB, Cryptococcus, syphilis, measles)

Risk factors for Dementia:

• Positive family History
• Serious Head Injury
• Aging
• DM/HTN/Impaired Cholesterol
• Low Education

Dementia must be differentiated from:

• Senility:- Age related cognitive impairment
• Pseudo dementia:- Depressed patients who are cognitively impaired
• Delirium:- Sudden confusional state.

How to screen for dementia?

Mini Mental status Examination (MMSE) is a 30 score test performed by neurologist which tells the cognitive function of the person.

Which investigations can be done in dementia?

• MRI Brain/CT Scan
• EEG
• PET Scan
• Lumbar Puncture if required
• Blood tests to look for reversible cause.

Is dementia treatable?

We must try to find any reversible cause of dementia particularly in rapidly progressive symptoms. Usually structural lesions/reversible cause can be treatable.

Dr Gourav Jain, MD, DM Neurology (PGI Chandigarh)
Consultant, Neurologist