Dementia; A Comprehensive Approach for Diagnosis and Management
Abstract
Dementia is a disease of aging and it is one of the diseases with significant change in one's life. With an increasing aging population, the incidence and prevalence of the disease are also steadily increasing. It increases dependence on others and adds significantly to the cost of health. It is also a major stress for the children of Pakistani patients living alone while children are settled abroad. It's a slow onset and progressive disease with subtle clinical manifestation in the early stage. Also, it can be commonly confused with other health diseases and the differential diagnosis can be broad. The cost and complications of the disease increase further when there is a delay in the diagnosis and appropriate management. This article aims to elaborate on the details of the disease, its varied manifestations and subtypes, and its management. Reversible causes of the disease are the main focus of this review article.
How to Cite This Article
Hussain A, Avais J. Dementia; A Comprehensive Approach for Diagnosis and Management. J Pak Soc Intern Med. 2024;5(4):681–689. doi:10.70302/jpsim.v5i4.2464
Conflict of Interest
All authors declare no competing interests.
Funding
No specific funding was received for this research.
Funder information follows the Crossref Funder Registry standard.
References
- Elahi, F.M., Miller, B.L., 2017. A clinicopathological approach to the diagnosis of dementia. Nat. Rev. Neurol. 13, 457–476. https://doi.org/10.1038/ nrneurol.2017.96
- Budson, A. E., Price, B. H. (2005). Memory Dysfunction. New England Journal of Medicine, 352, 692-699. DOI: 10.1056/NEJMra041071 doi:10.1056/NEJMra041071
- Akhter, F., Persaud, A., Zaokari, Y., Zhao, Z., Zhu, D., 2021. Vascular dementia and underlying sex differences. Front. Aging Neurosci. 13 https://doi.org/10.3389/ fnagi.2021.720715.
- Barbiellini Amidei, C., Fayosse, A., Dumurgier, J., Machado-Fragua, M.D., Tabak, A.G., Van Sloten, T., Kivim¨ aki, M., Dugravot, A., Sabia, S., Singh-Manoux, A., 2021. Association Between Age at Diabetes Onset and Subsequent Risk of Dementia. JAMA 325, 1640. https://doi.org/10.1001/jama.2021.4001. doi:10.1001/jama.2021.4001
- Arvanitakis, Z., Capuano, A.W., Leurgans, S.E., Buchman, A.S., Bennett, D.A., Schneider, J.A., 2017. The relationship of cerebral vessel pathology to brain microinfarcts. Brain Pathol. Zur. Switz. 27, 77–85. https://doi.org/10.1111/ bpa.12365.
- Arendt, J.F.H., Horvath-Puh ´ o, ´ E., Sørensen, H.T., Nexø, E., Pedersen, L., Ording, A.G., Henderson, V.W., 2021. Plasma Vitamin B12 Levels, High-Dose Vitamin B12 treatment, and risk of dementia. J. Alzheimers Dis. 79, 1601–1612. https://doi.org/ 10.3233/JAD-201096. doi:10.3233/JAD-201096
- Tiraboschi P, Attems J, Thomas A, et al. Clinicians’ ability to diagnose dementia with Lewy bodies is not affected by beta-amyloid load. Neurology 2015;84:496–499.
- Lillo, P., Hodges, J. R. (2009). Frontotemporal dementia and motorneuron disease: Overlappingclinicpathological disorders. Journal of Clinical Neuroscience, 16, 1131-1135. DOI: 10.1016/j.jocn.2009.03.005. doi:10.1016/j.jocn.2009.03.005
- Neary, D., Snowden, J., Mann, D. (2005). Frontotemporal dementia. The Lancet Neurology, 4, 771- 780. DOI: 10.1016/S1474-4422(05)70223-4 doi:10.1016/S1474-4422(05)70223-4
- Dupiereux, I., Zorzi, W., Quadrio, I., Perret-Liaudet, A., Kovacs, G. G., Heinen, E., Elmoualij, B., Creutzfeldt-jakob. (2009). Parkinson, lewy body dementia and Alzheimer diseases: from diagnosis to therapy Central Nervous System Agents in Medicinal Chemistry, 9, 2-11.
- Krobitsch, S., Kazantsev, A. G. (2011). Huntington’s disease: From molecular basis to therapeutic advances. International Journal of Biochemestry & Cell Biology, 43, 20-24. DOI: 10.1016/j.biocel.2010.10.014. doi:10.1016/j.biocel.2010.10.014
- Hansen L, Salmon D, Galasko D, et al. The Lewy body variant of Alzheimer’s disease: a clinical and pathologic entity. Neurology 1990;40:1–8.
- Fama, R., Marsh, L., Sullivan, E. V. (2004). Dissociation of remote and anterograde memoryimpairment and neural correlates in alcoholic Korsakoff syndrome. Journal of the International Neuropsychological Society, 10, 427-441. .DOI:10.1017/S135561770410310X. doi:10.1017/S135561770410310X
- Hillbom, M., Marttila, M. (2010). Encephalopathies due to vitamin deficiency. Duodecim, 126, 2132- 2138. PMID:21072960.
- Kamphuis, P. J., Wurtman, R. J. (2009). Nutrition and Alzheimer’s disease: Preclinical concepts. European Journal of Neurology, 16, 12-18. DOI: 10.1111/j.1468-1331.2009.02737.x doi:10.1111/j.1468-1331.2009.02737.x
- Kazui, H. (2008). Cognitive impairment in patients with idiopathic normal pressure hydrocephalus. Brain and Nerve, 60, 225-231.
- Korczyn, A. D., Halperin, I. (2009). Depression and dementia. Journal of Neurological Sciences, 283, 139-142. DOI: 10.1016/j.jns.2009.02.346. doi:10.1016/j.jns.2009.02.346
- Husband, A., Worsley, A. (2006). Different types of dementia. The Pharmaceutical Journal, 277, 579- 582.
- Cyngiser, T. A. (2008). Creutzfeldt-Jakob disease: a disease overview. American Journal of Electroneurodiagnostic Technology, 48, 199-208. PubMed ID-18998478.
- Herta, K. D., Sturzenegger, M., Berkhoff, M. (2005). Human immunodeficiency virusassociatedtuberculous meningoencephalitis causing abnormal behaviour in a prisoner. Der Nervenarzt, 76, 68-71. DOI: 10.1007/s00115-004-1702-y. doi:10.1007/s00115-004-1702-y
- DeKosky, S. T., Ikonomovic, M. D., Gandy, S. (2010). Traumatic brain injury--football, warfare, and long-term effects. New England Journal of Medicine, 363, 1293-1296.
- Chun, M. M. (2005). Drug-induced amnesia impairs implicit relational memory. Trends in Cognitive Sciences, 9, 355-357. DOI: 10.1016/j.tics.2005.06.015 doi:10.1016/j.tics.2005.06.015
- Yokoi K, Nishio Y, Uchiyama M, Shimomura T, Iizuka O, Mori E. Hallucinators find meaning in noises: pareidolic illusions in dementia with Lewy bodies. Neuropsychologia 2014;56:245–254.
- Tiraboschi P, Corso A, Guerra UP, et al. (123) I-2betacarbomethoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and (123) I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with Lewy bodies from other dementias: a comparative study. Ann Neurol 2016;80:368–378.
- Colloby SJ, McParland S, O’Brien JT, Attems J. Neuropathological correlates of dopaminergic imaging in Alzheimer’s disease and Lewy body dementias. Brain 2012; 135:2798–2808.
- Iranzo A, Fernandez-Arcos A, Tolosa E, et al. Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients. PLoS One 2014;9:e89741.
- Förstl H and Kurz A Clinical features of Alzheimer’s disease. EEur Arch Psychiatry Clin Neurosis. 1999; 249: 288-290.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th edition). Arlington, Va.: American Psychiatric Publishing, 2013.
- Yiannopoulou KG and Papageorgiou SG. Current and future treatments for Alzheimer’s disease. There Adv Neurol Disord. 2013; 6: 19-33.
- Ballard C and Corbett A Management of neuropsychiatric symptoms in people with dementia. CNS Drugs. 2010; 24: 729-739.
- Chiang K, Koo EH. Emerging therapeutics for Alzheimer’s disease. Annual Review of Pharmacology and Toxicology. 2014; 54: 381-405
- Stinton C, McKeith I, Taylor JP, et al. Pharmacological management of Lewy body dementia: a systematic review and meta-analysis. Am J Psychiatry 2015;172: 731–742.
- Vigen CL, Mack WJ, Keefe RS, Sano M, et al. Cognitive effects of atypical antipsychotic medications in patients with Alzheimer’s disease: outcomes from CATIE-AD. Am J Psychiatry. 2011; 168: 831-839.
- Corbett A, Williams G and Ballart C. Drug repositioning: an opportunity to develop novel treatments for Alzheimer’s disease. Pharmaceuticals. 2013; 6: 1304-1321.
Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.