Q: Your recent column about Alzheimer’s disease mentioned “other forms” of dementia that may be more treatable. Can you tell me more about them?
A: It is important to distinguish “treatable” from “curable.” Dementias brought about by Alzheimer’s disease, Lewy body disease or by other brain disorders are treatable: Symptoms may improve with therapy, or progression can be altered slightly. But these diseases are not curable. While patients may obtain some relief for a few months or even several years when treated with the best available drugs, sooner or later their decline resumes.
It is also important to distinguish full-blown dementia from “cognitive impairment.” Dementia is marked by the patient’s loss of intellectual and social abilities severe enough to interfere with daily functioning, while cognitive impairment – reduced ability in one or more realms of cognition such as memory, language, attention, reasoning, judgment, reading, or writing – can vary from mild to severe.
It is common for clinicians to look for curable conditions before considering a brain disorder like Alzheimer’s. Cognitive impairment can derive from sleep problems; metabolic abnormalities; nutritional deficiencies; emotional problems; infections; heart, liver, or lung disease; or substance abuse.
In these cases, treating the underlying cause may eliminate the symptoms, including the cognitive impairment; the condition is not only treatable but also curable.
While dementias caused by degenerative brain disorders are not currently curable, long-term prospects are encouraging. Researchers are investigating various drugs targeted at suspected protein culprits in each of the major dementias. Meanwhile, there are readily available options that have dementia-altering potential: Studies point toward the importance of healthy living, intellectual stimulation, and social relationships. And recent research indicates that improving cardiovascular health by losing weight, exercising and controlling high blood pressure and cholesterol may also help lower the risk of developing dementia.
– Dr. Bradley F. Boeve, Neurology, Mayo Clinic, Rochester, Minn. Write to medicaledge@mayo.edu, or Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207.
