Once called "senility" and assumed to be a normal part of aging, dementia is a brain disease that causes a decline in cognitive abilities. According to the Alzheimer's Association, Alzheimer's disease is the most common type of dementia, followed by vascular dementia. There are several other conditions, however, that cause memory impairment and confusion that may be reversible after treatment. These include: depression, infections, medication side effects, metabolic problems, nutritional deficiencies and alcoholism.
Depression
A person suffering from severe depression might experience cognitive impairment and poor memory. According to the Alzheimer's Society, depression is common during all stages of dementia and it is difficult to diagnose whether or not a person with dementia has depression because the symptoms are so similar. Those with depression may not have dementia even though they appear confused. They may only have difficulties concentrating. The person with dementia gradually loses abilities to communicate and becomes disoriented to place and time. When patients with depression who don't have dementia are treated with antidepressant medications such as fluoxetine or sertraline, the improved brain chemistry may reverse the dementia-like symptoms.
Infection
According to Lisa and Gary Radin, authors of "What If It's Not Alzheimers?," chronic infections such as tuberculosis meningitis or human immunodeficiency virus, HIV, can cause cognitive impairment. Tuberculosis meningitis is a bacterial infection that attacks the membranes surrounding the brain and spinal cord. Symptoms of confusion don't occur until the later stage of the disease, when treatment with antibiotics is less likely to be successful. According to the Meningitis Research Foundation, 70 to 85 percent survive after treatment and about one quarter suffer long term effects. Encephalitis, an inflammation of the brain itself, is a viral infection that is usually mild, with flu-like symptoms. Treatment may include the antiviral drugs acyclovir, ganciclovir, anti-inflammatory drugs to reduce pressure inside the skull and/or anticonvulsants. With successful treatment, the dementia symptoms will be reversed. Symptoms such as memory loss and incoherence may be permanent, however, in the most severe cases. HIV infection also can cause brain inflammation with behavioral changes that may be reversed with antiretroviral medications.
According to the Mayo Clinic, untreated syphilis, Lyme disease and diseases such as leukemia that compromise the immune system also can cause dementia. With treatment the dementia may be reversed.
Medication Side Effects
Seniors are vulnerable to medication side effects because of the aging process and increased risk of dangerous drug interactions because they often take several medications. According to the consumer information site of the American Society of Consultant Pharmacists, seniors take more medication than any other age group and on average seniors between ages 65 and 69 years have 13.6 prescriptions filled per year. Medications that may cause confusion in seniors include: indomethacin (used to control pain and swelling), Pentazocine (used to control pain), Meperidine (used to control pain), Clonidine (used to treat high blood pressure) and cimetidine (used to treat heartburn). Confusion caused by medications often will be reversed once the medication is stopped.
Metabolic Problems and Nutritional Deficiencies
According to the Mayo Clinic, dementia may be caused by thyroid problems, impaired ability to absorb vitamin B-12 and too much or too little sodium or calcium. Chronic alcoholics typically have a deficiency in vitamins B1, B6 and B12 and individuals suffering from alcohol dementia can reverse some of the damage with high dosages of B vitamins and alcohol cessation. According to doctors William Rodman Shankle and Daniel G. Amen, other metabolic disorders that may cause dementia include diabetes, hypoglycemia and seizures. Treatment to control sugar levels and seizures may reverse symptoms of confusion or at least prevent worsening of symptoms.
Hydrocephalus
Hydrocephaly is a condition typically caused by increased cerebral spinal fluid and pressure, making the head large. According to Wippincott's Nursing Center, 375,000 Americans misdiagnosed with having dementia or Parkinson's disease actually have normal pressure hydrocephaly. The exact cause of this is unknown, but it seems to be caused by either abnormal production or absorption of the fluid. Symptoms include abnormal gait, confusion and urinary incontinence. Treatment that involves placing a shunt to drain the cerebral spinal fluid; allowing normal re-absorption can reverse the symptoms of dementia.
References
- "What If It's Not Alzheimer's?"; Lisa Radin and Gary Radin; 2003
- "Preventing Alzheimer's"; William Rodman Shankle, M.S. and M.D. &Daniel G. Amen, M.D.; 2004
- The Alzheimer's Association: Depression and Alzheimers
- Normal Pressure Hydrocephalus: Dementia's Hidden Cause
- Tuberculosis Meningitis
