Every man, by his own natural will, hates God; but when he is turned to the Lord, by evangelical repentance, then his will is changed; then his conscience, now hardened and benumbed, shall be quickened and awakened; then his hard hearts shall be melted, and his unruly affections shall be crucified. Thus, by that repentance, the whole soul will be changed, and he will have new inclinations, new desires, and new habits.
George Whitefield

The Many Faces Of Dementia

The Many Faces Of Dementia

THE MANY FACES OF DEMENTIA

Reprinted from the November 1985 issue of the FDA Consumer, a publication of the Food and Drug Administration.

Despite its name, dementia is not synonymous with insanity; it is not a psychiatric disorder but rather an abnormal loss of the use of parts of the brain associated with intellectual skills. Many people fear that dementia (and therefore Alzheimer’s disease) is an inevitable part of aging. This is not so. Only about 5 percent of the U.S. population 65 and over is severely affected by dementia, and another 10 percent may be mildly to moderately impaired. Nevertheless, this represents from 2.5 to 3 million people and the numbers will grow as the population ages.

Some of these individuals, perhaps 20 to 25 percent of them, have dementia that is reversible. Their condition maybe secondary to another, possibly treatable, disorder such as a brain tumor, abnormal thyroid function, or abnormalities in the spinal fluid system (hydrocephalus).

Or they may have a “pseudodementia”–a condition whose symptoms mimic those of true dementia. One of the most common pseudodementias is drug intoxication. The elderly, as a group, take more medication than younger people. Often victims of one or more chronic diseases, they may take as many as 14 to 18 different prescription drugs in the course of a year.

This, along with age-related changes in the way their bodies handle drug metabolism, makes the elderly more vulnerable to side effects and interactions between different drugs that can lead to confusion and disorientation. Diuretics, digitalis, oral anti-diabetic drugs, painkillers, antiinflammatory agents, sedatives, and antipsychotic drugs have all been implicated in such adverse drug reactions.

Another common cause of usually treatable dementia-like symptoms is depression. Depressed individuals are often passive and unresponsive and may appear confused, slow and forgetful. Chronic alcoholism can also impair mental faculties, particularly memory for recent events.

For the remaining 75 to 80 percent of those elderly who suffer from dementia, the condition is irreversible–it cannot be cured. A small number of these victims have multi-infarct dementia. In these cases, obstruction of the blood flow to the brain has caused a series of minor strokes resulting in death of brain tissue. (At one time, this condition was called, somewhat inaccurately, “hardening of the arteries of the brain.”) The rest have Alzheimer’s disease.