This article uses material from the Wikipedia article “Dementia”, which is released under the Creative Commons Attribution-Share-Alike License 3.0.
Dementia, also known as senility, is a broad category of brain diseases that cause a long term and often gradual decrease in the ability to think and remember that is great enough to affect a person’s daily functioning. Other common symptoms include emotional problems, problems with language, and a decrease in motivation. A person’s consciousness is not affected. A dementia diagnosis requires a change from a person’s usual mental functioning and a greater decline than one would expect due to aging. These diseases also have a significant effect on a person’s caregivers.
The most common type of dementia is Alzheimer’s disease, which makes up 50% to 70% of cases. Other common types include vascular dementia (25%), (15%), and frontotemporal dementia. Less common causes include normal pressure hydrocephalus, Parkinson’s disease, syphilis, and Creutzfeldt–Jakob disease among others. More than one type of dementia may exist in the same person. A small proportion of cases run in families. In the DSM-5, dementia was reclassified as a neurocognitive disorder, with various degrees of severity. Diagnosis is usually based on history of the illness and cognitive testing with medical imaging and blood work used to rule out other possible causes. The mini mental state examination is one commonly used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes, and obesity. Screening the general population for the disease is not recommended.
There is no cure for dementia. Cholinesterase inhibitors such as donepezil are often used and may be beneficial in mild to moderate disease.  Overall benefit, however, may be minor. For people with dementia and those who care for them many measures can improve their lives. Cognitive and behavioral interventions may be appropriate. Educating and providing emotional support to the caregiver is important. Exercise programs are beneficial with respect to activities of daily living and potentially improve outcomes. Treatment of behavioral problems or psychosis due to dementia with antipsychotics is common but not usually recommended due to there often being little benefit and an increased risk of death.
Globally, dementia affects 36 million people. About 10% of people develop the disease at some point in their lives. It becomes more common with age. About 3% of people between the ages of 65–74 have dementia, 19% between 75 and 84 and nearly half of those over 85 years of age.  In 2013 dementia resulted in about 1.7 million deaths up from 0.8 million in 1990. As more people are living longer, dementia is becoming more common in the population as a whole. For people of a specific age, however, it may be becoming less frequent, at least in the developed world, due to a decrease in risk factors. It is one of the most common causes of disability among the old. It is believed to result in economic costs of 604 billion USD a year. People with dementia are often physically or chemically restrained to a greater degree than necessary, raising issues of human rights. Social stigma against those affected is common.
Signs and symptoms
The symptoms of dementia vary across types and stages of the diagnosis. The most common affected areas include memory, visual-spatial, language, attention and problem solving. Most types of dementia are slow and progressive. By the time the person shows signs of the disease, the process in the brain has been happening for a long time. It is possible for a patient to have two types of dementia at the same time. About 10% of people with dementia have what is known as mixed dementia, which is usually a combination of Alzheimer’s disease and another type of dementia such as frontotemporal dementia or vascular dementia. Additional psychological and behavioral problems that often affect people who have dementia include:
Speech and language difficulty
Trouble eating or swallowing
Memory distortions (believing that a memory has already happened when it has not, thinking an old memory is a new one, combining two memories,
or confusing the people in a memory)
Wandering or restlessness
Perception and visual problems
Behavioral and psychological symptoms of dementia (BPSD) almost always occur in all types of dementia. BPSDs may manifest as:
Abnormal motor behavior
Disinhibition and impulsivity
Delusions (often believing people are stealing from them) or hallucinations
Changes in sleep or appetite.
When people with dementia are put in circumstances beyond their abilities, there may be a sudden change to crying or anger (a “catastrophic reaction”).
Depression affects 20–30% of people who have dementia, and about 20% have anxiety. Psychosis (often delusions of persecution) and agitation/aggression also often accompany dementia. Each of these must be assessed and treated independently of the underlying dementia.
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