Dementia

Dementia is a mental disorder that includes memory impairment and at least one of the following: difficulty speaking impaired movement and inability to plan and initiate appropriate behaviors socially or at work. Dementia usually occurs in elderly people. It is rare in children. Approximately 2 to 4 percent of the population over age 65 has dementia caused by Alzheimer's disease.

Signs and Symptoms

• Memory impairment
• Language problems
• Motor skills impairment (such as balance and walking)
• Impaired ability to recognize objects
• Inability to think abstractly
• Spatial disorientation (e.g. judging distances)
• Depression and suicidal behavior
• Uninhibited behavior
• Anxiety mood and sleep problems
• Hallucinations

What Causes It?

Alzheimer's disease accounts for half to two thirds of all dementia cases. Other causes of dementia are listed below.

• Vascular disease
• General medical conditions like traumatic brain injury
• Parkinson's Huntington's Creutzfeldt-Jakob and other diseases
• Brain tumor
• Vitamin B deficiencies
• Drug or alcohol abuse medications or exposure to toxic substances

What to Expect at Your Provider's Office

Your health care provider will go over your symptoms and will do a physical examination. However since there is no definitive test for dementia your provider will rely greatly on interviews with you and your family especially to discover noticeable declines in mental and physical abilities.

Treatment Options

Treatment Plan

The goal of treatment is to reverse or lessen symptoms. Your health care provider will closely evaluate your current medications for drug sensitivities that could be making the dementia worse. He or she possibly may prescribe some other drugs for your symptoms. Psychiatric and behavioral therapies can help you to cope with the disease. It is important to have a safe and predictable living environment. Exercise both physical and mental can slow the progress of the dementia.

Drug Therapies

Prescription

• Acetycholinesterase inhibitors—help to reduce dementia
• Neuroleptics—help behavioral problems that arise from having dementia
• Benzodiazepines—reduce agitation
• Selective serotonin reuptake inhibitors (SSRIs)—relieve depression that comes with dementia
• Estrogen therapy—may help reduce Alzheimer's disease in postmenopausal women

Over the Counter

N/A

Complementary and Alternative Therapies

Alternative therapies may offer great promise in treating dementia without the side effects of pharmaceuticals. Treatment with nutrition can provide rapid results in some people with nutritional deficiencies. Herbal treatment is widely used in Europe with promising results.

Nutrition

• Antioxidants are key—vitamin E (400 to 800 IU per day) vitamin C (1 000 mg three times per day) and coenzyme Q10 (10 to 50 mg three times per day)
• Vitamins: biotin (300 mcg); B₁ (50 to 100 mg) B₂ (50 mg) B₆ (50 to 100 mg) B₁₂ (100 to 1 000 mcg). B₁₂ may need to be administered through injection for best results.
• Minerals: calcium and magnesium (1 000 and 500 mg per day respectively) zinc (30 to 50 mg per day); excess of manganese and copper can increase the risk for dementia
• Intravenous chelating agents such as ethylenediaminetetraacetic acid (EDTA) may help restore normal circulation in the brain.
• Essential fatty acids regulate certain types of blood cells stabilize arterial walls and have anti-inflammatory properties. Dietary changes include reducing intake of animal fats and increasing that of fish.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Choose four to six herbs from the most appropriate category and use one cup or 30 to 60 drops three times per day.

• Ginkgo (Ginkgo biloba) is specific for preventing and treating Alzheimer's and senile dementia. May be taken in a standardized extract of 40 to 50 mg three times per day. If you are taking an anticoagulant drug use ginkgo only under the supervision of your provider.
• Hawthorn (Crataegus oxyacantha) is a circulatory stimulant .
• Rosemary (Rosemarinus officinalis) stimulates circulation improves digestion relieves depression.
• Siberian ginseng (Eleuthrococcus senticosus) increases endurance and increases cerebral circulation. Use this herb with caution if you have high blood pressure.
• Lemon balm (Melissa officinalis) reduces spasms and anxiety .
• Ginger (Zingiber officinale) helps with general weakness.
• St. John's wort (Hypericum perforatum) helps relieve depression and anxiety.

Homeopathy

Some of the most common remedies used for dementia are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Alumina for dullness of mind vagueness slow answers to questions
• Argentum nitricum for dementia with irritability especially with lack of control over impulses
• Cicuta for dementia after head injuries especially with convulsions
• Helleborus for stupefaction when a person answers questions slowly and stares vacantly
• Silica for mental deterioration with anxiety over small details

Following Up

Someone with dementia probably will require continuous care and monitoring by both your health care provider and family members.

Special Considerations

Caregiver and patient education focusing on knowledge of the disease health and the patient's well-being results in better patient care. Caregivers must also closely monitor patients to make sure they are taking medications appropriately.

Supporting Research

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: American Psychiatric Association; 1994.

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:214 376.

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Gruenwald J Brendler T Jaenicke C et al eds. PDR for Herbal Medicines. Montvale NJ: Medical Economics Company; 1998:967–968 1101–1102 1219–1220 1229–1230.

Hofferberth B. The efficacy of EGb 761 in patients with senile dementia of the Alzheimer type; A double-blind placebo-controlled study on different levels of investigation. Hum Psychopharmacol. 1994;9:215–222.

Kanowski S Hermann WM Stephan K Wierich W Horr R. Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate dementia of the Alzheimer's type or multi-infarct dementia. Pharmacopsychiatry. 1996;29:47–56.

Le Bars et al. A placebo-controlled double-blind randomized trial of an extract of Gingko biloba for dementia. JAMA. 1997;278:1327–1332.

Maurer K. et al. Clinical efficacy of Gingko biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiatr Res. 1997;31:645–655.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:17–17 32–33 124–125 176–177 248–249.

Morris JC ed. Handbook of Dementing Illnesses. New York NY: Marcel Dekker Inc; 1994.

National Institutes of Health. Available at http://text.nlm.nih.gov/.

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Rakel RE. Conn's Current Therapy 1997: Latest Approved Methods of Treatment for the Practicing Physician. Philadelphia Pa: WB Saunders; 1997.

Werbach M. Nutritional Influences on Illness. New Canaan Conn: Keats Publishing; 1988:149–154.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.