Dementia

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Central nervous system

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia 

The goal of treatment is to control the symptoms of dementia. Treatment depends on the specific condition causing the dementia. Some people may need to stay in the hospital for a short time.

Stopping or changing medications that make confusion worse may improve brain function. Medicines that contribute to confusion include anticholinergics, analgesics (painkillers), cimetidine, central nervous system depressants, and lidocaine.

Medical conditions that can lead to confusion should be treated. Such conditions include heart failure, decreased oxygen (hypoxia), thyroid disorders, anemia, nutritional disorders, infections, and psychiatric conditions such as depression. Treatment of co-existing medical and psychiatric disorders often greatly improves a person's mental functioning.

Medications may be needed to control behavior problems. Possible medications include:

• Anti-psychotics, given at night
• Serotonin-affecting drugs (trazodone, buspirone)
• Dopamine blockers (haloperidol, risperdal, olanzapine, clozapine)
• Cholinesterase inhibitors such as donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne, formerly called Reminyl) for Alzheimer's-type dementia
• Mood stabilizers such as fluoxetine, imipramine, or Celexa
• Stimulants such as methylphenidate to increase activity and spontaneity

A person's eyes and ears should be checked regularly. Hearing aids, glasses, or cataract surgery may be needed.

Psychotherapy or group therapy usually does not help because it may further confuse a person with dementia.

LONG-TERM TREATMENT:

A person with dementia may need monitoring and assistance at home or in an institution. Possible options include in-home care, boarding homes, adult day care, and convalescent homes.

Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may help a family care for a patient with dementia. In some communities, support groups may be available (see elder care - support group). Family counseling can help family members cope with home care.