Talk:Dementia/Archive 1

Archive 1

Gelder et al

The citations found in the "Comorbidities" section to (Gelder et al 2005) are incomplete.

Dave Earl (talk) 08:57, 2 June 2011 (UTC)

Contraindicated section

Should this be modified? Antipsychotic medications are included in this section, and the bit on these meds clearly states that they are 'not indicated'. That is different to contraindicated!. They do cause an increased risk of death (as do most treatments for most conditions, including for example chest-xrays), but their use needs to be carefully considered, weighing up the risks and benefits (e.g. without this treatment, there is a high risk that the patient will come to harm, or die, or be distressed etc). Perhaps antipsychotics should be moved to the 'off-label' section, where they belong? :) 166.83.21.221 (talk) 03:59, 21 April 2009 (UTC)

Chat

Do ya think it is possible to halt the decline of people with dxsxtia by giving them love and attention? I do.

My name is Monica Mariniello and I do believe love and attention can help those suffering from dementia like me. It has worked wonders in my life. I'm a new woman.

---

I understand that it is possible for dementia to arise out of deprivation of activities that require cognitive thought. This would include human contact.

Perhaps this should be mentioned in the article?

I was redirected here from Senility, and this page does not so much as mention the word. I would like to know if the definitions are one and the same, or what the difference is.

--203.217.18.196 15:08, 2 Dec 2004 (UTC)

Yes: there is something about social networking and being connected to individuals that helps persons cope with this illness. there also be a biologic mechanism of social stimulation. new article just came out in Journal of American Geriatrics that documents this. We could put this in based upon this article by lopez, will work on it, but first need to finish a wiki article on informed consent, also check out my blog at http://stefanospantagis.net/journal/Culturejamstef

---

Types

(...)
Vitamin B6 (thiamin) deficiency

F Vitamin B6 is NOT thiamin. What is meant ?

• Vitamin B6 (pyridoxal) deficiency
• Vitamin B1 (thiamin) deficiency

Thanks
Eras-mus 23:54, 2 Feb 2005 (UTC)

---

Why was the addition of Lyme Disease as a type of subcortical dementia removed? Given that 80,000 cases a year in Europe and 20,000 in the USA are being diagnosed every year with this disease, it seems to me to be as important a differential as Syphilis.

Damwiki1 (talk) 08:09, 21 May 2008 (UTC)

Disagree with kangaroo court pointing its fingers at cannabis. —Preceding unsigned comment added by 173.89.244.190 (talk) 13:49, 19 January 2009 (UTC)

False dementia

With regards to the recent addition of a "false dementia" section on this page, I understand this phenomenon to be more often called delirium, which is already mentioned elsewhere in the article. The distinction beteween dementia and delirium is an important one, and more development of this theme would be valuable. However, I think the use of terminology needs to be consistent, and the discussion of delirium and its relationship to dementia should be brought together into one place. sallison 09:25, 1 October 2005 (UTC)

In my vocabulary delirium is something really really bad. Do you really say that each and every weak old person who gets a urinary tract infection gets delirium? Still, I am not that familiar with the English terminology so I take your word for it. I have tried and merge the info on the two places in the article. I am sure it can be improved though. / Habj 18:04, 1 October 2005 (UTC)

Delirium is serious, but to call it "really really bad" is perhaps a bit over the top. Effectively it is the occurrence of psychotic symptoms (hallucinations and delusions, typically worse at night) as a result of an organic brain problem, which may be poisoning, infection, withdrawal of medication or various other things (e.g. electrolyte disturbances). The distinction is indeed vital, because delirium is readily treatable with removal of the precipitants and sometimes antipsychotics and benzodiazepines. Dementia, while it may be worsened by these causes, is not typically reversible in such a fashion. JFW | T@lk 22:37, 1 October 2005 (UTC)

agreed with JFW on all counts. sallison 03:32, 2 October 2005 (UTC)

Absolutely agreed on the reversibility criterion, which was why I added the subsection in the first place. There is a common observation that dementia patients get better by improvement in daily life, and relatives often don't realise that this can not affect the disease progression. Most dementia symptoms are not psychotic, like the typical malfunctioning memory regarding thing that happened recently (not childhood memories etc) and desorientation. I sincerely doubt that most dementia patients suffer from clinical delirium, but most dementia patients have a false dementia a.k.a. pseudo-dementia on top of the neurological disease that makes the day-to-day-status worse, but that can be improved. I haven't spent much time googling, but one of my first hits is this article talking about pseudo-dementia caused by depression which usually has nothing to do with psychosis. [1] I do suspect we are actually talking about different things, and that both aspects deserve a space in the article. I should check more sources to find good ways of putting it, though. / Habj 13:42, 3 October 2005 (UTC)

Dementia or Mental Confusion

I would like to place a link to this page from the Complications section of the article on Hip fracture (& others). However, I note there is another article on Mental confusion which seems less clinical and more descriptive of thought processes (possibly including my own!). Is it your opinion that the type of Confusion commonly encountered after hip fracture is properly dementia so the link should be to here? --Mylesclough 05:25, 25 October 2005 (UTC)

So which is it?=

"dementia, by definition, is irreversible. . . . Probably less than 10% of all dementias are reversible"

What?? -Branddobbe 08:18, 29 October 2005 (UTC)

I removed the absolute statement; it didn't make any sense given the context around it. -Cymsdale 10:14, 26 December 2005 (UTC)

parkinson's is listed as a less common cause of dementia. the more recent epidemiology on parkinson's dementia would tend to indicate that perhaps 80 percent of parkinson's patients ultimately go on to develop dementia. i've also seen it listed as the second most common cause of dementia in individuals over age 50. I am willing to find documentation for this; i'd like to move PD from the "less common" list to the "more common list."Bldavids 15:29, 10 February 2006 (UTC)

"Senile"

"Senile dementia" is a common term in the UK (at least) and I was surprised that this article did not include or explain the phrase, especially when the entry for "senile" redirects to this article.

When used on its own, the word "senile" (on its own) means 'physical or mental infirmity associated with old age' but in common use (again, in the UK at least) it refers specifically to generic dementia. Is it possible for someone (with more expertise than I have) to include the term in an appropriate place? Mrstonky 19:20, 27 August 2007 (UTC)

In the U.S., "senile" is now considered offensive and agist, and is largely replaced by "demented". Sylvia A (talk) 00:08, 13 December 2008 (UTC)

The word would have a place in this article if it had a "history" section. Why is there no history section? Takeshi357 (talk) 12:31, 22 May 2009 (UTC)

Colloquial use of 'demented'

The word 'demented' is used (in the UK at least) as a colloquial and non-PC insult for someone who is considered stupid or slghtly mad. I've also encountered terms like "herd of demented elephants" used. Could someone add a note to this effect to the article, please? I'd rather not do it myself as I'm not enough of an expert on this particular piece of vernacular. Sidefall 13:52, 31 August 2007 (UTC)

"When used on its own, the word "senile" (on its own) means 'physical or mental infirmity associated with old age'" Thats the exact reasoning as to why it has not been included in this article. DEMENTIA IS NOT A NORMAL AGING PROCESS. —Preceding unsigned comment added by Wistfuldesires (talk • contribs) 10:41, 18 May 2010 (UTC)

WikiProject class rating

This article was automatically assessed because at least one WikiProject had rated the article as start, and the rating on other projects was brought up to start class. BetacommandBot 16:25, 10 November 2007 (UTC)

Senility

Considering the words "senile" and "senility" both redirect here and that both are quite common terms, surely the article should at least mention these words in passing? Thedreamdied (talk) 15:59, 13 April 2008 (UTC)

Causes section needed

I think the article would be improved with a section on causes. The serpinopathy section of another article claims that "Well characterised serpinopathies include emphysema, cirrhosis, thrombosis and dementia." and provides a citation. I suspect their may be other causes as well, but was surprised to find this article mentioning nothing on it at all. N2e (talk) 18:54, 19 July 2008 (UTC)

I think you misunderstand the comment in serpin. It is not that all serpinopathies cause dementia, it is just that one particular serpin (neuroserpin) has been associated with (not even causally linked) with dementia. It is a technicality not perhaps necessarily worth mentioning in this article.

A section on "causes" is not needed in this article. Dementia comprises several syndromes (Alzheimer's, vascular dementia, amnestic syndrome etc), each of which has its own causes. JFW | T@lk 13:55, 20 July 2008 (UTC)

Dementia as a cause of death

Which forms of dementia are fatal, and what is the manner of death? I ask in regard to the recently created category Category:Deaths from dementia. Thanks. Delicious carbuncle (talk) 20:33, 23 August 2008 (UTC)

Detailed contribution from RoyallMD

Looks like a person made a well-intentioned edit a few days ago (January 23) that ended up confusing several readers. RoyallMD replaced a good general introduction with a very detailed one. I've reverted this, but here's a copy-and-paste of their contribution in case it can be re-integrated into the article in a useful way. Dreamyshade (talk) 05:15, 28 January 2009 (UTC)

Dementia (from Latin de- "apart, away" + mens (genitive mentis) "mind") is an acquired syndrome (set of symptoms) of cognitive decline in a clear sensorium that is sufficient to cause disability. By "acquired" it is suggested that dementia is not a developmental delay, as normal adult cognitive function was previously achieved. As a syndrome, the definition suggests a cluster of symptoms that occur frequently together, but this does not implicate any particular disease or pathological process. Cognitive decline from a previous baseline allows the consideration of aging-related dementias ("senility"), as "impairment" is usually referenced to age-specific norms. This practice precludes the possibility of aging-related dementias, despite evidence of disabling age-related cognitive declines relative to young adult levels of performance. Cognitive impairments in a clouded sensorium better characterize delirium, which is often confused with dementia. Cognitive dysfunction per se may not be disabling and may be a cause of handicap, but dementia implies a functional disability.

This definition avoids many of the presumptions about dementia that derive from confusing this syndrome with a particular disease process, such as Alzheimer's disease (AD), a common cause of the dementia syndrome. As a syndrome, dementia may be associated with many causes, some of which have unique pathological characteristics and natural histories. Thus, AD is associated with charateristic patholgical lesions, but these do not charaterize the dementia syndrome. AD is also associated with progressive decline, but other causes of dementia may not. AD tends to affect the elderly, but dementia can occur in any stage of adulthood. AD affects memory in the vast majority of cases, but the definition of dementia does not require memory impairment, and memory may be spared in certain non-AD dementias. AD is generally not reversible, but the dementia syndrome may be transient, and some dementias are reversible. The requirement for disabling cognitive decline may constrain the set of cognitive functions that can be invoked to define dementia because not all cognitive functions are equally related to functional outcomes. Executive function may be particularly relevant to disability, while memory impairment may be less so. Finally, cognitive decline is used rather than "impairment" becasue the latter is often defined relative to age-specific norms. This practice artificially defines disabling age-related cognitive declines as "normal" and effectively excludes aging as a potential cause of dementia syndrome.

Symptoms of dementia include cognitive, behavioral or affective disturbances, depending on the specific cause and brain regions affected by that disorder.Memory, attention, language, and problem solving are commonly affected. "Stages" of dementia have little meaning across diagnoses, but some disorders, notably AD, have very stereotyped presentations. AD begins with olfactory impairments, followed years or decades later by forgetfulness and memory loss. Disturbances of higher mental functions follow. Affected persons may be disoriented in time (not knowing what day of the week, day of the month, month, or even what year it is), to place (not knowing where they are), or to person (not knowing who they are or others around them)(agnosia). They may have difficulties in judgement or problem solving (executive impairment). They may have trouble reading, expressing themselves, or understanding others (aphasia). They may have trouble dressing themselves or using household implements (apraxia).

Treatment

The section on treatment is very sparely referenced.--Doc James (talk · contribs · email) 12:39, 28 January 2009 (UTC)

New 'causes' section

I've just rewritten the 'types' section and renamed it 'causes'. I notice that a previous major rewrite got reverted for being too technical - I hope mine doesn't suffer the same fate, but I'd be very happy to work it into less technical language if other users feel it would help.

This is my first major Wikipedia edit, so be gentle!

Neurotip (talk) 15:05, 12 October 2009 (UTC)

Treatment

Would the 'Treatment' section be better if the content were incorporated into the pages for each cause? In particular it seems redundant to have a section on the treatment of Alzheimer's disease here, when this is treated comprehensively on the Alzheimer's page itself. Similar comments apply to depression.

It would be reasonable to include comments relating to the management of patients with dementia here, where such management does not relate to the specific cause. Examples might include use of memory aids, management of behavioural problems, criteria for admission to institutional care, etc.

I don't know whether there's a tag for this - if so, perhaps someone could enter it if they agree.

Neurotip (talk) 15:14, 12 October 2009 (UTC)

I agree with the above, Neurotip. Anthony (talk) 09:46, 14 November 2009 (UTC)

Pain in dementia

Recently, a new editor posted a link on Pain to an article she/he wrote on her/his user page about the important emerging issue of assessing pain in dementia patients. Unfortunately she/he got blowtorched very rudely by a zealous editor and, I fear, chased away. Although I'm not studying this issue in particular, I encounter it frequently in my study of the cognitive effects of pain, and can fairly judge it a very competent and valuable contribution. I think this is it's home, because family and even healthcare professionals dealing with dementia are more likely to go to this page than Pain. And it is extremely important to the welfare of the patient. The essay is at: ♥♥♥ And the author's Talk page: ♣♣♣.

Anthony (talk) 22:05, 11 November 2009 (UTC)

I agree that the article is a useful contribution to an important subject, and that the Dementia page would be an appropriate place for it. Kudos to the author. Neurotip (talk) 19:42, 12 November 2009 (UTC)

Painaware has posted her/his essay as the Wikipedia article Pain in Persons with Dementia. I'd like to move it now into this article as a subsection and redirect from Pain in Persons with Dementia to here. Any objections? Anthony (talk) 09:22, 14 November 2009 (UTC)

I think this merge is improper by WP:SYNTH, this article is already big.--Nutriveg (talk) 13:18, 4 December 2009 (UTC)

The article is only 55 kb in size. Dementia is a widelyscoped topic that an article 80 - 100 kb could be justified. If synthesis of sources has occured then that will need to be fixed.--Literaturegeek | T@1k? 19:28, 4 December 2009 (UTC)

I've just included references to Hadjistavropoulos et al. (2007) - an authoritative review that, along with Shega et al. (2007) and Herr et al. (2006) supports every word of the subsection. As to the size of the article, are there Wikipedia guidelines relating to this? Anthony (talk) 19:29, 5 December 2009 (UTC)

Thank you for adding references. Yes there is, see WP:SIZE and a short cut to relevant section of the same article WP:SIZERULE. The individual types of dementia should probably be under 60 kb but this is the main article which is meant to summarise the whole topic of dementia and its different types etc.--Literaturegeek | T@1k? 19:40, 5 December 2009 (UTC)

Thank you Literaturegeek Anthony (talk) 19:47, 5 December 2009 (UTC)

This sentence needs fixing, IMO.

Research into the use of NSAID pain relievers has been going on for decades, but it is unlikely to ever be recommended, due to the fact that most NSAIDs are off patent and can be made very cheaply.

Both grammatical & other problems here. Grammar: "Research is unlikely to ever be recommended..." Huh? :-)

If it is NSAIDs which are unlikely to be recommended, being off-patent and cheaply made shouldn't play a role?

- Hordaland (talk) 17:24, 12 November 2009 (UTC)

Agree. It's speculative and unreferenced and should go. Anthony (talk) 09:31, 14 November 2009 (UTC)

missing defintions

Wow, this article has certainly improved since I last looked at it - good job all!

Somewhere in this improvement, the definition of cortical and subcortical dementia has been dropped, there is one reference to these types left in article. Looks like the limited definition which was [[2]] has merged into causes. I'm not sure if these are worth defining, but I would have thought so .. Lee∴V (talk • contribs) 12:12, 18 March 2010 (UTC)

I fear that was probably me. While I haven't looked into this issue specifically, I have a lurking suspicion that the cortical-subcortical distinction is much less clear-cut than used to be thought, and that the features thought to be characteristic of one may occur in the other. Both Alzheimer's disease (quoted as cortical) and Parkinson's disease with dementia (quoted as subcortical) typically involve both cortical and subcortical pathology, each of which may contribute to the cognitive impairment. In any case, does 'subcortical' mean (a) any white matter, (b) just 'subcortical' white matter, (c) deep grey matter nuclei, or (d) any of the above? Discussion welcome, but personally I think they're really legacy terms. Neurotip (talk) 19:57, 27 March 2010 (UTC)

Genetic factors

What is missing in the article is the discussion of genetic factors in dementia. I've added a sentence about protein handling to the lead. --Eleassar ^{my talk} 14:05, 12 June 2010 (UTC)

Prognosis

I've removed the Prognosis section

Severe dementia is frequently complicated by pneumonia, febrile illnesses, and eating problems. Life expectancy is 18 months.[57]

because the cited article does not proffer a life expectancy. Anyway, dementia is a feature of several distinct diseases and conditions, each of which has its own clinical course. Anthony (talk) 12:46, 20 September 2010 (UTC)

Sounds like a good move.--Literaturegeek | T@1k? 20:56, 22 September 2010 (UTC)

I read the reference, the 18 months mortality rate is 54 percent within 18 months for advanced dementia. The reference had been misinterpreted. I think that the text and reference should be added back in but with the corrections I have just mentioned. What do you think?--Literaturegeek | T@1k? 22:44, 22 September 2010 (UTC)

I'm not sure we can offer a blanket prognosis section for dementia, because it is a symptom cluster common to many diseases and conditions, each with its own prognosis and course. Anthony (talk) 19:32, 24 September 2010 (UTC)

Yes, that is exactly the problem. SBHarris 23:52, 24 September 2010 (UTC)

Good point, I agree with your reasoning. What might be good is if we or someone could find a review which discusses the mortality prognosis varying for different types of dementia.--Literaturegeek | T@1k? 16:01, 2 October 2010 (UTC)

How serious must impairment be to qualify as dementia?

I am not a medical doctor, and therefore do not feel qualified to amend this entry. However, I would like an opinion on whether dementia must, by definition, be a serious loss of cognitive ability. Is it not possible for dementia to be less than "serious" in its effects? I am concerned that the word "serious" here may alarm some people who have been diagnosed with dementia, and their relatives. — Preceding unsigned comment added by Redmagic (talk • contribs) 18:45, 21 January 2011 (UTC)

Classically the diagnosis is one of symptomatology-only, and so classically it must be fairly severe (enough to compromise at least some normal activities of daily living), by definition. Dementia is a symptom, as the article notes. However, sometimes "dementia" is used synonymously with "having one of the dementing diseases" (like Alzheimers). In this sense, it's possible to speak of "early dementia" (meaning in the early stages of a dementing disease) in which case the symptomatic impairment is not YET serious, but the implication is that (probably) it WILL be. With PET scans and other sophisticated technologies, "early dementia" is found more and move often, so that's a problem for the definition (which is changing, and is also not used correctly even by physicians). Probably something of this sort should be added to the lede. I'll see what I can do. SBHarris 19:42, 21 January 2011 (UTC)

Moved from article

An editor added this information to the Epidemiology section:

A study which followed subjects for 15 years found that higher levels of silica in water appeared to decrease the risk of dementia. The study found that with an increase of 10 milligram-per-day of the intake of silica in drinking water, the risk of dementia dropped by 11%.

What does everyone think? Does it belong in the article? I've seen a lot of information on aluminum (though not much on silica), and there seems to be a lot of variability in the results. Also, correlation often doesn't mean causation. Epidemiological studies always drive me crazy because I can give you dozens of reasons why increased silica why it might be correlated, but I can't think of any physiological reason why it might be causative. But before we add something like this (which really belongs in the Cause section), I thought we should discuss it. OrangeMarlin ^{Talk• Contributions} 17:54, 27 March 2011 (UTC)

Media coverage of dementia

I am not sure whether this is the best place to mention it, but there could be a mention somewhere in Wikipedia about how Radio Four are broadcasting, in May 2011, monologues about people with dementia in their series "Ancient Mysteries". ACEOREVIVED (talk) 19:55, 11 May 2011 (UTC)

The programmes are being broadcast at 7: 45 pm (after Front Row) each night in the week beginning May 9. ACEOREVIVED (talk) 19:56, 11 May 2011 (UTC)

Again, another media topic! I am so glad that this article mentions the problems of antipsychotic drugs - it was broadcast on news on Radio Four on June 9 2011 that there have been numerous problems with prescriptions of antipsychotic drugs to dementia sufferers. Perhaps the problems with antipsychotic drugs should go at the start of the article? The article could also mention recent (at time of typing) news coverage of antipsychotic drugs. ACEOREVIVED (talk) 19:57, 9 June 2011 (UTC)

Newest Changes

I made a few changes

• Edited ambiguous/incorrect statement regarding age as a “definining cut-off” and put in a reference for early onset dementia.
• Deleted information related to alcohol from the introduction that was repeated later in the article.
• Added a small list of the major forms of dementia with links to these pages. (This maybe better placed somewhere else, but I think a list needs to be somewhere on its own as it gets lost in amongst other information)
• Added some information on medications

I'm aware that I need to fix up some citation duplications. I'd be happy to discuss any of these changes

MitchMcM (talk) 22:56, 31 July 2011 (UTC)

Agree with all this. The main reason to delete alcohol is not that it's repeated (the lede is a summary and thus repeats things) but that it's a small part of the etiology stuff below-- much too long a list to mention in the lede, since we're talking about etiologies of dozens (who knows how many?) processes. There was a bit of history in the lede also, but not enough, since the article had no "history of the term" section. I wrote one and incorporated the history info in the lede into it. A line or two in the lede could be devoted to summarizing the history, I suppose, but it's long already. If anybody would like me to put a bit back in, I'll try. Otherwise, I think it's okay left out, given all the extra work that the lead/lede has to do now. SBHarris 15:12, 1 August 2011 (UTC)

Format in disrepair

I'm not sure what happened, but the article is in a three-column layout right now, and I have no idea how to fix it. fds^Talk 16:39, 24 August 2011 (UTC)

Vandalism

The article seems a bit short and it got pretty weird at the end. — Preceding unsigned comment added by 71.201.8.250 (talk) 01:22, 10 September 2011 (UTC)

Thanks, it's been fixed. You can fix vandalism yourself. See how to revert.-gadfium 06:49, 10 September 2011 (UTC)

A bias in this article

This article seems to be very much biassed towards a mainstream ultra-scienfitic neuro-biological approach to dementia. If one does a Google search, one can find articles on the spiritual care of people with dementia, and also on transpersonal, core process, humanistic and existential approaches to dementia. If no else does this, I may add some of this information to the article to remove its current bias. ACEOREVIVED (talk) 09:51, 20 September 2011 (UTC)

I have now added a little section on spiritual care of patients with dementia. It is still in embryonic stage at present, but at least it is a beginning. ACEOREVIVED (talk) 10:47, 20 September 2011 (UTC)

The new section:

Considerable literature has looked at the spiritual care of people with dementia. Literature on this subject was reviewed by Keast, Leskovar and Brohm (2010),who found the literature tackled three major common themes.

These were: (1) maintaining a sense of purpose in life, nurturing meaningful connections with the surrounding environment, and retaining a relationship with God; (2) identification of effective strategies for assessing individual spiritual needs and (3) use of formal religious interventions, such as prayer or spiritual reminiscence. (SOURCE: http://www.annalsoflongtermcare.com/content/systematic-review-spirituality-and-dementia-ltc)

The cited review does not describe the literature as "considerable," and the authors observe that "The majority of these studies had very small purposive samples, limiting the ability to generalize the results. A number of these articles originated from faith-based organizations; thus, the possibility of bias is present. There were no randomized, controlled studies, making it difficult to evaluate the effectiveness of the spiritual interventions." That is, nothing can be said with any confidence about the effectiveness of spiritual interventions in dementia care. There may be a place for a mention of this review somewhere in Wikipedia, but this overview article is not it. I'd be very much in favor of an article on spiritual aspects of palliative and dementia care being created. I have removed the section. --Anthonyhcole (talk) 12:26, 20 September 2011 (UTC)

Thank you - I appreciate and respect your views there. I wondered whether typing in "spirituality" and "dementia" into Google Scholar might yield better results. I did find this article:

http://dem.sagepub.com/content/2/3/379.short

But again, you might feel this is not sufficiently comprehensive enough to be added to the article. I shall leave it to readers of this article who might have knowledge / expertise in this area to add information on this theme to the article. ACEOREVIVED (talk) 15:12, 20 September 2011 (UTC)

(I took the liberty of indenting your comment, ACEOREVIVED, per this essay. If that was impertinent, please revert.) The article you cite there describes a single study; that is, it is a "primary source." Wikipedia medical articles are built on secondary sources – reviews like the one you linked to first, graduate-level textbooks, and national or international professional body guidelines. The relevant Wikipedia guideline governing sources for med articles is WP:MEDRS. I'll shortly be reading up on psychosocial and spiritual aspects of cancer pain management. If I find anything in that quest that is suitable for this article I'll certainly look at including it here. --Anthonyhcole (talk) 15:48, 20 September 2011 (UTC)

My review on Bbucks added sentence

It looks like Bbuck added a informational sentence on how consuming alcohol slows down the development of dementia. He sourced his sentence correctly.AlyceBort (talk) 23:10, 8 October 2011 (UTC)AlyceBortAlyceBort (talk) 23:10, 8 October 2011 (UTC) [User:AlyceBort|AlyceBort]] (talk— Preceding unsigned comment added by AlyceBort (talk • contribs) 22:44, 8 October 2011 (UTC)

It's a self-selected epidemiological study, and thus has all the problems of studies of self-selected groups. We hardly know WHAT else might be different about Italians who drink moderately than those who don't drink at all. I suspect a lot of things. The authors of the study say the same, and qualify it that way. As they should. I've added their qualification to this article. SBHarris 23:16, 8 October 2011 (UTC)

please let me know how to cure progressive dimentia...... — Preceding unsigned comment added by 14.99.144.17 (talk) 16:44, 1 November 2011 (UTC)

If I knew I'd be rich and famous. SBHarris 20:23, 1 November 2011 (UTC)

Need editor for link I think is of interest please

Hello, would an editor be so kind to place a link to www.dementia.co.uk under the links section of dementia. I have a conflict of interest, but feel that this site would be a valuable addition to the links on the article dementia. Thankyou John cordingly (talk) 18:46, 10 December 2011 (UTC)

I think it would be appropriate for us to reconsider the existing external links, in a similar process to what's happening at Talk:Huntington's disease#Inadequacy of dmoz for external links.

John, could you please explain who runs your site? Is it just you, or is it the site of an organisation involved in dementia care or research? How can we be assured that the material on it is accurate? In general, we would prefer to link to a site which gives its sources for stories, and which has a well-known body behind it.-gadfium 22:22, 10 December 2011 (UTC)

Hello, I run the site but the articles are written by workers at a daycare centre that runs sessions for dementia sufferers. So the articles are written from hands on people who have direct contact with families, friends and sufferers of dementia. I dont think you can get closer to the subject than that. I think the site i have suggested contains as much, if not more information than most of the links listed, and the subject matter is DEMENTIA not Alzheiemer's, yet Alzheimer's sites are listed. I think small sites should also be considered alongside big company sites because they give real views and advise from the front line, from people who deal with dementia everyday. You cannot just include "Well known body" organisations because that dosen't allow for the small man to have his voice heard. Thankyou John cordingly (talk) 12:57, 13 December 2011 (UTC)

Can puzzles help to reduce risk of dementia?

It was announced on the front page of the Daily Express some time ago that doing puzzles, such as crosswords, may help to reduce risk of dementia. It is true that a national newspaper may hardly be an academic source (see WP: Reliable sources),but if any one does know a good, academic source for this claim, it could go in the article. ACEOREVIVED (talk) 16:47, 15 December 2011 (UTC)

"Off label"

I have no idea what the heading "Off label" means. Can someone insert a definition? If not, I will suggest removing that sub-heading. 66.67.24.71 (talk) 17:28, 21 January 2012 (UTC)

It means use of drug for a purpose the FDA never formally approved it for (such approved uses are indicated on the drug "label" which practive means the package insert (it's too long to be a label stuck to a bottle), a list of which is tabulated in the Physicians' Desk Reference (PRD) which is either paper or electronic. Such uses, BTW, are not illegal. Once a drug is approved for some use, it can usually be legally prescribed for any other that the physician wants to, with no problems with the FDA (though the DEA and state licensing boards and civil courts still get their say if something goes wrong). A fair fraction of drugs are used by doctors in off label uses, since often the studies (difficult, risky, expensive) have never been done. Using adults drugs off-label in pediatrics is a common practice, for example. SBHarris 20:53, 21 January 2012 (UTC)

Good to see this change

It is good to see the change that said "Many mental disorders are actually a B-12 deficiency or malabsorption which nursing homes, mental facilities and clinics do not check. Please see your regular doctor to be tested for deficiency in B-12. B-12 deficiency can also cause mania and psychosis", i.e. to see that this has been removed from the article; this was clearly an inappropriate comment for an encyclopaedia such as Wikipedia. ACEOREVIVED (talk) 10:35, 18 July 2012 (UTC)

diphenhydamine

are there any studies that show this drug increases liklyhood od dimentia or alzheimers? — Preceding unsigned comment added by 96.35.15.96 (talk) 18:40, 9 August 2012 (UTC)

Brain biopsy

PMID 15901648 and PMID 20640903 are billed as reviews, but both look at the role of brain biopsy in the diagnosis of dementia. In our article, the introduction alludes to this test but it is not covered anywhere in the text. We should ideally spend a few lines on this, because brain biopsy is occasionally used in undifferentiated rapidly progressive dementia in young people. JFW | T@lk 21:29, 4 November 2012 (UTC)

How this article could be updated

It was announced on the news this morning that the government of the United Kingdom are aiming to improve the lives of people with dementia, by making certain people "dementia friends", trained in spotting the first signs of dementia. If one goes to this website:

http://news.bbc.co.uk/today/hi/today/newsid_9767000/9767741.stm

one will hear the health secretary in the United Kingdom, Jeremy Hunt, talking about this idea, and explaining how the idea is one borrowed from Japan. If any one knows about this concept of "dementia friends" and feels competent enough to add it to the article, to do so would help to make the article more up-to-date, and show that it is keeping up-to-date with recent coverage of the subject. ACEOREVIVED (talk) 11:28, 8 November 2012 (UTC)

This is very local and also very specific information, so I wonder if it really should be in the article. Lova Falk talk 12:03, 8 November 2012 (UTC)

Proposed revision: add specific section on cognitive losses

Cognitive Losses The cognitive losses and behavioral changes in dementia are the direct result of the destructive processes of the disease, which ultimately leads to the breakdown of communication between some nerve cells and the loss of increasing numbers of neurons. These cognitive losses define the hardships that those with dementia are forced to face in everyday life and are what may lead to a disability. Examples of cognitive losses in dementia include: impaired use of language and speech, [decreased] visual-spatial function, loss of ability to recognize familiar objects, loss of ability to carry out motor tasks, and executive dysfunction.

-Aphasia (Impaired use of language and speech)

The direct meaning of aphasia is a difficulty in both understanding speech and or/expressing oneself in words. . Those experiencing aphasia have a hard time following verbal directions and have difficulty in finding the right words to express how they feel. Many times, people with aphasia will know what they want to say, but can not get the right words to come out, leading to the usage of a wrong word or word that doesn’t make sense contextually. Aphasia also affects a person’s concentration, memory, and inhibits them from being able to cognitively do two things at once.

-Decreased Visual-Spatial Function

This may lead to problems with depth perception within the person. Additionally, someone experiencing decreased visual-spatial function may lose their sense of direction and end up getting lost.

-Agnosia (Loss of ability to recognize familiar objects) The cognitive loss of agnosia may interfere with a person’s daily life when they see an object, but cannot recognize what it is or what it is used for. . Those suffering from agnosia due to dementia may also become unable to recognize familiar sounds or people.

-Apraxia (Loss of ability to carry out motor tasks) This particular cognitive loss comes in three forms: manual apraxia (e.g., inability to button a button, zip a zipper, remove the lid of a jar); oral apraxia (e.g., inability to chew efficiently); and gait apraxia (e.g., difficulty coordinating walking movements) Apraxia also interferes with the brain’s ability to plan movement that occur in each form.

-Executive Dysfunction Simply put, this cognitive loss leaves a person with an impaired ability to perform a sequence of motor tasks (such as those involved in cooking a meal or brushing [their] teeth. . Many daily activities end up being beyond the capacity of the person suffering from executive dysfunction due to dementia.

Cplankenhorn (talk) 05:22, 29 November 2012 (UTC)

Replied at user talk. Biosthmors (talk) 23:33, 14 December 2012 (UTC)

Proposed revision to "signs and symptoms"

Dementia, as defined by the Merriam-Webster dictionary is, “a usually progressive condition (as Alzheimer's disease) marked by the development of multiple cognitive deficits (as memory impairment, aphasia, and inability to plan and initiate complex behavior).” Having dementia does not only mean that a person will have memory loss; it is not merely a problem of memory. Other symptoms such as changes in personality, and impaired intellectual functions can indicate that an individual has dementia. It reduces the ability to learn, reason, retain or recall past experience and there can be a loss of patterns of thoughts, feelings and activities (Gelder et al. 2005). Dementia presents itself with psychological and behavioral changes. You may notice declines in many different areas of living, such as communication, problem solving, and remembering. Signs may start with small difficulties in everyday tasks and frequency in those difficulties. These minor difficulties, say “Where did I park my car?,” may progress into “What are cars for?.” Behavioral changes include depression, anxiety, and circadian rhythm disturbance. Depression affects 20–30% of people who have dementia, and about 20% have anxiety. Specific warning signs of dementia include: repeating a question multiple times, being lost in a familiar place, and neglecting personal safety and hygiene. The progression of dementia may vary greatly. — Preceding unsigned comment added by Mart9212 (talk • contribs) 16:16, 29 November 2012 (UTC)

Replied at user talk. Biosthmors (talk) 23:33, 14 December 2012 (UTC)

proposed addition of new sections: Lewy-Body Dementia and Multi-Infarct Dementia

Lewy-Body Dementia Lewy-Body Dementia, closely associated with Parkinson’s disease, is the second common form of dementia. This form of dementia affects 23%of cases of people with dementia. Lewy-Body Dementia is a form of dementia in which lewy body protein clumps, damage neurons in the brain.

[Lewy-Body Dementia and Parkinson’s disease] are “both progressive neurodegenerative dementias associated with global cognitive deterioration and impairment of self-care and other activities of daily living” (Ballard, Kahn & Corbett, 2011). “According to these consensus criteria, the distinction between [Lewy-Body Dementia] and Parkinson’s disease dementia (PDD) is made using the time of onset of cognitive symptoms in relation to motor symptoms” (Andersson, Zetterberg, Minthon, Blennow & Londos, 2011). Symptoms of Lewy-Body Dementia include: “progressive dementia with pronounced attentional, visuospatial and executive dysfunction, visual hallucinations, cognitive fluctuations, parkinsonism and sleep disturbances such as excessive daytime sleepiness and rapid eye movement (REM)-sleep behavioural disorder” (Ballard, Kahn & Corbett, 2011). Lewy-Body Dementia and Alzheimer’s disease have similar psychological and cognitive symptoms but they are differentiated in that Lewy-Body dementia has distinct behavioral symptoms. Lewy-Body dementia behavior symptoms also include tremors, stopped posture, and attentional or organizational problems.

Multi-Infarct Dementia Multi-Infarct Dementia is the least common form of dementia affecting 15% of cases of people with dementia. Multi-Infarct Dementia is a type of vascular dementia (VaD). Multi-Infarct dementia is a form of dementia in which a series of small strokes damage neurons in the brain. These small strokes are caused by reduced blood flow and oxygenation of brain tissue, also known as ishemia. “Such ischaemic events results in deterioration of cognitive functioning, often associated with confusion, with subsequent partial recovery and then remaining stable until the next series of events” (Besson, Palin, Ebmeier & Eagles,1988).

“Supporting clinical features for diagnosis of VaD include early presence of gait disturbance, history of unsteadiness and frequent unprovoked falls, early urinary symptoms, personality and mood changes, depression, psychomotor retardation and abnormal executive function” (Erkinjuntti, 1999). These symptoms may be excessive but VaD can be preventable and improved with time. There are multiple risk factors that one may become informed about in order to prevent Multi-Infarct Dementia. Possible risk factors include “arterial hypertension, cardiac abnormalities, lipid abnormalities” (Erkinjuntti, 1999). — Preceding unsigned comment added by Welc0701 (talk • contribs) 16:44, 29 November 2012 (UTC)

Replied at user talk. Biosthmors (talk) 23:33, 14 December 2012 (UTC)

APA References Andersson, M. M., Zetterberg, H. H., Minthon, L. L., Blennow, K. K., & Londos, E. E. (2011). The cognitive profile and CSF biomarkers in dementia with Lewy bodies and Parkinson's disease dementia. International Journal Of Geriatric Psychiatry, 26(1), 100-105. doi:10.1002/gps.2496

Ballard, C., Khan, Z., Clack, H., & Corbett, A. (2011). Nonpharmacological treatment of Alzheimer disease. The Canadian Journal Of Psychiatry / La Revue Canadienne De Psychiatrie, 56(10), 589-595.

Ballard, C., Kahn, Z., & Corbett, A. (2011). Treatment of dementia with Lewy bodies and Parkinson's disease dementia. Drugs & Aging, 28(10), 769-777. doi:10.2165/11594110-000000000-00000

Besson, J. A., Palin, A. N., Ebmeier, K. P., & Eagles, J. M. (1988). Calcium antagonists and multi-infarct dementia: A trial involving sequential NMR and psychometric assessment. International Journal Of Geriatric Psychiatry, 3(2), 99-105. doi:10.1002/gps.930030206

Bilbul, M., & Schipper, H. M. (2011). Risk profiles of Alzheimer disease. The Canadian Journal Of Neurological Sciences/ Le Journal Canadien Des Sciences Neurologiques, 38(4), 580-592.

Erkinjuntti, T. (1999). Cerebrovascular dementia: Pathophysiology, diagnosis and treatment. CNS Drugs, 12(1), 35-48. doi:10.2165/00023210-199912010-00004

Kavanagh, S. S., Gaudig, M. M., Van Baelen, B. B., Adami, M. M., Delgado, A. A., Guzman, C. C., & ... Schäuble, B. B. (2011). Galantamine and behavior in Alzheimer disease: Analysis of four trials. Acta Neurologica Scandinavica, 124(5), 302-308. doi:10.1111/j.1600-0404.2011.01525.x

Zec, R. F., & Burkett, N. R. (2008). Non-pharmacological and pharmacological treatment of the cognitive and behavioral symptoms of Alzheimer disease. Neurorehabilitation, 23(5), 425-438.

Replied at user talk. Biosthmors (talk) 23:33, 14 December 2012 (UTC)

proposed revision to prevention of dementia

Even when individuals reach an older age, they are still able to protect themselves from developing dementia. Dementia is relatively prominent, with 50% of people over 85 having the condition. It is still present at younger ages, with 2% of people younger than 60 having it. A study published on July 17, 2012 revealed four treatment guidelines that reduced the chance of developing dementia by ten percent. These include quitting smoking, maintaining healthy cholesterol and blood pressure levels (further research is needed to find this conclusive), maintaining good nutrition and engaging in regular exercise. Sleep also improves memory, so steps should be taken to ensure that an individual is getting enough. Nighttime breathing abnormalities including sleep apnea greatly increase your risk for developing dementia, as much as 50 percent. A study was performed in which the nighttime breathing measurements of 1300 women over the age of 75 were taken for a period of 5 years. Patients who experienced sleep apnea as well as other sleep-disordered breathing were compared to patients who experienced none of these conditions. Over the five year period, it was found that patients who experienced disordered breathing were twice as likely to develop both dementia and mild cognitive impairment. There are multiple steps that can be taken to help lower your risk for cognitive harm due to sleep disordered breathing; quit smoking, avoid alcohol and sedating drugs as these can relax throat muscles, use saline nasal spray to keep nasal passages clear, control weight and blood pressure, know the symptoms of sleep apnea (loud snoring, abrupt awakenings, frequent morning headache, dry mouth or sore throat), and seek medical attention if you have any of these symptoms.

Apa Reference list

Memory maximizers: here's the latest research to help you keep your brain sharp. (2012). Mind, Mood & Memory, 8(10), 5. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA305759108&v=2.1&u=sunyfredonia&it=r&p=PPPC&sw=w

Mohajeri, M., & Leuba, G. (2009). Prevention of age-associated dementia. Brain Research Bulletin, 80(4-5), 315-325. doi:10.1016/j.brainresbull.2009.06.014 — Preceding unsigned comment added by Emilylinlin (talk • contribs) 17:09, 29 November 2012 (UTC)

Replied at user talk. Biosthmors (talk) 23:33, 14 December 2012 (UTC)

Proposed revision: Comorbidity

Comorbidity

Comorbidity with dementia is not an uncommon phenomenon. In fact, Comorbidity seems to increase with dementia severity (Solomon, Dobranici, Kåreholt, Tudose & Lăzărescu, 2011) and unfortunately, is known to influence mortality and functional dependence in older aged people with dementia (Solomon et al., 2011). In general, comorbid behaviors and other illnesses can be put into three categories. Hyperactivity, including aggression, psychomotor agitation, irritability and lack of social inhibition. Psychotic symptoms, including hallucinations, and delusions. Or affective symptoms, including depression, anxiety and apathy (Hval, Kristiansen, Lorentzen, Fagerstrøm & Tanum, 2012). Some physical comorbidity may occur with dementia which is usually treatable if not reversible. Epilepsy, falls, malnutrition, sleep disorders and visual dysfunctions are seen at an increasing rate in patients with dementia. In most cases, patients of dementia tend to have comorbid psychological disorders such as depression and anxiety disorders. However, one in three dementia patients present signs of depression (Prado-Jean, Couratier, Druet-Cabanac, Nubukpo, Bernard-Bourzeix, Thomas & Clément, 2010) rather than anxiety.These disorders cause a great deal of stress among the person themselves because they reduce the person’s ability to live on their own, and are probably associated with an increase of cognitive decline (Ballard & Oyebode, 1995). While depression and anxiety are two disorders that are the most prevalent, other disorders such as bipolar disorder, schizophrenia and psychosis have also been found to be comorbid with dementia. Prevalence of psychological symptoms in patients with dementia range between 11.7% to 70.6% (Ballard & Oyebode, 1995). There is some medical comorbidity which may increase the risk of dementia, along with genetics.

Comorbidity of other diseases with dementia tends to lead to many complications in treatment. In 2000, 14.5% of 35 million Americans represented people aged 65 years and older. Of this 14.5%, 65% were suffering from two or more chronic illnesses along with dementia (Schubert, Boustani, Callahan, Perkins, Carney, Fox, & Hendrie, 2006) Other chronic illnesses include: hypertension, diabetes mellitus, osteoarthritis, and coronary artery disease (Schubert et al., 2006). Having two or more of these chronic illnesses can become problematic when comorbid with dementia because it’s pharmacological treatment. Common complaints in older aged people such as urinary incontinence, dizziness, and pain may result in them having to take a particular medicine. “Some medications used to treat these symptoms, such as meclizine, amitriptyline, and oxybutynin have anticholinergic activity” (Schubert et al., 2006). If a cholinesterase inhibitor is being used to treat dementia in a patient who is also taking a drug with anticholinergic activity, pharmacological antagonism can result (Schubert et al., 2006). In other words, the medications used to treat dementia and the medications used to treat common complaints will cancel each other and both will become ineffective in their specific uses.

While most cases of dementia may be comorbid with disorders or other illnesses, dementia is also comorbid with specific behaviors. One behavior specifically, is aggressiveness. Agitation and aggressive behavior are distressing experiences for those with dementia (Hval et al., 2012). Occurring in 30 to 50% of dementia patients, aggressiveness can consequently result in antipsychotic medications, use of physical restraints, institutionalization and other greater healthcare costs (Cipriani, Vedovello, Nuti, & Di Fiorino, 2011).

References:

Ballard, C., & Oyebode, F. (1995). Psychotic symptoms in patients with dementia. International Journal Of Geriatric Psychiatry, 10(9), 743-752. doi:10.1002/gps.930100904

Cipriani, G., Vedovello, M., Nuti, A., & Di Fiorino, M. (2011). Aggressive behavior in patients with dementia: Correlates and management. Geriatrics & Gerontology International, 11(4), 408-413. doi:10.1111/j.1447-0594.2011.00730.x

Hval, S., Kristiansen, K., Lorentzen, B., Fagerstrøm, L., & Tanum, L. (2012). Treatment in nursing home versus hospital for patients with behavioral and psychological symptoms of dementia: A pilot study. Geropsych: The Journal Of Gerontopsychology And Geriatric Psychiatry, 25(2), 97-102. doi:10.1024/1662-9647/a000058

Prado-Jean, A., Couratier, P., Druet-Cabanac, M., Nubukpo, P., Bernard-Bourzeix, L., Thomas, P., & ... Clément, J. (2010). Specific psychological and behavioral symptoms of depression in patients with dementia. International Journal Of Geriatric Psychiatry, 25(10), 1065-1072. doi:10.1002/gps.2468

Schubert, C. C., Boustani, M., Callahan, C. M., Perkins, A. J., Carney, C. P., Fox, C., & ... Hendrie, H. C. (2006). Comorbidity Profile of Dementia Patients in Primary Care: Are They Sicker?. Journal Of The American Geriatrics Society, 54(1), 104-109. doi:10.1111/j.1532-5415.2005.00543.x

Solomon, A., Dobranici, L., Kåreholt, I., Tudose, C., & Lăzărescu, M. (2011). Comorbidity and the rate of cognitive decline in patients with Alzheimer dementia. International Journal Of Geriatric Psychiatry, 26(12), 1244-1251. doi:10.1002/gps.2670 — Preceding unsigned comment added by Welc0701 (talk • contribs) 20:59, 16 December 2012 (UTC)

Proposed revision: Epidemiology and etiology

Epidemiology and Etiology

There are an estimated 24.3 million people around the world have dementia and with an estimated 4.6 million new cases every year, we can expect about 43 million people and their families to face the challenge of dementia by 2020 (McNamara, 2011). Alzheimer’s disease, which is a form of dementia, accounts for 40 % of all cases of dementia. Another form of dementia, vascular dementia, accounts for 25% of all cases, and dementia with Lewy bodies, (which also accounts for 25 % of all cases) is related to the increasingly important form of dementia associated with Parkinson's disease (McNamara, 2011). In terms of the severity of dementias experienced by those who live in America, an estimated 2 million people in the United States suffer from severe dementia and another 1 to 5 million people experience mild to moderate dementia (Swierzewski, 2000). The prevalence of dementia has increased over the past few decades, either because of greater awareness and more accurate diagnosis, or because increased longevity has created a larger population of elderly people, the age group most commonly affected (Swierzewski, 2000). According to a study performed by Plassman, et al. (2007), the national prevalence of Alzheimer’s disease, vascular dementia and all dementia increased with age, reaching a prevalence rate of 37.4% among individuals aged 90 and older. This phenomenon of increased longevity leaves those who survive into elder hood with the likely chance that they will experience some form of dementia and at the present time, Alzheimer’s disease is the 6th leading cause of death among adults aged 18 years and older (Xu, Kochanek, Murphy, et al., 2007). Some studies suggest that female sex is associated with increased risk of dementia. Up to the year 2000, the number of people with dementia was estimated at about 25 million people worldwide (approximately 0.5% of the whole worldwide population), of which 59% of cases were female (Hofman et al. 1991). The effect of gender on incidence of gender remains a controversial subject, however.

In terms of geographic prevalence, in the USA, vascular dementia is significantly more prevalent in individuals of African American and Hispanic origin versus Caucasian Americans (Miles et al. 2001). Worldwide, a 100% increase is predicted in developed countries from 2001 to 2040, while more rapid changes in life expectancy in developing countries is estimated to result in a more noticeable effect, with the number of people with dementia in China and India likely to rise over 300% over this time period. In Latin America and Africa, depending on region, the prevalence of dementia is estimated to either double or triple (Ferri et al., 2005). Some parts of the world have experienced a ‘Westernization’ trend of Alzheimer’s disease being more prevalent in their areas than other forms of dementia. In Japan, prior to 1990 vascular dementia was found to be more common than Alzheimer’s disease, although more recent data shows that Alzheimer’s disease is now nearly twice as prevalent as vascular dementia. Many of these trend changes have also been linked to urbanization, industrialization and lifestyle changes (e.g. alcohol use) (Ferri, et al., 2005).

References:

Ferri, C.P., Prince, M., Brayne, C., Brodaty, H., Fratiglioni, L. et al. (2005) Global prevalence of dementia: a delphi consensus study. Lancet, 366: 2112–17.

Hofman, A., Rocca, W.A., Brayne, C., Breteler, M.M.B., Clarke, M. et al. (1991) The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. International journal of epidemiology, 20, 736–48.

McNamara, P. (2011). Dementia, volumes 1–3: History and incidence, science and biology, treatments and developments. Santa Barbara, CA: Praeger/ABC-CLIO.

Miles, T.P., Froehlich, T.E., Bogardus, S.T. and Inouye, S.K. (2001) Dementia and race: Are there differences between african americans and caucasians? Journal of the american geriatrics society, 49, 477–84.

Plassman, B. L., et al. (2007). Prevalence of dementia in the united states: The aging, demographics, and memory study. Neuro-epidemiology, 29(1-2), 125-132. doi: 10.1159/000109998

Swierzewski, III, S. J. (2000, January ). Dementia. Retrieved December 8th, 2012 from http://www.healthcommunities.com/dementia/dementia-overview-types.shtml

Xu J.Q., Kochanek K.D., Murphy S.L., et al. (2009). Deaths: Preliminary data for 2007. Nat’l Vital Stat Rep. 2009; 58(1). Hyattsville, MD: National Center for Health Statistics. — Preceding unsigned comment added by Welc0701 (talk • contribs) 21:04, 16 December 2012 (UTC)

Proposed revision: signs and symptoms

Dementia, as defined by the Merriam-Webster dictionary is, “a usually progressive condition (as Alzheimer's disease) marked by the development of multiple cognitive deficits (as memory impairment, aphasia, and inability to plan and initiate complex behavior).” There are many causes of dementia, but they can be split into two categories: irreversible and reversible. Dementia is irreversible when there are damaged brain cells in both the cortical and subcortical areas. Treatment of irreversible dementia focuses on slowing down the progression of the disease. According to emedicinehealth, causes of irreversible dementia include: Alzheimer’s disease, vascular dementia, Parkinson disease, Lewy Body dementia, Huntington disease and Pick disease (frontotemporal dementia). Alzheimer’s disease is the most common form of dementia, accounting for almost half of cases (emedicinehealth). Even though it is most common, most cases of death are reported from other causes such as infections and diseases. Causes of reversible dementia include: head injuries, infections, brain tumors, toxic exposure, hormone disorders and poor oxygenation. When it comes to these cases of dementia, usually the dementia can be at least partially reversed, even if the underlying cause may not be. Cortical dementia and subcortical dementia are the two categories of dementia. In cortical dementia, the cerebral cortex is affected. This section of the brain covers the cerebellum and is split into a left and right hemisphere. This section is responsible for thinking, perceiving, and understanding/producing language. In subcortical dementia, a portion of the brain beneath the cortex is affected. This kind does not typically result in memory or language loss. Subcortical dementia can affect personality changes and processing speed. This type of dementia generally occurs with diseases like Huntington’s disease or Parkinson’s. It is possible to have both cortical and subcortical dementia. Signs of dementia vary greatly and are different across the various types of dementia. The earlier it is detected, the better the chance that it can be treated and either stopped or slowed. Having dementia does not only mean that a person will have memory loss; it is not merely a problem of memory. It reduces the ability to learn, reason, retain or recall past experience and there can be a loss of patterns of thoughts, feelings and activities (Gelder et al. 2005). Dementia presents itself with psychological and behavioral changes. Other symptoms such as changes in personality, and impaired intellectual functions can indicate that an individual has dementia. You may notice declines in many different areas of living, such as communication, problem solving, and remembering. Signs may start with small difficulties in everyday tasks and frequency in those difficulties. These minor difficulties, say “Where did I park my car?,” may progress into “What are cars for?.” Behavioral changes include depression, anxiety, and circadian rhythm disturbance. Depression affects 20–30% of people who have dementia, and about 20% have anxiety. Specific warning signs of dementia include: repeating a question multiple times, being lost in a familiar place, and neglecting personal safety and hygiene. According to the Alzheimer’s Association, there are ten distinct warning signs to look for. These are: memory loss that disrupts daily life, challenges in solving problems, difficulty completing familiar tasks, confusion with time or place, trouble with visual images and spatial relationships, problems with words in speaking or writing, misplacing things, decreased or poor judgment, withdrawal from social activities, and changes in mood or personality (alz.org). The progression of dementia may vary greatly. An excerpt from the book Dementia: Guidelines for Diagnosis and Treatment portrays a woman’s pains from her experience with dementia. “I shouldn’t be here. I am just waiting until I die… I think I am getting better and all the time I am getting worse…I’ve lost everything.” (Washington, D.C. : Dept. of Veterans Affairs).

References:

"Dementia." Home. N.p., n.d. Web. 11 Dec. 2012.

"Dementia Symptoms: Signs of Different Types of Dementia." WebMD. WebMD, n.d. Web. 11 Dec. 2012.

Department of Veterans Affairs. "Dementia : Guidelines for Diagnosis and Treatment." Washington, D.C. : Dept. of Veterans Affairs, 1989 2 (1989): n. pag. Web. 11 Dec. 2012.

"Memory Loss & 10 Early Signs of Alzheimer's | Alzheimer's Association." Memory Loss & 10 Early Signs of Alzheimer's | Alzheimer's Association. N.p., n.d. Web. 11 Dec. 2012.

Nordqvist, Christian. "What Is Dementia? What Causes Dementia? Symptoms of Dementia." Medical News Today. MediLexicon International, 13 Mar. 2009. Web. 11 Dec. 2012.

"Physical Comorbidities of Dementia." Cambridge University Press. N.p., n.d. Web. 11 Dec. 2012.

"Read What Your Physician Is Reading on Medscape." EMedicineHealth. N.p., n.d. Web. 11 Dec. 2012.

"Symptoms." Dementia Warning Signs and Symptoms. N.p., n.d. Web. 11 Dec. 2012.

"Understanding Dementia." : Signs, Symptoms, Types, Causes, and Treatment. N.p., n.d. Web. 11 Dec. 2012.

Keith A. Swanson, PharmD, CGP, and Ryan M. Carnahan, PharmD, MS, BCPP. "Dementia and Comorbidities: An Overview of Diagnosis and Management." Pharmacy Practice (n.d.): n. pag. Sage. Web. 11 Dec. 2012. — Preceding unsigned comment added by Welc0701 (talk • contribs) 21:08, 16 December 2012 (UTC)

Proposed revision: prevention

Prevention

An individual can do several things to help prevent the development of dementia later in life. The development of dementia is on the rise. The prevalence is thought to reach epidemic proportions within the near future. (International Journal of Alzheimer’s Disease) Currently about 50% of the population over the age of 85 suffers from dementia. It is also present within the younger population, as about 2% of people under the age of 60 are afflicted. (Mohajeri and Leuba, 2009) It is crucial to take a number of steps to help prevent dementia as well as other cognitive impairments later in life. There are multiple factors that can contribute to your risk of developing both dementia and Alzheimer’s Disease. These include age, genetics, environment and lifestyle. There is also an increased risk if an individual has had a stroke, heart attack, or any other ailment that may have damaged blood vessels. (alz.org) There is no sure way to prevent dementia but there are several steps that can be taken to help lower your risk. One step that can be taken is to engage in mental exercise. Partaking in mentally stimulating activities is proven to help lower your risk. Activities include doing puzzles or word games, playing an instrument, or learning a language. Keeping the mind active can also help even if the onset of dementia has already occurred. Remaining socially active is also a step that one can take for the prevention of cognitive decline. Various social activities include traveling, attending theatre and art events, and games involving other individuals. (Mayo Clinic)

Physical activity is widely proven to help with the prevention of dementia and cognitive decline. Several studies have shown that physical activity can help for many reasons. A recent study by Colcombe and Kramer showed that a higher level of physical activity helped to reduce the loss of hippocampal brain tissue, thus delaying the onset of dementia. Another study by Larson and colleagues involved a population of 1740 individuals over the age of 65. The participation in physical activity of these individuals helped to pause the onset of dementia for 6 years. (International Journal of Alzheimer’s Disease)

A healthy diet is a step to be taken which can help prevent many ailments that can eventually lead to dementia. Cholesterol is a risk factor in the development of dementia. It can be caused by the deposits in the brain of someone with high cholesterol, and this can eventually lead to dementia. (Mayo Clinic) Diabetes is also a risk factor. Persons with diabetes have twice the risk of developing dementia and cognitive impairment. Diabetic patients can have a high blood viscosity, which can cause a low blood flow, and contribute to stroke, which is a possible cause of dementia. (Sorrentino, Migliaccio, Bonavita) The ideal diet for contribution to the prevention of dementia is one that includes fruits and vegetables, fish, little red meat, and is rich in healthy fats such as olive oil. (alz.org) A study was performed in which the findings were that a diet with high vegetable consumption could significantly help in slowing the onset of dementia and cognitive decline over six years. This was based on 3700 participants of the Chicago Health and Age Project. (International Journal of Alzheimer’s Disease)

A major proven cause of dementia is sleep apnea. An individual with sleep apnea has a double chance of developing dementia next to a person who doesn’t have the disorder. A study was performed involving over 1300 women over the age of 75 over the age of 5 years. They were tested to see if there was a correlation between sleep disordered breathing and cognitive impairment. The findings were that participants that had the sleep disordered breathing were twice as likely to develop dementia or cognitive impairment. Steps can be taken to prevent sleep apnea. These include quitting smoking, avoiding alcohol and drugs that can relax throat muscles, and controlling weight and blood pressure. It is also important to know the signs of sleep apnea, including loud snoring, abrupt awakenings, morning headaches, dry mouth, and sore throat. It is crucial that an individual seek medical attention if they believe they may suffer from sleep apnea, as to prevent problems in the future such as dementia and other cognitive impairment. (Mind, Mood, Memory)

References:

Alzheimer's and dementia prevention and risk. (2011). Retrieved from alz.org

Maria Cristina Polidori, Gereon Nelles, and Ludger Pientka, “Prevention of Dementia: Focus on Lifestyle,” International Journal of Alzheimer's Disease, vol. 2010, Article ID 393579, 9 pages, 2010. doi:10.4061/2010/393579

Mayo Clinic Staff. (2011). Dementia: Prevention. DOI: www.mayoclinic.com

Memory maximizers: here's the latest research to help you keep your brain sharp. (2012). Mind, Mood & Memory, 8(10), 5. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA305759108&v=2.1&u=sunyfredonia&it=r&p=PPPC&sw=w

Mohajeri, M., & Leuba, G. (2009). Prevention of age-associated dementia. Brain Research Bulletin, 80(4-5), 315-325. doi:10.1016/j.brainresbull.2009.06.014

Sorrentino, G. G., Migliaccio, R. R., & Bonavita, V. V. (2008). Treatment of vascular dementia: The route of prevention. European Neurology, 60(5), 217-223. doi:10.1159/000151696

I'm sorry, but none of the above is usable. Epidemiological studies show associations, not causations. If people who feel lonely are more likely to later develop dementia, this is NOT any kind of evidence that feeling lonely CAUSES dementia (and that you can prevent dementia by finding a friend). And the same of true of snoring. The only kind of evidence acceptable for prevention of dementia is that from a study where people have been randomized to the treatment or not, with a control, so we can get rid of confounding variables, which otherwise are completely impossible to get rid of. SBHarris 04:15, 19 December 2012 (UTC)

Village in Amsterdam

This does article does not mention the village in Amsterdam that is a special place for people with dementia. If it did, it would bring the article nicely up-to-date. ACEOREVIVED (talk) 14:34, 18 December 2012 (UTC)

These are some websites that give citations about it:

http://www.dailymail.co.uk/news/article-2109801/Dementiaville-How-experimental-new-town-taking-elderly-happier-healthier- pasts-astonishing-results.html

http://www.jrf.org.uk/node/58520

http://topsy.com/www.guardian.co.uk/society/2012/aug/27/dementia-village-residents-have-fun?allow_lang=fr

This will give some citations, but my Google searches did not find any articles in academic journals - these appear to be from national newspaper websites. If any one does know any academic sources on this village in Amsterdam, s/he could add them to the article. ACEOREVIVED (talk) 14:47, 18 December 2012 (UTC)

If you want to write something about this little village for the rich and demented, you should also write about the miserable institutions in which many, many more demented spend their last years. Lova Falk talk 09:36, 26 December 2012 (UTC)

Regarding the last, there's already a long article at Congress of the United States. SBHarris 01:18, 1 May 2013 (UTC)

GPS system to track people with dementia

It was on the news on April 30 2013 that Sussex police force have started a GPS tag to track people with dementia if they go missing - does any one think that this news should go here? It will be headlines of the the Telegraph. ACEOREVIVED (talk) 22:52, 30 April 2013 (UTC)

As you can see from this website:

http://www.telegraph.co.uk/

"GPS tags for dementia patients" is the headlines on the Daily Telegraph on May 1, 2013. ACEOREVIVED (talk) 22:55, 30 April 2013 (UTC)

• ACEOREVIVED, what you suggest above sounds like something I would like to see on Wikipedia. However it seems this article is strictly for the medical aspects. Have you looked at Category:Dementia to see if there is an existing article this can fit into? Ottawahitech (talk) 15:13, 2 May 2013 (UTC)

Links

>> Dementia: A global disaster in waiting? (Lihaas (talk) 16:42, 12 December 2013 (UTC)).

Pain control

... is suboptimal in people with dementia and needs more focus. Br Med Bull doi:10.1093/bmb/ldu023 JFW | T@lk 15:59, 4 September 2014 (UTC)

Issues

None of these references mentions dementia "However, the head of the National Institute of Mental Health, Thomas Insel, has stated that the DSM-5 lacks scientific validity and has since directed all NIMH research away from it." Thus IMO this is inappropriate here. Doc James (talk · contribs · email) 05:31, 7 March 2015 (UTC)

is WP:UNDUE in the lead, i agree. Jytdog (talk) 16:51, 7 March 2015 (UTC)

This is WP:Undue weight. IP, look at what WP:Due weight states about the different forms of WP:Undue weight. Criticism of the DSM-5 is made clear in its Wikipedia article. Flyer22 (talk) 22:31, 7 March 2015 (UTC)

Regarding DSM-5 and the way it is being presented

Here is the problem: Psychiatry is in fact not the field of medicine that specializes in research or treatment of dementia. Yet the DSM-5 is being introduced to the reader in the context of “what is dementia?”. I think that most reasonable and unbiased people would agree that only those qualified and specializing in a disease should be considered credible when educating people as to what it is. In this case, that would be neurology. I think most people would agree that this makes the reader inclined to think that psychiatry does indeed specialize in dementia, which makes the mention of the DSM-5 seem much more like it was planted there by someone with a pro-psychiatry bias, but is inappropriate in that context because its implication is both misleading and inaccurate. I would have no objection to the DSM-5 being introduced in another section of the article concerning behavioral health and comorbid disorders. However, it will not be my job to do because I have already made my contribution, and it was both sourced and reasonable. Considering that my contribution is in fact sourced and relevant in context, it should not be removed until the issues I’ve raised are resolved. My contribution may be a bit boorish, but it indeed balances the bias and is good enough until someone else finds a better way to do it. And this is the whole spirit of wikipedia, mind you. To revise and grow, not to bicker and destroy. If you can not find a way to improve my contribution, add to it or otherwise nullify its purpose, then please just leave it alone. — Preceding unsigned comment added by 24.236.138.19 (talk) 21:28, 7 March 2015 (UTC)

Replies about this are above, and I made your section a subsection of that. Flyer22 (talk) 22:34, 7 March 2015 (UTC)

Your behavior is not just "boorish" it is blockable. Edit warring is not OK here. Jytdog (talk) 22:57, 7 March 2015 (UTC)

Lancet series

This week three articles on the various dementias. JFW | T@lk 09:10, 26 October 2015 (UTC)

Causes

I took "An article in Scientific American magazine suggests that general anesthesia can cause dementia in susceptible people.Jacobson, Roni. "Can General Anesthesia Trigger Dementia?". Scientific American. Retrieved 23 October 2014." out of the wp:lead, as it's not in the body. Perhaps there's enough reason to insert this in the article, with better sourcing, but after a quick scan, I'm not sure which subsection of the Causes section it would go in. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 20:31, 15 September 2015 (UTC)

This was than added "There is a link between surgery, general anesthesia, and dementia, particularly Alzheimer’s disease. "

Now if we read the ref in question it says "A meta-analysis of case-control studies found no association between prior exposure to surgery utilizing GA and incident AD (pooled odds ratio =1.05, P=0.43)."

User:InformedConsent why is that? Doc James (talk · contribs · email) 20:41, 19 September 2015 (UTC)

I am about to again revert the edit by InformedConsent (talk · contribs); let me explain why. As Doc James pointed out in his edit summary, the sources used are primary sources in the sense explained at WP:MEDRS. High quality secondary sources are available, namely PMID 25284995 and PMID 22771690, but they come to a different conclusion: that no clear link between general anesthesia and AD has yet been demonstrated. Looie496 (talk) 15:37, 31 October 2015 (UTC)

Sourcing and inline citations

I very much enjoyed this article because it took the time to make sure I understood what was being said. So many medical-related articles that appear here are written by medical professionals who evidently believe their audience is their peers. Most of the time this material is so full of jargon that it reads like a medical textbook or a journal article that is way beyond the average Wikipedia reader.

However, there is a real problem here with sourcing and inline citations. The sections between "1.1 Mild cognitive impairment" and "1.4 Late stages" have only one source (#4) which is at the end of the each paragraph, instead of being placed as inline citations with page numbers throughout these sections to support the material.

This same problem exists with "2 Causes." There are two or three other sources here but the primary one is #4, and, here again, there are virtually no inline citations. #4 is also the only source for sections "2.4 Dementia with Lewy bodies," "2.5 Frontotemporal dementia," and "2.7 Corticobasal degeneration."

These sections have no citations at all: "2.6 Progressive supranuclear palsy, "2.8 Rapidly progressive," and "2.9 Other conditions."

There are lots of citations after that until we get to my favorite, "7 History," a very long section that doesn't have any sources either. "8 Society and culture" has four citations to four sources (109, 110, 111 and 112) which isn't nearly enough given the type of material being discussed here.

Thank you very much. Rissa, Guild of Copy Editors (talk) 07:23, 8 November 2015 (UTC)

Moved tags to the appropriate sections. Doc James (talk · contribs · email) 04:50, 10 November 2015 (UTC)

Possible Rewording of "Eating Difficulties" Section?

In the first part, it mentions that feeding tubes are associated with a few things (need for chemical/physical restraints, possibility of pressure ulcers, etc.), and then just two or so sentences later, it says possible risks are (and then restates everything that it said above). To me, this seems redundant and seems that it should be reworded. I can't really think of a better way to word it, but if anyone else agrees with me, please try and find a way to make this section better. Thanks! 108.34.228.32 (talk) 08:30, 21 November 2015 (UTC)

Need Help Identifying Whether There is a Typo

In the section on "Progressive supranuclear palsy", in the sentence 'The person may also have certain "frontal lobe signs" such as perseveration, a grasp reflex and utilization behavior (the need to use an object once you see it)', I'm not sure if there is supposed to be a comma after 'grasp reflex' and before 'and utilization behavior'. I have been noticing a large amount of missing commas (e.g., "one, two and three" as opposed to "one, two, and three"), but for this particular instance, I'm not sure if 'grasp reflex' and 'utilization behavior' go together. I don't think they do, and I think the comma is supposed to be there, but I don't want to add it in case I'm wrong, because I don't know enough about either one of those topics to be sure whether or not they go together. This is why that extra comma is important, and this is why not including it can be misleading, and this is why I have been adding it everywhere I see it missing when it is grammatically necessary. Anyone have any insight? Thanks! 108.34.228.32 (talk) 07:50, 21 November 2015 (UTC)

This is actually a style issue, as explained in our article on the Oxford comma. The relevant Wikipedia policy is explained at MOS:OXFORD. The bottom line is that each article can choose whether it wants to use "serial commas", but within any given article we should try to be consistent. Changing the style of an article should be avoided unless clear consensus is gained beforehand. Looie496 (talk) 12:43, 21 November 2015 (UTC)

"A person's consciousness is not affected."

Dementia can profoundly disturb and alter consciousness. How on earth is this sentence in the introduction of the article.131.191.57.0 (talk)

Dementia and delerium are different. Per WHO "It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. " [3] Doc James (talk ·

contribs · email) 23:43, 10 January 2016 (UTC)

---

I can read that quote but it's simply not true. The article associates all these symptoms with dementia, and most of them would not occur without changes to consciousness: "Agitation, Depression, Anxiety, Abnormal motor behavior, Elated mood, Irritability, Apathy, Disinhibition and impulsivity, Delusions (often believing people are stealing from them) or hallucinations"

Lewy-body dementia, in particular, is associated with profound changes in consciousness: "Disturbances of consciousness, including fluctuations in attention and awareness, are a common and clinically important symptom in dementia with Lewy bodies (DLB)." (http://www.ncbi.nlm.nih.gov/pubmed/12435378) 131.191.57.0 (talk)

Yes okay while most types of dementia and most causes of dementia consciousness is not affected in some types it is [4] Doc James (talk · contribs · email) 01:44, 11 January 2016 (UTC)

Proton pump inhibitors

I have just reverted a set of edits by an IP editor which assert a connection between PPIs and dementia. However all the cited sources are primary research articles as defined in WP:MEDRS. This material only belongs in the article if it can be supported by good secondary sources, i.e., high-quality review articles. Looie496 (talk) 19:12, 18 February 2016 (UTC)

Have rates of dementia been overestimated?

Any one who has Radio Four news this week will know that there are now claims that there are actually fewer people in the United Kingdom with dementia than would have been predicted many years ago. Should this go in the article to keep the article up-to-date?Vorbee (talk) 20:33, 20 April 2016 (UTC)

Epidemiology

Ref says "The prevalence of dementia rises from 3% at ages 65 to 74 years, to 18.7% at ages 75 to 85 years..."[5]

This appears to be current rates [6] not future predictions. Doc James (talk · contribs · email) 14:11, 14 July 2016 (UTC)

Disorientation

With regards to disorientation I'm taking the week part out of time - it's disorientation to not know the day of the week, maybe day of the month, but how many people can tell you which week of the year it is? — Preceding unsigned comment added by 203.49.218.60 (talk • contribs)

Suggestions for more content

What about Wernicke's encephalopathy, and Korsakoff's syndrome?

And I happen to be looking for a full list of the aetiology of dementia. Would be very grateful for any pointers/links to such a list.

Thanks

— Preceding unsigned comment added by 62.253.53.227 (talk • contribs) 18:38, 14 June 2006 (UTC)

Drop in feeding tube usage

@Doc James: (and any other MEDRS editors) I have added the content below. Wanted to ping you on your patrol so you could help me in case it is not kosher. Interesting article in NYT today.

http://www.nytimes.com/2016/08/30/health/tube-feeding-dementia-patients.html?_r=0

I also added the JAMA cite

http://jama.jamanetwork.com/article.aspx?articleid=2544627

"The percentage of terminal patients using feeding tubes in the USA has dropped from 12% in 2000 to 6% as of 2014."

Thank you!

References

-- Jtbobwaysf (talk) 15:36, 31 August 2016 (UTC)

Looks good. Doc James (talk · contribs · email) 00:57, 1 September 2016 (UTC)

Exercise and Dementia

Hello. I am new to wikipedia editing, and thought I would try to update a few references in order to learn more about editing. I noticed that ref 14 (Cochrane review on exercise programs for dementia from 2013) has been updated by a 2015 Cochrane version. While reading through the review, I am wondering if the wording in the wikipedia Introduction and Management section should be changed. It is presently "Exercise programs are beneficial with respect to activities of daily living and potentially improve outcomes.[14]". The management section of the wikipedia article also includes "Exercise programs are beneficial with respect to activities of daily living and potentially improve dementia.[14]" The authors conclusions in the 2015 review states that, "There is promising evidence that exercise programs may improve the ability to perform ADLs in people with dementia, although some caution is advised in interpreting these findings. The review revealed no evidence of benefit from exercise on cognition, neuropsychiatric symptoms, or depression. There was little or no evidence regarding the remaining outcomes of interest (i.e., mortality, caregiver burden, caregiver quality of life, caregiver mortality, and use of healthcare services)."

Should the line in the intro be changed to:

"Exercise programs may be beneficial with respect to activities of daily living." ?

What do you think about the wiki article sections that say "may improve dementia" and "potentially improve dementia", given the Cochrane review findings? Please let me know what you think. As I mentioned, I am a new editor and would love some feedback and suggestions so I can learn how to contribute. Thanks very much!

References

--JenOttawa (talk) 17:08, 4 November 2016 (UTC)

that change seems great. thanks! Jytdog (talk) 19:50, 4 November 2016 (UTC)

Agree looks good Doc James (talk · contribs · email) 17:39, 5 November 2016 (UTC)

Thanks for the feedback. I made the change. JenOttawa (talk) 19:09, 5 November 2016 (UTC)

Cerebral Health Website

As director of a website, I would like to offer an appeal to the editors of this page to include a link to either the homepage at cerebralhealth (dot) com — Preceding unsigned comment added by Psiguy (talk • contribs) 15:44, 29 December 2006 (UTC)

Why is this not signed? Anyone object if I delete this link, looks like SEO to me. Jtbobwaysf (talk) 16:02, 31 August 2016 (UTC)

I have replaced the above link (unsigned by an editor) to reduce SEO. This looks like drive by SEO tagging, and there is no attempt to create any sort of conversation, just an editor asking other editors to add his website link (which won't happen) or maybe use his primary source content (which also wont happen). Feel free to ping me if what I have done is not kosher.Jtbobwaysf (talk) 05:52, 1 September 2016 (UTC)

Jtbobwaysf I signed this old comment. It was a long time ago when there was less understanding of Wikipedia. Blue Rasberry (talk) 23:58, 7 November 2016 (UTC)

Withdrawing Antihypertensive Drugs and Cognition

I am thinking of adding this new Cochrane Review to the article, under the "Management- Medications" section. http://www.cochrane.org/CD011971/DEMENTIA_antihypertensive-withdrawal-prevention-cognitive-decline

There is presently no references that I can see re hypertensive meds and cognition in this wikipedia article. Authors conclusions, quoted from the review: "The effects of withdrawing antihypertensive medications on cognition or prevention of dementia are uncertain. There was a signal of a positive effect in one study looking at withdrawal after acute stroke but these results are unlikely to be generalisable to non-stroke settings and were not a primary outcome of the study. Withdrawing antihypertensive drugs was associated with increased blood pressure. It is unlikely to increase mortality at three to four months' follow-up, although there was a signal from one large study looking at withdrawal after stroke that withdrawal was associated an increase in cardiovascular events."

Suggested addition: Evidence linking anti-hypertensive medication to cognition and dementia is not clear, and there is a possibility that people may experience an increase in cardiovascular-related events if this medication is withdrawn.

That said, it still appears that the findings of this review are aligned with the "it can't hurt" mentality, but it may be worth noting that the reviewers did not find conclusive data with respect to the impact of music therapy on behaviours. Just a suggestion! Mcbrarian (talk) 14:25, 18 September 2018 (UTC)

Jytdog did a lot of good work on article content; I miss him. Seppi333 (Insert 2¢) 01:22, 13 March 2019 (UTC)

Does not belong in the lead IMO

The refs is question are celiac specific and not about dementia generally. This can go in the body of the text. These are tentative associations at best.

This is the reason that WHO does not mention it. https://www.who.int/en/news-room/fact-sheets/detail/dementia Doc James (talk · contribs · email) 10:12, 12 March 2019 (UTC)

Text in question

"A strict gluten-free diet started early may help protect against gluten-related dementia.

Zis P, Hadjivassiliou M (26 February 2019). "Treatment of Neurological Manifestations of Gluten Sensitivity and Coeliac Disease". Curr Treat Options Neurol (Review). 21 (3): 10. doi:10.1007/s11940-019-0552-7. PMID 30806821.{{cite journal}}: CS1 maint: year (link)

Makhlouf S, Messelmani M, Zaouali J, Mrissa R (2018). "Cognitive impairment in celiac disease and non-celiac gluten sensitivity: review of literature on the main cognitive impairments, the imaging and the effect of gluten free diet". Acta Neurol Belg (Review). 118 (1): 21–27. doi:10.1007/s13760-017-0870-z. PMID 29247390."

The Makhlouf ref is a little concerning. They state "Several types of impairment were reported in the context of association with CD: Alzheimer dementia, vascular dementia, frontotemporal dementia, dementia miming a Creutzfeldt–Jakob"

This does not appear to be English "dementia miming a Creutzfeldt–Jakob" Additionally the impact factor of the journal is only 1.7. Not really that high quality of a source. Doc James (talk · contribs · email) 10:18, 12 March 2019 (UTC)

We are not guided solely by the WHO criteria, like that brief general article (older than the references) that you showed. In that case, we would have to erase... half? 70%? plus...? of the Wikipedia medicin content. Anyway and although I do not share your opinion, I will accept that it be removed from the lead.

A typo is not a reason for a text to be removed. It is very clear what it meant and it's as simple as correcting it [7].

Also, you removed an important content supported by the 2019 review [8] fact that you did not mention in the edit summary [9]. I will restore it. --BallenaBlanca 🐳 ♂ (Talk) 16:32, 12 March 2019 (UTC)

Considering that gluten-related dementia is a (putative?) subtype that can only occur in individuals who have gluten sensitivity and are exposed to gluten, I'm not sure that the term "gluten-related dementia" is worth mentioning even in passing in the lead. Also, that claim is understating a self-evident/obvious fact about causality; it's almost like writing "Avoiding alcohol consumption may help protect against alcohol-related dementia." Well, no shit, it's termed "alcohol-related" for a reason: excessive alcohol consumption is the sole cause. Seppi333 (Insert 2¢) 17:42, 12 March 2019 (UTC)

@Seppi333:, better now? [10] --BallenaBlanca 🐳 ♂ (Talk) 18:24, 12 March 2019 (UTC)

Yes. Seppi333 (Insert 2¢) 18:51, 12 March 2019 (UTC)

Not every article is an indepth overview of celiac disease. This goes at that article not here "It should be started as soon as possible" and "People who do not have digestive symptoms are less likely to receive early diagnosis and treatment." Doc James (talk · contribs · email) 11:38, 13 March 2019 (UTC)

Please, Doc James explain why you deleted these two brief sentences but you keep, for example, all this text that I have removed here as a example [11]. They also have their own pages ...

"Indepth overview" of celiac disease? Is that what you consider "indepth"? Oh, sure you're making a joke, it can not be anything else coming from a doctor ...--BallenaBlanca 🐳 ♂ (Talk) 15:44, 13 March 2019 (UTC)

This is not the article to discuss how hard the diagnosis of celiac disease is. AD is the most common cause of dementia. The association between dementia and celiac disease is very tentative with some reviews finding no association. Doc James (talk · contribs · email) 08:05, 14 March 2019 (UTC)

You are not giving valid arguments. They should be based on policies and guidelines, and not your personal perceptions WP:ATADP. What I am going to explain next is necessary to put this discussion in context:

• WP:DLC, WP:LACK [12] [13] You've even pressed me to stop editing [14] "Seriously you need to drop the stick."
• WP:IDONTLIKEIT “This goes at that article not here” “This is not the article to discuss how hard the diagnosis of celiac disease is” You are distorting the meaning of what I wrote. We are in this context: the treatment (for which a previous diagnosis is obviously needed) of dementia associated with gluten-related disorders (by the way, not just "celiac disease", non-celiac gluten sensitivity is recognized since 2011).
• WP:IDONTLIKEIT, WP:LACK, WP:DLS, WP:CENSOR You systematically eliminate mentions of the possible absence of digestive symptoms, although it is a key point to be able to relate extra-intestinal manifestations. Or the importance of an early treatment to avoid complications. This is an encyclopedia and we have to write for lay people. On confusing or little known topics outside of its main page to make clarifications is usual, to help the comprehension of any reader. But you do not want to allow it in these cases. Why? Because in your opinion (and only in your opinion, not in that of the experts in the subject), to give importance to the extra-digestive symptoms is "undue weight". You think that talking about dermatitis herpetiformisis enough. [15] You do not allow updating the definition to systemic (or multi-organic) disease [16] [17]. A few small examples of your deletions: [18] [19], [20] [21], [22] [23] That's why you're also forgetting to mention CD in associated disorders, despite clearly appearing as one of the main causes in the references you use, and I had to adjust it, as for example [24] [25], [26] [27] --BallenaBlanca 🐳 ♂ (Talk) 03:06, 15 March 2019 (UTC)

  I haven't read the sources, but if there isn't an unambiguous medical consensus on an association between gluten-related disorders and dementia, then asserting or implying that there is in this article would necessarily constitute an WP:NPOV violation and possibly an WP:OR violation, depending on how that statement is worded against the cited source's assertions. If this is indeed the case, I strongly agree with Doc James about excluding content on that in this article. Seppi333 (Insert 2¢) 07:41, 15 March 2019 (UTC)

You can read the abstracts (PMID 30806821, PMID 29247390) and the comments that I wrote in the edit summaries, where I also extracted quotes like this [28] and this [29]. --BallenaBlanca 🐳 ♂ (Talk) 09:35, 15 March 2019 (UTC)

Reversible Causes

Within this section 'hypothyroidism, vitamin B12 deficiency, Lyme disease, and neurosyphilis' are given as reversible causes but there are no sources. I raise this because dementia is not mentioned in the hypothyroidism article and it seems appropriate to have a source before raising it there. JDE92.6.165.215 (talk) 20:03, 2 December 2019 (UTC)

Statistical Timelines Of Disease Progression

I do not see any information about how long it takes for any kind of the diseases to be noticed, develop, and run its' course. I don't even see statistics of the ages at which these maladies appear. This would certainly help someone start to know what to expect if someone in their life just got one of these diagnosed. ♠Ace Frahm♠^talk 20:19, 4 March 2020 (UTC)

It depends on the type on those details are generally found in the articles on the types. Doc James (talk · contribs · email) 22:36, 23 April 2020 (UTC)

Adding a 2019 Cochrane review on Cognitive Training?

I would like to add a citation to the article below under the Psychological Therapies heading (first paragraph) with the following description. A 2019 Cochrane review found that cognitive training is probably associated with small to moderate improvements in global cognition and verbal semantic fluency when compared to control groups but was no more effective than alternative treatments. BDD user (talk) 14:59, 23 May 2020 (UTC)

subsection for positive + negative signs/symptoms?

I am wondering whether positive (the presence of something) and negative (the abscence of something) behaviours should be a subsection of signs/symptoms? I don't have enough expertise/knowledge to justify an edit, but I do believe that it is important to maybe categorize behaviours, as to maybe help someone identify patterns in certain specific kinds of dementias. Knowledge is power, and if this small piece helps remotely, shouldn't we try to be as specific and precise as possible?

I agree with you that having this be part of the subsection would be beneficial. Because the signs and symptoms listed seem very general now, adding a little more detail would be useful. Though I think labeling them more along the lines of things that appear because of the disease and things that are no longer present because of the disease, would be wise. Possibly something along the lines of "effects of dementia", only because positive and negative could be interpreted as opinion than fact. 2605:7FC0:0:81:CDBF:F0E4:CD29:DEF8 (talk) 22:49, 1 October 2020 (UTC)

Referring to dementia as a broad category of brain diseases instead of a collection of symptoms

I was wondering if the first sentence of the article should be changed to reflect the fact that dementia is not a specific disease or set of diseases, but rather a collection of symptoms. This is actually reflected in the source for this sentence, which describes dementia as a syndrome. I am aware that the line between syndrome and disease is often blurred, as mentioned in the article for syndrome, but I still feel it would be beneficial to reword this sentence to not imply dementia is "a broad category of brain diseases".

As an additional source for dementia referring to a set of symptoms, the CDC page for Dementia states that "Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interferes with doing everyday activities.".--SlowImprovement (talk) 21:08, 3 November 2020 (UTC)

@Doc James: care to comment? Jtbobwaysf (talk) 07:40, 5 November 2020 (UTC)

Sure. Per WHO "Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities." Doc James (talk · contribs · email) 15:26, 5 November 2020 (UTC)

Since Syndrome begins "A syndrome is a set of medical signs and symptoms which are correlated with each other", then I think we might want to change the first sentence from "Dementia is a broad category of brain diseases" to something like "Dementia is set of related symptoms that involve impairments to memory, thinking, behavior, and the ability to perform everyday activities". WhatamIdoing (talk) 15:53, 6 November 2020 (UTC)

"Consciousness is usually not affected." in lead section.

This sentence does not seem to be explained further in the article, and the WHO source only contains one sentence about consciousness: "Consciousness is not affected.". Might it be better to remove the sentence? I find it confusing and the source does not help me at all in understanding what is meant with it.

Meerpirat (talk) 10:52, 29 November 2019 (UTC)

User:Meerpirat this separates it from delirium Doc James (talk · contribs · email) 19:07, 14 April 2020 (UTC)

Doc James The linked Wikipedia article about consciousness substantiates my worries: Definitions of consciousness are controversial, just read the lead section. I worry that saying "Consciousness is not affected.", citing a source that doesn't explain what they mean with the term, and us not explaining it in the body of the article, is misleading. Meerpirat (talk) 13:30, 23 April 2020 (UTC)

We state "consciousness is usually not affected" which is accurate. We cite the World Health Organization which is definitely a good source. Sure there is some controversy but that is only for certain aspects of the concept.Doc James (talk · contribs · email) 21:46, 23 April 2020 (UTC)

Not sure what you mean with accurate. The term is inprecise, therefore it is unclear to what it refers. Quoting the lead section in Consciousness: "Today, with modern research into the brain [Consciousness] often includes any kind of experience, cognition, feeling or perception. It may be 'awareness', or 'awareness of awareness', or self-awareness.[6] There might be different levels or orders of consciousness,[7] or different kinds of consciousness, or just one kind with different features." As the WHO article nowhere explains how they define it, and it's not explained in our article, I still think it's too ambiguous and would recommend replacing it with for example "self-awareness", in case that was the intended meaning. Meerpirat (talk) 10:07, 27 April 2020 (UTC)

Slightly expanded on.--Iztwoz (talk) 18:35, 6 November 2020 (UTC)

Iztwoz, I don't think we're there yet. Delirium-onset DLB is a well understood thing, even proposed as a subset (but pending better biomarkers). Here we are excluding delirium, when DLB is the second leading cause of neurodegenerative dementia. SandyGeorgia (Talk) 19:35, 6 November 2020 (UTC)

My fixes of that error (and other three-year-old errors in this article) here. SandyGeorgia (Talk) 19:59, 6 November 2020 (UTC)

Thanks --Iztwoz (talk) 19:24, 7 November 2020 (UTC)

Primary Resources

The article lists several resources that contain information that is given by the same researchers who conducted the experiments. This would technically qualify as a primary resource while Wikipedia strongly suggests using secondary sources when contributing to articles having to do with health and medicine. Should that be addressed in order to increase the quality of the article? Kennashell (talk) 23:16, 3 May 2021 (UTC)

Medicine

I could find the term medication as part of the Article. There could not be a proper medicine. As I see there could be 40 types of migraines, and I exactly don't know how worst this Dementia, but in search engine like Bing, I can find this as part of the index,- "ginkgo biloba for dementia", so as is in Google

So, what about scribbling something about Ginkgo Biloba, in this Article, or making a reference for it. And I well understood this is a Phytochemical

—AtTEnigma^t@lk 04:32, 9 February 2021 (UTC)

I agree, I think that there needs to be some more information about medicine added. Avacullen (talk) 20:52, 29 September 2021 (UTC)

Lengthy Lead

It seems like the lead on this article contains too much information to be introductory. I wonder if there is information contained in the lead that could be moved to the body of the article to make the lead more concise and clear. Does anyone else have any thoughts or opinions on this? Joh18060 (talk) 22:33, 29 September 2021 (UTC)

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New sub-chapter proposal: charity

In the "Society and culture" chapter, there are a number of donations mentioned. Regardless of the necessity for a list of performed donations, is there support for splitting it off and adding a new "donations and charities" sub-chapter? Sp3ktrum21 (talk) 08:29, 7 April 2022 (UTC)

I would lend at first pass to pruning the donations, looks somewhat current news-ey or maybe promotional. Money is donated all the time for all kinds of health initiatives, i would think that only super notable donations would deserve to be WP:DUE here and adding a sub-section would add additional WP:WEIGHT. I would say I am not strongly opposed to it, but leaning more against than for. But totally open to comments and willing to change my mind. Thanks! Jtbobwaysf (talk) 09:25, 7 April 2022 (UTC)

Copyright problem removed

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pictures

This article could use some more pictures to help readers more understand the topic and what is going on. Brennam29 (talk) 15:18, 3 October 2022 (UTC)

India

The best thing 94.173.202.128 (talk) 21:08, 8 February 2023 (UTC)

Extra cases

The 3rd sentence in the 5th paragraph of the intro here:

The number of cases is increasing by around 10 million every year.

should probably be

The number of cases is increasing by around 1 million every year.

logically; given the other info in the intro.

One every 3 seconds (as stated by Alzheimer's Disease International) works out to 10,512,000 per year.Kitb (talk) 23:19, 12 February 2023 (UTC)

References