Treatments for memory disorders vary widely from person to person and are determined by an individual patient’s diagnosis. Treatments at the UC Memory Disorders Center can involve medications, lifestyle modifications, strategies for improved sleep with the UC Health Sleep Medicine Center or surgical interventions.
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No single test can diagnose Alzheimer disease. Instead healthcare providers use a series of tests to rule out other health conditions. The tests may include:
- A complete medical history. This may include questions about overall health and past health problems. The healthcare provider may ask how well the person can do daily tasks. The healthcare provider may ask family or close friends about any changes in behavior or personality.
- Mental status test. This is a test of memory, problem solving, attention, counting, and language.
- Standard medical tests. These may include blood and urine tests to find possible causes for the problem.
- Brain imaging tests. CT, MRI, or positron emission tomography (PET) may be used to rule out other causes of the problem.
Alzheimer disease has no cure. Instead healthcare providers can help ease some symptoms. This can make a person with Alzheimer more comfortable. Treatment can also make it easier for their caregivers to take care of them.
Some medicines may help slow the decline of a person’s memory, thinking, and language skills. They may help with problems of behavior, such as aggression. They can lessen hallucinations and delusions. These medicines can work for some but not all people. And they may help for only a limited time. Medicines include:
- Cholinesterase inhibitors
Remaining physically and intellectually active, socially engaged and maintaining a healthy diet are associated with a slower clinical progression of Alzheimer’s disease in multiple epidemiologic studies. Supplements like Ginkgo biloba, curcumin and huperzine are used by people with Alzheimer’s disease.
Clinicians have not established a widely accepted diagnostic criteria for autoimmune encephalopathy. Tests that may be done to confirm encephalitis may include:
- Magnetic resonance imaging (MRI). This procedure uses large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- Computed tomography scan (also called a CT or CAT scan). A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Blood tests. In this test, the blood is examined for signs of infection.
- Electroencephalogram (EEG). This test records the brain’s continuous, electrical activity using electrodes attached to the scalp.
- Spinal tap (also called a lumbar puncture). For this test, a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.
The key to treating encephalitis is early detection and quick treatment. A person with encephalitis requires immediate hospitalization and close monitoring. The goal of treatment is to reduce the swelling in the head and to prevent other related complications. Medications to control the infection, seizures, fever or other conditions can be used.
At present, there’s no cure for dementia. But with proper care, many people can live comfortably for years:
- Medicines are a key part of treatment. Some types can help slow the progression of symptoms, such as memory loss. Others can help ease mood, behavior, and sleep problems. These medicines work for some people but not all.
- Activity and exercise are good for body and mind. They may even help slow the progression of the disease. Simple, repetitive activities are good choices.
- Regular healthcare provider visits help keep track of symptoms and overall health.
- Sleep-wake cycle can be mixed up in patients with dementia. They may function better being up at nighttime and sleeping during the daytime.
- Social interactions are important to maintain.
Read about the lifestyle choices that can reduce your risk of cognitive impairment at dementia.
Family members are often the first to notice subtle changes in behavior or language skills. It’s important to see a healthcare provider as early as possible to these symptoms. No single test can diagnose FTD. Typically, healthcare providers will order routine blood tests and perform physical exams to rule out other conditions that cause similar symptoms. If they suspect dementia, they may:
- Evaluate neurological status health including reflexes, muscle strength, muscle tone, sense of touch and sight, coordination, and balance
- Assess neuropsychological status such as memory, problem-solving ability, attention span and counting skills, and language abilities
- Order magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain
There is no cure for frontotemporal dementia. Treatment focuses on medications that may alleviate the severity of symptoms associated with the disease and help ensure the safety of patients and those around them. Speech and language pathologists and physical and occupational therapists can help adjustment to some of the changes caused by FTD.
A physician will take a careful clinical history and physical examination. A laboratory workup may include thyroid studies, a complete metabolic panel, a complete blood count and vitamin levels to rule out another cause of cognitive problems. Imaging of the brain with an MRI or a CT usually does not show atrophy or shrinkage of the brain until later stages of the disease process. If there is a concern about an underlying sleep issue, such as dream enactment behavior, a sleep study may be ordered to determine whether the patient’s symptoms are being caused by a REM sleep behavior disorder.
Dementia with Lewy bodies (DLB) has no cure. Treatment involves managing symptoms.
Medicines used to treat Alzheimer disease (AD) and Parkinson disease (PD) may also be used to treat DLB. Other treatments, such as supportive care, physical therapy, psychotherapy, and behavioral interventions, may also be used.
It’s important that the healthcare provider treating a person with DLB be familiar with all aspects of the disease. Other specialists are often involved in care. Because DLB shares features with AD and PD, those features will need to be treated. Many people with DLB, however, can’t tolerate some of the medicines for AD or PD. Caution must be used when prescribing certain medicines for DLB.
A physician will begin an evaluation of a patient who is experiencing cognitive difficulties by taking a thorough history and performing a complete physical examination. A laboratory workup may include thyroid studies, a complete metabolic panel, a complete blood count, and vitamin levels. Imaging of the brain with an MRI or a CT may also be ordered to determine whether there are any structural changes that might be associated with the cognitive changes. If there is a concern about an underlying sleep issue, a sleep study also may be ordered.
Treatment for MCI is primarily geared toward easing symptoms. Medications may be considered if the patient is experiencing significant memory changes or signs of parkinsonism. Individuals who have undergone a sleep study that shows evidence for obstructive sleep apnea may benefit from continuous positive airway pressure treatment. Those with underlying depression and/or anxiety may benefit from appropriate medications and a referral for psychotherapy. Treatment of other medical conditions, such a vitamin deficiency, thyroid disease, hypertension and dyslipidemia is highly recommended.
Non-medication strategies include exercise, cognitive exercises and remaining socially active.
Evaluation of a patient with cognitive symptoms always begins with a careful history, a physical examination and a thorough neurologic examination. In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography (CT). This imaging test uses X-rays and a computer to make horizontal, or axial images (often called slices) of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram (EEG). This test measures electrical activity in the brain
- Magnetic resonance imaging (MRI). This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
Vascular cognitive impairment can’t be cured. The main goal is to treat the underlying conditions that affect the blood flow to the brain. This can help cut the risk for further damage to brain tissue.
Such treatments may include:
- Medicines to manage blood pressure, cholesterol, triglycerides, diabetes, and problems with blood clotting
- Lifestyle changes, such as following a healthy diet, getting physical activity, quitting smoking, and quitting or decreasing alcohol consumption
- Procedures to improve blood flow to the brain, such as carotid endarterectomy, angioplasty, and stenting; the carotid arteries are in the neck and provide blood flow from the heart to the brain
- Medicines, such as cholinesterase inhibitors to treat the symptoms of dementia or antidepressants to help with depression or other symptoms
In patients with vascular cognitive impairment, a significant arterial narrowing or blockage can potentially be treated with a surgical or endovascular intervention, such as carotid endarterectomy or carotid artery stenting. Our team of specialists includes highly skilled neurosurgeons who are affiliated with the UC Comprehensive Stroke Center.