Over a six-month period, a 78-year-old businessman with a clever wit and superb leadership skills became less able to talk. He gradually became more confused and lost his ability to learn new things. In the end, he lost his capacity to swallow well and started inhaling some liquids and food until finally pneumonia gently shuffled him off this mortal coil.

Dementia is a progressive deterioration of intellect, memory and social skills which, by definition, interferes with normal activities and relationships. It is an umbrella term which includes various types and causes. Alzheimer’s disease and vascular disease (caused by small and large strokes) make up the lion’s share of dementias. Other rarer forms of dementia include frontotemporal dementia, Lewy body dementia, traumatic brain injury and various combinations of any of these conditions.

Classic Alzheimer’s accounts for more than 60 percent of dementias. Early symptoms include recent memory loss or loss of the ability to learn a new thing. Until very late in the disease, people with Alzheimer’s usually retain the capacity to walk normally. Gait abnormalities, by comparison, are usually found with most of the other causes of dementia. It is important to note that some people can have gait abnormalities without dementia. (Try to walk a mile a day, if you are able.)

The prevalence of dementia increases with age. Five percent of those aged 71 to 79 have dementia, while the incidence increases to 38 to 50 percent in those 90 or older. This also means more than 50 percent of the very old DO NOT HAVE DEMENTIA.

Your care provider should evaluate and treat, if apropos, some often reversible or temporary causes for dementia-like symptoms. These include depression, low thyroid, certain infections, multiple sclerosis, low blood sugars, too low or too high sodium or calcium, chronic alcohol use, malnutrition (along with vitamin B1, B12 and D deficiency), dehydration, bleeding under the lining of the skull of the brain, poisoning from heavy metals or pesticides, smoking, high levels of carbon monoxide (check your furnace), low levels of oxygen, moderate to severe sleep apnea, brain tumors, any major medical illness and, last but not least, side effects from certain medications (especially tranquilizers like Ativan or Xanax). Look at that list again and make sure those conditions are considered when you or your loved one is first being evaluated for dementia.

Beware of scammers, who are thick as thieves, looking to sell you false treatments. For more credible information about dementia, go to medlineplus.gov. There is no changing the devastating nature of dementia but knowing all about it can help.


Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central. 

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