At this time, dementia cannot be reversed, but it can be slowed. Dementia is an incurable neurodegenerative disease in which patients gradually lose cognitive and physical skills. However, by making smart lifestyle choices and seeking appropriate treatment, dementia patients can prolong their independence.
The good news is that there are some conditions which masquerade as dementia. Sometimes, patients or their families suspect dementia because of memory and other cognitive problems when another medical condition is actually behind these issues. Many of those conditions are reversible if correctly diagnosed and treated.
So while dementia is not reversible, not all patients who experience memory problems are suffering from this incurable condition. That’s why it’s so important to be evaluated for dementia and other conditions that affect brain and nervous system health.
In this post, we explain the following:
- Ways to slow down dementia progression
- What research in dementia currently shows
- Which conditions are most commonly mistaken for dementia
Neural Effects uses the latest evidence-based techniques to diagnose and help dementia patients. We are located in Provo, Utah and serve anyone in Salt Lake City or the Utah Valley area. We are in network for most types of medical insurance. Schedule your evaluation today.
Dementia Can’t Be Reversed, But It Can Be Slowed
There is no such thing as reversible dementia.
Some people mistake mild cognitive impairment, or MCI, as a type of reversible dementia, but MCI is actually not a type of dementia. It may be viewed as reversible because it does not always develop into dementia. Catching it early can help your prognosis.
Read more about this in our post on how to recognize the signs of mild cognitive impairment.
Currently, there are no treatments that can reverse the neurological damage caused by true dementias, which include Alzheimer’s disease, vascular dementia, frontotemporal dementia, Lewy Body dementia, Parkinson’s disease dementia, and more. However, approaches that slow down the progression of the disease include a combination of exercise and therapy, as well as making important lifestyle changes.
For in-depth information about treatment options, see our post on 24 dementia interventions (including medication options to reduce the symptoms of dementia, therapy types, and at-home changes). For an overview, continue reading below.
The Power of Combining Cardio Exercise with Therapy
Dementia patients can participate in many different types of therapies, from occupational therapy and physical therapy to art therapy and reminiscence therapy.
Many of these therapies are administered one at a time because the therapists only specialize in one to two types of therapy. Although this method can be very beneficial for patients, research shows that using a combination of exercises from different types of therapy after a workout can boost the results even further.
At Neural Effects, our patients undergo a short session of aerobic exercise before therapy. Not only does exercise facilitate healthy blood flow within the brain, it also triggers a post-exercise cognitive boost (PECB). Exercise leads to the release of chemicals in the brain, such as brain-derived neurotrophic factor (BDNF), that make it more flexible, allowing patients to benefit more from therapy shortly after exercise. This is especially important for dementia patients, since they often experience a reduction in BDNF concentrations that exercise can help counteract.
Exercise and therapy promote brain plasticity, which is the brain’s ability to form new neural connections and communication pathways. While brain plasticity is not strong enough to cure dementia, it may boost brain function while delaying dementia progression, especially in the early stages of Alzheimer’s disease and other forms of dementia.
Further reading: Learn common physical therapy exercises for dementia
At our clinic, the focus on interdisciplinary therapy means patients gain exposure to helpful interventions more quickly than in a traditional setting. One session often includes exercises from physical therapy, occupational therapy, cognitive therapy, and more. The selection of exercises is based on the specific cognitive deficits that the patient is experiencing.
Lifestyle Choices
In addition to therapy, patients can often slow down their cognitive decline with healthy lifestyle choices. Multiple studies (cited below) demonstrate how engaging in regular exercise and staying socially active, for example, can have a significant impact on the patient’s wellbeing.
Engage in Regular Exercise
Engaging in regular physical exercise can slow down symptom progression in dementia patients. Physical activity helps these patients by improving blood flow to the brain and simultaneously stimulating its ability to maintain old connections and make new ones.
The amount of exercise does not have to be extreme. Patients should aim for at least 30 minutes every day, five days a week. The ideal exercise plan involves a combination of cardio exercise, strength training, balance, and coordination exercises. Good activities for dementia patients include walking, swimming, yoga, and gardening.
For patients who have never been very active, it can be intimidating to start an exercise program. The best way is to start small, such as with a 10-minute walk a few times a week, and gradually build up from there.
Follow a Healthy Diet
Growing evidence suggests that following a healthy diet can help reduce inflammation and protect the brain. The MIND diet, for example, is an excellent choice for dementia patients. This diet is a combination of a traditional Mediterranean diet and the DASH diet, which was designed to lower blood pressure. Studies show that patients following a MIND diet experience a slow down in brain aging equivalent to 7.5 years.
This brain health-focused diet includes eating vegetables, fruits, nuts, whole grains, low-fat dairy products, and lean protein foods, while avoiding salty, sugary, and fatty processed foods.
Challenge the Brain
It’s important for dementia patients to continue challenging their brains. Cognitively stimulating activities are some of the best ways to slow down the progression of dementia symptoms.
Any activities that help patients recall information, think quickly, solve problems, or make decisions can help with cognitive skills. Examples include solving puzzles, learning something new, reading at a slightly harder level than is normal for them, playing board games, playing a musical instrument, or engaging in arts and crafts.
Keep Socially Active
We all need social interaction, and dementia patients are no exception. Staying socially engaged with friends and family helps slow down progression of symptoms. It also helps patients feel less stressed and more motivated to follow healthy habits like playing games and being physically active.
Social interaction can take many forms; patients can volunteer at a local charity, join a book club, get to know neighbors, go out regularly with friends, or simply phone a family member.
Follow a Healthy Sleep Pattern
It’s common for dementia patients to experience sleep disturbances, such as difficulty falling asleep at night followed by drowsiness during the day. Some patients experience sundowning — a phenomenon that causes them to feel confused and anxious as it gets dark.
The best way to improve sleep is to follow a regular sleep pattern by going to bed at the same time every day, including weekends and holidays.
Patients can create a relaxing bedtime ritual by listening to calming music or reading a book. It’s important to avoid caffeinated drinks and alcohol late in the day and to ban television and computers from the bedroom.
Research for New Treatments Is Ongoing
Over the past few years, researchers have made huge strides in understanding the mechanisms that cause dementia and developing new treatments. This work is ongoing and there are many more research studies and clinical trials currently taking place. Although a cure for dementia is not guaranteed, there are some very promising advances.
Here are some of the areas researchers are working on at the moment:
Repurposing Medicines
Developing new medicines to treat dementia takes years — and costs millions of dollars. On the other hand, repurposing existing drugs used for other conditions may be a quicker way to find new treatments. These are medicines that have already been tested for safety and efficacy, so much of the development process can be shortened.
Medicines currently being explored as possible treatments for dementia include those used for:
- Diabetes
- High blood pressure
- Heart conditions
- Seizures
- Bipolar disorder
- Asthma
- Rheumatoid arthritis
- Depression
Stem Cells
Stem cell therapy is a unique approach to treat dementia. When introduced in large quantities into the body, stem cells target inflammation and repair it. In dementia patients, this type of therapy aims to restore disrupted neuronal networks and improve cognitive function.
Recent research suggests that stem cell therapy may be able to:
- Improve memory and other cognitive functions
- Regenerate nerve cells
- Accelerate recovery
- Replace damaged cells with healthy cells
Despite promising results, the effectiveness of the therapy depends on many different factors, such as duration of the illness, age of the patient, hereditary predisposition, lifestyle, etc. In addition, stem cell therapy often produces better results when combined with other therapeutic methods that stimulate the tissue repair process.
Immunotherapy
Many recent studies turn to immunotherapy for a new treatment for dementia. In simple terms, immunotherapy works by stimulating the body’s immune response to target and eliminate undesired and dangerous proteins.
In dementia, researchers have tried this approach against abnormal proteins, such as amyloid-β or tau, that build up in the brains of patients with Alzheimer’s disease. Recently, the dementia drug Aducanumab was developed using this method, and researchers are now targeting other proteins. (We’ve written in detail about Aducanumab in another article, where you can find out more about our reservations.)
Another area of research involves specialized immune cells in the brain called microglia, which are support cells for neurons responsible for cleaning unwanted proteins in the brain. In Alzheimer’s disease, these immune cells become overactive, which may cause further damage to the brain. Current studies are trying to find a way to prevent this.
Immunotherapy is a powerful treatment approach that holds considerable promise for the future. Many researchers believe immunotherapy could be our first truly effective weapon to cure dementia.
Gene-based Therapies
Gene-based therapy is another possibility to treat dementia by targeting genes that cause the condition. This therapy involves inserting healthy human DNA into cells as a way to stop mutated DNA from causing dementia.
One of the biggest difficulties with delivering drugs to the brain is the blood-brain barrier, as it blocks large molecules from crossing over to the brain. Gene therapy for dementia is the perfect way to circumvent this barrier as new genes are delivered to the brain in the same way as viruses infect brain cells.
In the future, gene therapy may replace drug treatments and surgery altogether to treat many types of conditions, including dementia.
Conditions That Can Be Mistaken for Dementia
It’s surprisingly easy for patients to mistake signs and symptoms of many different conditions for dementia.
Some of the most common causes of dementia-like symptoms include:
Delirium
Delirium involves a change in mental state or consciousness. This condition develops quickly and can be very serious. Patients with delirium become confused and may struggle with memory and understanding conversations. Sometimes they suffer personality changes, too.
Delirium can be caused by a sudden illness, such as an untreated infection, severe pain, or heart attack. Caregivers of patients who have an increased risk for delirium, such as those with known heart disease, should remain vigilant. It can be treated easily if detected early.
Depression
Patients with depression experience low mood and/or a loss of interest and enjoyment in life. It’s probably the condition that is most often mistaken for dementia. Some patients with depression, especially older people, also have memory loss and feel confused.
Even for trained doctors, it can be hard to distinguish between the two conditions. Diagnosis is further complicated for patients suffering with depression and dementia at the same time. Finding the right healthcare regimen is key to recovery.
Anxiety
Everyone feels anxious sometimes, but generalized anxiety disorder is a long-lasting kind of anxiety. Some symptoms overlap with dementia, including restlessness, difficulty concentrating, and sleep problems. Patients may have both dementia and anxiety.
For treatment, your doctor may suggest cognitive behavioral therapy, which involves talking about your thoughts, behaviors, and feelings.
Mild Cognitive Impairment (MCI)
Mild cognitive impairment is common in older people. Patients with MCI become forgetful, but not enough to affect daily activities. This condition looks like the early stages of dementia. Patients may struggle with thinking and following conversations or become disoriented in familiar places.
People with MCI have a higher risk of dementia, but MCI does not always develop into dementia.
Further reading: Mild cognitive impairment treatment
Hormonal Conditions
Some hormonal imbalances can cause dementia-like symptoms, including:
- Hypothyroidism, caused by an underactive thyroid gland.
- Hyperthyroidism, caused by an overactive thyroid gland.
- Cushing’s syndrome, caused by having high levels of cortisol.
- Hypopituitarism, caused by an underactive pituitary gland.
For example, patients with hypothyroidism can struggle with cognitive skills, such as concentrating and thinking. They may also find it hard to learn new things or remember recent events. Patients with hyperthyroidism may also find it difficult to focus, feel anxious, and suffer from depression.
Memory Changes That Happen with Age
Becoming forgetful is normal as patients get older, but there are significant differences between expected memory lapses and dementia symptoms. Occasionally forgetting where you placed your keys or walking into a room and forgetting what you needed are normal events. However, if these memory problems start to affect everyday life, they may be a sign of dementia.
Further reading: How to tell the difference between normal aging and dementia
Reactions to Medication
There are many different medicines that affect the way the brain works. In addition, side effects and interactions between drugs can cause symptoms that are similar to dementia. Confusion is one of the most common side effects mistaken for dementia. Some examples of medicines that can cause symptoms similar to dementia include:
- Benzodiazepines (prescribed for anxiety)
- Opioids (painkillers)
- Some antidepressants and antipsychotics
- Antihistamines (prescribed for allergies)
- Some medicines for epilepsy
- Anticholinergics (prescribed to treat bowel conditions)
- Corticosteroids (prescribed for lung conditions)
- Non-steroidal anti-inflammatory painkillers
Elderly patients are more likely to develop side-effects because their bodies don’t process and eliminate medicines as effectively as younger patients.
Lack of Vitamin B12 or Thiamine
Lack of vitamin B12 or thiamine may cause symptoms that can be mistaken for dementia, including confusion, memory loss, irritability, and a change in mental state.
Following a healthy diet is the best way to avoid these nutritional deficiencies. Foods rich in vitamin B12 and folate include meat, fish, eggs, and cheese, while thiamine can be found in whole-grain foods, beans, peas, nuts, and seeds.
Your doctor can do a blood test to check your B12 levels. Patients with low levels can be prescribed vitamin supplements to help.
Head Injury
Head injuries — even minor ones — can cause cognitive problems. Symptoms of head injury that are similar to dementia include memory loss, difficulty concentrating, mood swings, and brain fog. It’s important to seek treatment as soon as these symptoms start to develop, but it’s never too late to seek medical care for a head injury, even if it’s been years since the injury.
Further reading: Symptoms of an old head injury
Urinary Tract Infections (UTI)
In older patients, urinary tract infections can cause a sudden onset of symptoms that look like Alzheimer’s disease. Patients may get confused, irritable, sleepy, or struggle to focus. Doctors can test urine for infections and prescribe antibiotics to clear it up, if needed.
Diabetes
If patients with diabetes are struggling to keep the right balance of insulin and blood sugar in their bloodstream, it can lead to a condition called hypoglycemia. In simple terms, when sugar levels drop too low in the blood, the brain doesn’t get enough fuel to work as it should. In severe cases, patients become confused, clumsy, look like they’re drunk, or even faint.
Often, patients feel better after eating to restore normal sugar levels. If that doesn’t help, patients should seek medical attention immediately.
Lyme Disease
Some ticks carry bacteria that get into the patient after a bite, causing a condition called Lyme disease. If left untreated, the bacteria can affect the nervous system.
Common symptoms include brain fog, difficulty keeping up with conversations, headaches, and fatigue. These symptoms may not develop until months, or even years, after the tick bite. This condition can be treated with antibiotics; the earlier it’s caught, the easier it is to treat.
Hearing or Eyesight Problems
Elderly patients with poor vision can appear to have dementia due to symptoms such as poor spatial awareness or difficulty following television programs. A simple eye test and glasses are usually enough to overcome these problems.
Similarly, patients with hearing difficulties struggle to follow conversations and may seem withdrawn and confused. A hearing test and hearing aids may resolve these problems.
Sleep Problems or Disturbed Sleep
Sleep disturbances are common in older patients, causing dementia-like symptoms such as trouble focusing, confusion, mental fatigue, and irritability.
Some older adults also suffer from sleep apnea, a breathing problem that deprives the brain of oxygen at night, potentially causing long-term damage. Many patients don’t realize they have the condition and thus don’t seek treatment. If you have signs of apnea, such as loud snoring, waking up gasping, high blood pressure, and a headache or a dry mouth upon waking, it’s advisable to check with your doctor.
Dehydration and Electrolyte Balance
Dehydration is common in older patients and can also look like dementia. As the body gets older, its ability to retain water in the bloodstream lessens.
In addition, the thirst mechanism isn’t as strong, making it easy to get dehydrated without noticing it. This is further aggravated if patients need to take diuretics or laxatives. Patients should also be aware that hyponatremia (low electrolyte concentrations) can play a role here, too.
Dehydration and hyponatremia can make patients seem lost and confused. Urine that is dark yellow or brown may indicate a lack of fluids. For severe cases, intravenous fluids can reverse cognitive problems caused by dehydration.
Some Types of Cancer
Early symptoms of some brain tumors can mimic those of dementia. Depending on their location, brain tumors can cause cognitive decline, resulting in confusion, memory loss, and changes in personality. They can also trigger other symptoms like headaches, seizures, or vomiting.
Alcohol Abuse
Excessive consumption of alcohol over a long period can cause memory, mental orientation, and attention span to deteriorate. In the long term, regularly drinking too much causes brain damage that can lead to a condition called alcohol-related dementia.
Unlike Alzheimer’s disease or vascular dementia, alcohol-related dementia is not certain to get worse over time. If patients get the right treatment and support, there is a chance that symptoms will improve.
Normal Pressure Hydrocephalus
Normal Pressure Hydrocephalus is caused by a buildup of fluid in the brain. NPH normally occurs spontaneously, but it can also develop after head trauma, brain hemorrhage, or meningitis. This fluid buildup can cause dementia-like symptoms including mental impairment, and poor coordination. Patients need medical care to treat NPH.
Liver or Kidney Disease
Liver and kidney diseases can lead to a buildup of toxic metabolic waste in the blood, eventually leading to cognitive decline that can be mistaken for dementia. Patients need medical care to check liver and kidney function and receive treatment as appropriate.
Emotional Distress
The death of a spouse, financial problems, or worrying about moving can create emotional problems that can be easily mistaken for dementia.
For example, bereavement can cause a range of symptoms, including fatigue, sleep deprivation, headaches, and irritability. Moving into a smaller house or assisted living can make patients become withdrawn, angry, and restless. They may also struggle to communicate with others and suffer memory problems.
The support of family and friends is invaluable in helping someone cope with stress. Counseling may be another way to support patients dealing with these issues.
Diagnosing These Conditions
With the right diagnosis and medical care, many of these medical conditions can be successfully treated. Assessments for dementia should include tests to rule out other conditions. This process can include blood tests, thyroid tests, kidney functions, liver enzymes, metabolic screening, and urine analysis. Some patients may need further examination with Lyme disease tests, heavy metal screening, chest X-rays, EEG, or neuroimaging with MRI and/or PET scans.
Visit Neural Effects for Dementia Diagnosis & Treatment
At Neural Effects, patients undergo a neuropsychological exam (also called a neurocognitive evaluation) to find out how dementia has affected their brain. This examination includes tests to check memory, thinking, and other cognitive skills. Our team also assesses the patient’s reflexes, eye movements, balance, posture, and how well their senses are working. A mental health assessment checks for signs of anxiety, depression, or stress.
After these exams, patients and their loved ones meet with a member of our team to discuss what treatments we can offer. Typically, treatment involves sessions of aerobic exercises followed by a series of therapies such as cognitive therapy, neuromuscular therapy, and occupational therapy.
Patients are encouraged to bring a family member or caregiver to the sessions so that they can learn the exercises to help at home. At the end of each session, one of our therapists will also give patients a list of exercises to complete at home. Completing these exercises goes a long way to improve the overall effect of therapy.
Our staff are fully trained to help dementia patients and their families and can answer questions about diagnosis or treatment. We also keep informed about the latest research developments and will pass on any helpful information to our patients.
Neural Effects uses the latest evidence-based techniques to diagnose and help dementia patients. We are located in Provo, Utah and serve anyone in Salt Lake City or the Utah Valley area. We are in network for most types of medical insurance. Schedule your evaluation today.