Dementia is a broad term that applies to cognitive decline and loss of memory. Alzheimer’s disease is the most common type of dementia. Often, dementia is diagnosed through a doctor’s exam. Correct diagnosis is an important first step toward getting the appropriate treatment, care and family education. Dementia can affect several aspects of one’s daily life. Early signs and symptoms of dementia include:
- Changes in mood, such as depression or other behavior and personality changes
- Confusion with location or passage of time
- Difficulty concentrating, planning or problem solving
- Having visual or space difficulties, such as not understanding distance in driving, getting lost, misplacing items
- Language problems, such as word-finding problems or reduced vocabulary in speech or writing
- Memory impairment, such as difficulty remembering events
- Poor judgment in decisions
- Problems finishing daily tasks at home or at work, such as writing or using utensils
- Withdrawal from work events or social engagements
Diagnosis and treatment
To diagnose dementia, a patient’s primary doctor, a doctor trained in brain conditions (neurologist) or a doctor trained to treat older adults (geriatrician) will review symptoms, medical history, medication history and will interview someone who knows the patient well, such as a close friend or family member. Cognitive testing may be conducted to assess thinking and memory. In some cases, a neuropsychologist will perform a comprehensive assessment of skills and abilities linked to brain function. Finally, to confirm diagnosis, the physicians may order laboratory and brain imaging tests like magnetic resonance imaging (MRI), computerized tomography (CT) or positron emission tomography (PET).
Treatment options include medication to help with memory symptoms and to slow down the progression of diseases. Cholinesterase inhibitors (e.g., donepezil) are used to treat dementia symptoms and work by boosting levels of the chemical acetylcholine in the brain that increases cell to cell communication. Cholinesterase inhibitors may also improve symptoms related to behavior (e.g., agitation, depression). In addition, there are medications (e.g., lecanemab, memantine) that can slow down disease progression.
Yale New Haven Hospital also offers the Dorothy Adler Geriatric Assessment Center, one of the oldest and most comprehensive geriatric assessment programs in the United States. This outpatient consultative service evaluates patients with age-related problems — medical, psychological, cognitive and social — that affect daily living. A multidisciplinary staff comprised of geriatric physicians, psychiatrists and social workers works with patients who have Alzheimer’s disease and other types of dementia as well as their families to provide optimal care and coordinated resources.
Yale Alzheimer’s Disease Research Center
Patient care at Yale New Haven Hospital is built on a solid research foundation. The Yale Alzheimer's Disease Research Center (ADRC) is one of only a few Alzheimer’s disease research centers across the country designated and funded by the National Institute on Aging of the National Institutes of Health. The ADRC conducts clinical research in the treatment, neuroimaging and genetics of Alzheimer’s disease and healthy aging.
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