Dementia is a disease of later life with its onset typically in the 60’s, 70’s or 80’s. In the past, progression was gradual and steadily downward. However, newer medications allow for the stabilization and even in some patients improvement of the condition. Dementia is characterized by cognitive deficiencies particularly in memory. Attention and concentration as well as judgment and social behaviors can be affected. Five percent of the population older than 65 have severe dementia and 15% have mild dementia. Roughly 20% of the population over age 80 have severe dementia.
Dementia can either be of the Alzheimers type, the most common type, affecting 50-60% of patients. Risk factors for developing dementia include being female, having a first degree relative with this disorder and having had a traumatic brain injury. Vascular dementia is the type occurring the second most frequently accounting for 15-30% of all dementia cases and is generally associated with hypertension. Other commonly associated conditions are alcohol dependence and Parkinsons disease. Treatment includes cognitive behavioral therapy, pharmacotherapy and family education and problem solving. A guardianship for medical affairs or one for financial affairs or a comprehensive guardianship including both can become necessary for the best interest of the patient. Patients can be referred for MRI’s and CT scans of the brain as well as other specialized studies and for neuropsychological testing and for consultations with appropriate legal advisors. Usually, Dr. Covert functions as the “team leader.”