Genetic Disorders

Stenosis

Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the spinal degeneration that commonly occurs with aging. It can also sometimes be caused by osteoporosis, spinal disc herniation, or a tumor.

Spinal stenosis may affect the cervical, thoracic or lumbar spine.

Symptoms include:

  • Pain
  • Weakness
  • Tingling of the legs

Surgery for spinal stenosis is the most common spinal operation in people over the age of 50. However, spinal stenosis caused by developmental narrowing of the spinal canal may occur in people in their 20s and 30s.

Operations used to treat stenosis include:

  • Anterior Cervical Discectomy and Fusion — A small incision in the front of the neck is used to access the upper spine. The ruptured or herniated disc is removed and replaced with a small bone plug, which eventually grows to connect the two adjacent vertebrae.
  • Cervical Corpectomy — Part of the vertebra and discs are removed and replaced with a bone graft or a metal plate and screws to support the spine.
  • Decompressive Laminectory — The roof of the vertebrae, called the lamina, is surgically removed. The procedure also may include removing part of the disc or fusing the vertebrae (spinal fusion).
  • Foramenotomy — The area where nerve roots leave the spinal canal, called the foramen, is removed. This procedure can be performed using a minimally invasive approach with an endoscope, an instrument that allows the surgeon to see inside the body through a tiny incision. The surgeon can then use other tiny incisions to perform the surgery, avoiding the discomfort and muscle atrophy associated with the traditional open technique that uses a large incision.
  • Laminoplasty — The compressive bone in the back of the neck is gently lifted off of the spinal cord creating a new “roof” over the spinal cord and nerve roots. This procedure effectively decompresses the spinal cord over multiple segments without the need for fusion or hardware. It also minimizes the chance of spinal instability or deformity that may result from the traditional laminectomy procedure.
  • Laminotomy — Only a small portion of the lamina is removed.
  • Medial Facetectomy — Part of the bone structure in the spinal canal, called the facet, is removed.
  • Cervical Disc Replacement — Instead of fusing the affected area, the natural disc material is replaced with a metal and plastic prosthesis that maintains or restores the motion segment. This will hopefully prevent degeneration of the next disc level.

Cervical Stenosis

Stenosis in the neck, also called the cervical spine, affects the upper part of the body including the arms and hands. Stenosis is the narrowing of the bony canal that protects the spinal cord and its branching nerves to the point where it injures the spinal cord or nerves.

This may be caused by a number of conditions including:

  • Bone spurs
  • Rupture of the spinal discs

Cervical stenosis may cause pain, numbness, or weakness in the legs. The pain may move from one part of the body to another but is often most noticeable in the neck.

If the stenosis is severe and is not responding to other treatment methods, surgery to widen the spinal canal may be necessary. Because bone continues to deteriorate, additional treatment may be needed several years after even successful surgery.

Lumbar Stenosis

Stenosis in the lower back is called lumbar stenosis. It is often characterized by radiating pain in the buttocks and legs.

Frequently people afflicted with lumbar stenosis have varying degrees of low back discomfort. The pain typically occurs most often during activities and is relieved by resting, sitting or bending forward. In some cases, the pain is centralized in the lower legs and feet. In severe cases, it also can impact continence (bowel and bladder control) and sexual function.

The initial treatment for stenosis is to treat the symptoms rather than the condition itself. These treatments include:

  • Rest
  • Posture changes, such as lying with the knees drawn up to the chest or leaning forward while walking, may relieve the pressure on the nerves
  • Medication such as aspirin or ibuprofen to relieve inflammation and pain
  • Physical therapy
  • Losing weight
  • Corticosteroid injections to reduce inflammation and relieve pain
  • A cervical collar

If several months of treatment have not improved the symptoms, and if the stenosis is severe, surgery to widen the spinal canal may be necessary. Because bone continues to deteriorate, additional treatment may be needed several years after even successful surgery.

Muscular Dystrophy

The muscular dystrophies (MD) are a group of more than 30 genetic diseases characterized by progressive weakness and degeneration of the skeletal muscles that control movement.

Some forms of MD are seen in infancy or childhood, while others may not appear until middle age or later.

The disorders differ in terms of the distribution and extent of muscle weakness (some forms of MD also affect cardiac muscle), age of onset, rate of progression, and pattern of inheritance.

There is no specific treatment to stop or reverse any form of MD. Treatment may include:

  • Physical therapy
  • Respiratory therapy
  • Speech therapy
  • Orthopedic appliances used for support
  • Corrective orthopedic surgery

Drug therapy includes:

  • Corticosteroids to slow muscle degeneration
  • Anticonvulsants to control seizures and some muscle activity
  • Immunosuppressants to delay some damage to dying muscle cells
  • Antibiotics to fight respiratory infections

Some individuals may benefit from occupational therapy and assistive technology. Some patients may need assisted ventilation to treat respiratory muscle weakness and a pacemaker for cardiac abnormalities.

The prognosis for people with MD varies according to the type and progression of the disorder. Some cases may be mild and progress very slowly over a normal lifespan, while others produce severe muscle weakness, functional disability, and loss of the ability to walk. Some children with MD die in infancy while others live into adulthood with only moderate disability.

Duchenne Muscular Dystrophy

Duchenne MD (DMD) is the most common form of MD, affecting one in 4000 males. It is caused by the absence of dystrophin, a protein involved in maintaining the integrity of muscle.

DMD primarily affects boys. Onset is between 3 and 5 years and the disorder progresses rapidly. Most boys are unable to walk by age 12, and later need a respirator to breathe.

Girls in these families have a 50 percent chance of inheriting and passing the defective gene to their children.

Boys with Becker MD (very similar to but less severe than Duchenne MD) have faulty or not enough dystrophin.

The average life expectancy for patients afflicted with DMD varies from late teens to early to mid 20s. There have been reports of a few DMD patients surviving to the age of 40, but this is extremely rare.

Facioscapulohumeral Muscular Dystrophy

Facioscapulohumeral MD causes progressive weakness in muscles of the face, arms, legs, and around the shoulders and chest. It progresses slowly and can vary in symptoms from mild to disabling.

Facioscapulohumeral MD usually begins in the teenage years.

Life expectancy is normal, but up to 15% of affected individuals become severely disabled and eventually must use a wheel chair.

Myotonic Dystrophy

Myotonic MD is the disorder’s most common adult form, although Myotonic dystrophy can occur in patients of any age.

It is typified by:

  • Prolonged muscle spasms
  • Cataracts
  • Cardiac abnormalities
  • Endocrine disturbances

Individuals with myotonic MD have long, thin faces, drooping eyelids, and a swan-like neck.

Hip and Knee

The hip, the knee and the shoulder are the big working joints of the body. When something goes wrong with any of them, the problem can seriously impact your entire body and your ability to perform your normal activities.

Some conditions that affect the hip and knee include:

  • Osteoarthritis of the Hip
  • Osteoarthritis of the Knee

Osteoarthritis (of all types) affects nearly 27 million people in North America. It is estimated that 80% of the population have radiographic evidence of OA by age 65, although only 60% of those will have symptoms.

Joint replacement (arthroplasty) is required to treat severe cases of the hip, knee and shoulder conditions.

Osteoarthritis of the Hip

Osteoarthritis of the hip causes the hip joint to get stiff and inflamed and can progress until resting no longer relieves your pain. Bone spurs might build up at the edges of the joint. When the cartilage wears away completely, bones rub directly against each other, making it very painful to move. You may lose the ability to rotate, flex or extend your hip. If you become less active to avoid the pain, the muscles controlling your joint get weak and you may start to limp.

While you can’t reverse the effects of osteoarthritis, early treatment may help you avoid pain and disability and slow progression of the disease. If you have early stages of osteoarthritis of the hip, the first treatments may include:

  • Resting your hip from overuse
  • Following a physical therapy program of gentle, regular exercise like swimming, water aerobics or cycling to keep your joint functioning and improve its strength and range of motion
  • Using nonsteroidal anti-inflammatory medications like ibuprofen for pain
  • Getting enough sleep each night

In later stages of osteoarthritis, your hip joint hurts when you rest at night or your hip may be severely deformed. Your doctor may recommend total hip replacement surgery or arthroplasty. A two-piece ball and socket will replace your hip joint. This will cure your pain and improve your ability to walk. You may need crutches or a walker for a time after surgery. Rehabilitation is important to restore your hip’s flexibility and to work your muscles back into shape.

Osteoarthritis of the Knee

A normal knee glides smoothly because cartilage covers the ends of the bones that form joints. Osteoarthritis damages this cartilage, progressively wearing it away. The ends of the bones become rough like sandpaper. This damaged cartilage can cause the joint to “stick” or lock and your knee may get painful, stiff and lose range of motion.

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you’re sitting or lying down.

Symptoms may include:

  • Severe knee pain that limits your everyday activities, including walking, going up and down stairs, and standing up from a chair. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
  • Moderate or severe knee pain while resting, day or night.
  • Chronic knee inflammation and swelling that doesn’t improve with rest or medications.
  • Knee deformity a bowing in or out of your knee.
  • Knee stiffness inability to bend and straighten your knee.
  • Failure to get pain relief from non-steroidal anti-inflammatory drugs.

Medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness varies from person to person and may become less effective for patients with severe arthritis.

If medications, changing your activity level and using walking supports are not effective, you may want to consider knee surgery. Inability to tolerate or complications from pain medications or failure to substantially improve with other treatments such as cortisone injections, physical therapy or other surgeries may suggest a knee operation.

There are two surgical treatments for osteoarthritis of the knee:

  • An osteotomy is surgery that reshapes the shinbone (tibia) or thighbone (femur) to improve your knee’s alignment. The healthy bone and cartilage is realigned to compensate for the damaged tissue. Knee osteotomy surgically repositions the joint, realigning the mechanical axis of the limb away from the diseased area. This lets your knee glide freely and carry weight evenly. Osteotomies may restore knee function and significantly diminish osteoarthritis pain.
  • Total knee replacement surgery is another procedure that can help relieve your pain, correct your leg deformity and help you resume your normal activities. This procedure calls for removing the damaged cartilage and bone and inserting new metal and plastic joint surfaces to restore the alignment and function of your knee.

Dermatomyositis

Dermatomyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness.

Dermatomyositis’ cardinal symptom is a skin rash that precedes, accompanies, or follows progressive muscle weakness. The rash looks patchy, with purple or red discolorations, and characteristically develops on the eyelids and on muscles used to extend or straighten joints, including knuckles, elbows, knees, and toes.

Red rashes may also occur on the face, neck, shoulders, upper chest, back, and other locations, and there may be swelling in the affected areas. The rash sometimes occurs without obvious muscle involvement.

Adults with dermatomyositis may experience:

  • Weight loss
  • A low-grade fever
  • Inflamed lungs
  • Sensitivity to light

Children and adults with dermatomyositis may develop calcium deposits, which appear as hard bumps under the skin or in the muscle (called calcinosis). Calcinosis most often occurs 1-3 years after the disease begins. These deposits are seen more often in children with dermatomyositis than in adults.

In some cases of dermatomyositis, distal muscles (muscles located away from the trunk of the body, such as those in the forearms and around the ankles and wrists) may be affected as the disease progresses.

Dermatomyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus.

There is no cure for dermatomyositis, but the symptoms can be treated. Options include:

  • Medication
  • Physical therapy
  • Exercise
  • Heat therapy (including microwave and ultrasound)
  • Orthotics and assistive devices
  • Rest

The standard treatment for dermatomyositis is a corticosteroid drug, given either in pill form or intravenously. Immunosuppressant drugs, such as azathioprine and methotrexate, may reduce inflammation in people who do not respond well to prednisone. Periodic treatment using intravenous immunoglobulin can also improve recovery. Other immunosuppressive agents used to treat the inflammation associated with dermatomyositis include cyclosporine A, cyclophosphamide, and tacrolimus.

Physical therapy is usually recommended to prevent muscle atrophy and to regain muscle strength and range of motion.

Many individuals with dermatomyositis may need a topical ointment, such as topical corticosteroids, for their skin disorder. They should wear a high-protection sunscreen and protective clothing.
Surgery may be required to remove calcium deposits that cause nerve pain and recurrent infections.

Most cases of dermatomyositis respond to therapy. The disease is usually more severe and resistant to therapy in individuals with cardiac or pulmonary problems.

Infantile Spasm

An infantile spasm (IS) is a specific type of seizure seen in an epilepsy syndrome of infancy and childhood known as West Syndrome.

West Syndrome is characterized by:

  • Infantile spasms
  • Developmental regression
  • A specific pattern on electroencephalography (EEG) testing called hypsarrhythmia (chaotic brain waves)

Prevalence of West Syndrome is around 1 out of 3,500 live births. Boys are more likely to be affected than girls. The onset of infantile spasms is usually in the first year of life, typically between 4-8 months.

Many underlying disorders, such as birth injury, metabolic disorders, and genetic disorders can give rise to spasms, making it important to identify the underlying cause. In some children, no cause can be found.

The seizures primarily consist of a sudden bending forward of the body with stiffening of the arms and legs; some children arch their backs as they extend their arms and legs. Spasms tend to occur upon awakening or after feeding, and often occur in clusters of up to 100 spasms at a time. Infants may have dozens of clusters and several hundred spasms per day. Infantile spasms usually stop by age five, but may be replaced by other seizure types.

The prognosis for children with IS is dependent on the underlying causes of the seizures. The intellectual prognosis for children with IS is generally poor because many babies with IS have neurological impairment prior to the onset of spasms. Spasms usually resolve by mid-childhood, but more than half of the children with IS will develop other types of seizures. There appears to be a close relationship between IS and Lennox-Gastaut Syndrome, an epileptic disorder of later childhood.

Treatment with corticosteroids such as prednisone is standard, although serious side effects can occur. Several newer antiepileptic medications, such as topiramate may ease some symptoms. Some children have spasms as the result of brain lesions, and surgical removal of these lesions may result in improvement.

Hydrocephalus

Hydrocephalus is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as “water on the brain,” the “water” is actually cerebrospinal fluid (CSF) — a clear fluid surrounding the brain and spinal cord.

The excessive accumulation of CSF results in an abnormal dilation of the spaces in the brain called ventricles. This dilation causes potentially harmful pressure on the tissues of the brain.

Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by genetic abnormalities or developmental disorders such as spina bifida and encephalocele. Acquired hydrocephalus develops at the time of birth or at some point afterward and can affect individuals of all ages. For example, hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or traumatic injury.

Normal pressure hydrocephalus occurs most often among the elderly. Although many people develop normal pressure hydrocephalus without an obvious cause, it may result from:

  • A subarachnoid hemorrhage
  • Head trauma
  • Infection
  • Tumor
  • Complications of surgery

Symptoms of hydrocephalus vary with age, disease progression, and individual differences in tolerance to CSF.

In infancy, the most obvious indication of hydrocephalus is often the rapid increase in head circumstance or an unusually large head size. In older children and adults, symptoms may include:

  • Headache followed by vomiting
  • Nausea
  • Papilledema – swelling of the optic disk, which is part of the optic nerve
  • Downward deviation of the eyes (called “sunsetting”)
  • Problems with balance
  • Poor coordination
  • Gait disturbance
  • Urinary incontinence
  • Slowing or loss of development (in children)
  • Lethargy
  • Drowsiness
  • Irritability
  • Other changes in personality or cognition, including memory loss

Hydrocephalus is diagnosed through clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques.

The symptoms of normal pressure hydrocephalus usually get worse over time if the condition is not treated, although some people may experience temporary improvements. If left untreated, progressive hydrocephalus is fatal, with rare exceptions.

The prognosis for patients diagnosed with hydrocephalus is difficult to predict, although there is some correlation between the specific cause of hydrocephalus and the patient’s outcome. Prognosis is further complicated by the presence of associated disorders, the timeliness of diagnosis, and the success of treatment.

Hydrocephalus is most often treated with the surgical placement of a shunt system. This system diverts the flow of CSF from a site within the central nervous system to another area of the body where it can be absorbed as part of the circulatory process. A limited number of patients can be treated with an alternative procedure called third ventriculostomy. In this procedure, a small hole is made in the floor of the third ventricle, allowing the CSF to bypass the obstruction and flow toward the site of resorption around the surface of the brain.

The parents of children with hydrocephalus should be aware that hydrocephalus poses risks to both cognitive and physical development. Treatment by an interdisciplinary team of medical professionals, rehabilitation specialists, and educational experts is critical to a positive outcome. Many children diagnosed with the disorder benefit from rehabilitation therapies and educational interventions, and go on to lead normal lives with few limitations.

Coma

A coma, sometimes also called persistent vegetative state, is a profound or deep state of unconsciousness lasting more than 6 hours. Persistent vegetative state is not brain-death. An individual in a state of coma is alive but unable to move or respond to his or her environment. A person in a coma cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions.

Coma may occur as a complication of an underlying illness, or as a result of injuries, such as head trauma. Conditions that may result in a coma include:

  • Intoxication – such as illicit drug abuse, overdose or misuse of over the counter medications, prescribed medication, or controlled substances
  • Metabolic abnormalities
  • Central nervous system diseases
  • Acute neurologic injuries such as strokes or herniations
  • Hypoxia
  • Hypothermia
  • Hypoglycemia
  • Traumatic injuries such as head trauma caused by falls or vehicle collisions

It may also be deliberately induced by pharmaceutical agents in order to preserve higher brain functions following a brain trauma, or to save the patient from extreme pain during healing of injuries or diseases.

Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands.

Once an individual is out of immediate danger, the medical care team focuses on preventing infections and maintaining a healthy physical state. This will often include preventing pneumonia and bedsores and providing balanced nutrition. Physical therapy may also be used to prevent contractures (permanent muscular contractions) and deformities of the bones, joints, and muscles that would limit recovery for those who emerge from coma.

The outcome for coma and persistent vegetative state depends on the cause, severity, and site of neurological damage. Individuals may emerge from coma with a combination of physical, intellectual, and psychological difficulties that need special attention. Recovery usually occurs gradually, with some acquiring more and more ability to respond. Some individuals never progress beyond very basic responses, but many recover full awareness.

Individuals recovering from coma require close medical supervision. A coma rarely lasts more than 2 to 4 weeks. Some patients may regain a degree of awareness after persistent vegetative state. Others may remain in that state for years or even decades. The most common cause of death for someone in a persistent vegetative state is infection, such as pneumonia.

Vascular Dementia

One of the most common types of dementia in older adults, vascular dementia (VaD) refers to a subtle, progressive decline of memory and other cognitive function, such as thinking, learning, remembering, organization skills and complex visual processing. VaD is caused by a chronic, reduced blood flow in the brain. Normally, the brain cells receive an ample supply of blood, which is delivered through a network of blood vessels called the vascular system.

Males and African Americans are at an increased risk of developing the disease.

VaD may be caused by stroke, in which the blood supply to the brain becomes blocked, resulting in permanent brain damage. VaD caused by a single stroke is called single-infarct dementia. The condition can also be caused by a series of small, often unnoticeable strokes called multi-infarct dementia. Damage to tiny blood vessels that lie deep in the brain may also lead to a type of VaD known as sub-cortical vascular dementia. VaD may also occur with Alzheimer’s disease, which causes similar symptoms, such as memory loss.

Vascular dementia can occur suddenly or progress slowly over time. At times, people with VaD experience long periods without any noticeable changes, or even improvements. However, if another stroke occurs, their symptoms may progress rapidly.

VaD risk factors include:

  • High blood pressure
  • Heart disease
  • High cholesterol
  • Diabetes
  • Smoking
  • Alcoholism

It is important that these conditions are diagnosed and treated promptly as a way to prevent VaD.

The condition often occurs with Alzheimer’s disease, which further complicates its progression. VaD causes similar symptoms to those associated with Alzheimer’s disease (AD), such as memory loss. However, memory problems caused by VaD are usually easier to overcome with cues and reminders.

Common symptoms include:

  • Difficulty with organization and solving complex problems
  • Slowed thinking
  • Distraction or “absent mindedness”
  • Difficulty retrieving words from memory
  • Walking with rapid, shuffling steps
  • Speech difficulties
  • Difficulty following instructions

Other symptoms may include:

  • Mood and behavior changes, such as depression, irritability or apathy
  • Hallucinations or delusions, which may be very distressing to the patient and their caregiver
  • Balance and movement problems
  • Loss of bladder or bowel control
  • Symptoms of Parkinson’s disease, such as tremors

Currently, there is no cure for vascular dementia. Treatments are designed to prevent and control risk factors. Treating these conditions greatly reduces the risk of developing dementia.

Huntingtons Disease

Huntington’s disease (HD) is a fatal condition typically characterized by involuntary movements and dementia. The disease is caused by genetically programmed degeneration of brain cells, called neurons, in certain areas of the brain. This causes uncontrolled movements, loss of intellectual faculties and emotional disturbance.

The disease is a hereditary disorder passed on by a parent to child through a mutation in a gene. In North America, Huntington’s disease occurs in about one of every 10,000 to 20,000 persons, affects males and females equally and crosses all ethnic and racial boundaries. Typically, symptoms begin between age 30 and 55. Symptoms appear in children in about 10 percent of families and children who develop the juvenile form of the disease rarely live to adulthood.

Each child of a parent with Huntington’s disease has a 50 percent chance of inheriting the HD gene. If a child does not inherit the HD gene, he or she will not develop the disease and cannot pass it on to subsequent generations. A person who inherits the HD gene will eventually develop the disease. Whether one child inherits the gene has no bearing on whether others will or will not inherit the gene. In 1 percent to 3 percent of individuals with HD, there is no family history of HD.

Early symptoms of Huntington’s disease include:

In addition, patients may notice problems in their daily activities such as driving, learning new things, remembering a fact or making a decision.

As the disease progresses, concentration and short-term memory decline and involuntary movements increase. The ability to walk, speak and swallow deteriorates. Eventually, patients become unable to care for themselves. Death may occur from complications such as choking, infection or heart failure.

At this time, there is no known cure or treatment to reverse the course of the disease. There are treatments available to reduce the severity of some of its symptoms. As the disease progresses and a person’s ability to tend to their own needs reduces, carefully managed multidisciplinary care giving becomes increasingly necessary.

Dementia

Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain.

Although it is common in very elderly individuals, dementia is not a normal part of the aging process.

People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations.

While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions – such as memory and language skills — are significantly impaired without loss of consciousness.

Some of the diseases that can cause symptoms of dementia are:

Doctors have identified other conditions that can cause dementia or dementia-like symptoms including:

  • Reactions to medications
  • Metabolic problems and endocrine abnormalities
  • Nutritional deficiencies
  • Infections
  • Poisoning
  • Brain tumors
  • Anoxia or hypoxia – conditions in which the brain’s oxygen supply is either reduced or cut off entirely
  • Heart and lung problems

There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing.

Drugs to specifically treat Alzheimer’s disease and some other progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individual’s quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia.

Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking.