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Content Map Terms
Illnesses & Conditions Categories
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Allergies
- Allergy to Natural Rubber (Latex)
- Jellyfish Stings: Allergic Reaction
- Allergies: Should I Take Allergy Shots?
- Non-Allergic Rhinitis
- Allergic Reaction
- Allergies
- Allergy Shots for Allergic Rhinitis
- Allergies: Rush Immunotherapy
- Over-the-Counter Medicines for Allergies
- Allergic Rhinitis
- Types of Allergens
- Allergies: Avoiding Indoor Triggers
- Allergies: Avoiding Outdoor Triggers
- Controlling Dust, Dust Mites, and Other Allergens in Your Home
- Controlling Pet Allergens
- Allergies to Insect Stings
- Allergies: Should I Take Shots for Insect Sting Allergies?
- Immunotherapy for Allergies to Insect Stings
- Types of Allergic Rhinitis
- Allergic Reaction to Tattoo Dye
- Drug Allergies
- Penicillin Allergy
- Hay Fever and Other Seasonal Allergies
- Allergies: Giving Yourself an Epinephrine Shot
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Arthritis and Osteoporosis
- Rheumatoid Arthritis: Finger and Hand Surgeries
- Rheumatoid Arthritis: Classification Criteria
- Rheumatoid Arthritis: Systemic Symptoms
- Comparing Rheumatoid Arthritis and Osteoarthritis
- Rheumatoid Arthritis: Neck Symptoms
- Osteoporosis in Men
- Psoriatic Arthritis
- Arthritis: Shots for Knee Pain
- Complementary Medicine for Arthritis
- Steve's Story: Coping With Arthritis
- Bev's Story: Coping With Arthritis
- Quick Tips: Modifying Your Home and Work Area When You Have Arthritis
- Coping With Osteoarthritis
- Arthritis: Should I Have Shoulder Replacement Surgery?
- Juvenile Idiopathic Arthritis: Stretching and Strengthening Exercises
- Juvenile Idiopathic Arthritis
- Capsaicin for Osteoarthritis
- Small Joint Surgery for Osteoarthritis
- Osteoarthritis: Heat and Cold Therapy
- Modifying Activities for Osteoarthritis
- Osteoarthritis
- Gout
- Rheumatoid Arthritis
- Juvenile Idiopathic Arthritis: Inflammatory Eye Disease
- Juvenile Idiopathic Arthritis: Range-of-Motion Exercises
- Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement
- Complications of Osteoarthritis
- Arthritis: Managing Rheumatoid Arthritis
- Arthritis: Should I Have Knee Replacement Surgery?
- Arthritis: Should I Have Hip Replacement Surgery?
- Juvenile Idiopathic Arthritis: Pain Management
- Osteoporosis Risk in Younger Women
- Osteoporosis Screening
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Asthma
- Asthma: Peak Expiratory Flow and Personal Best
- Asthma and Wheezing
- Asthma: Using an Asthma Action Plan
- Asthma: Measuring Peak Flow
- Asthma: Identifying Your Triggers
- Steroid Medicine for Asthma: Myths and Facts
- Asthma
- Inhaled corticosteroids for asthma
- Inhaled quick-relief medicines for asthma
- Classification of Asthma
- Challenge Tests for Asthma
- Asthma's Impact on Your Child's Life
- Asthma Action Plan: Yellow Zone
- Asthma Triggers
- Asthma Action Plan: Red Zone
- Asthma and GERD
- Occupational Asthma
- Asthma Attack
- Asthma: Symptoms of Difficulty Breathing
- Exercise-Induced Asthma
- Asthma Treatment Goals
- Asthma: Overcoming Obstacles to Taking Medicines
- Asthma in Older Adults: Managing Treatment
- Asthma: Controlling Cockroaches
- Asthma: Educating Yourself and Your Child
- Allergy Shots for Asthma
- Asthma: Taking Charge of Your Asthma
- Monitoring Asthma Treatment
- Omalizumab for Asthma
- Asthma: Ways to Take Inhaled Medicines
- Asthma: Overuse of Quick-Relief Medicines
- Asthma Diary
- Asthma Diary Template
- Asthma Action Plan
- Assessing Your Asthma Knowledge
- My Asthma Action Plan
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Bowel and Gastrointestinal Conditions
- Abdominal Fullness or Bloating
- Irritable Bowel Syndrome: Criteria for Diagnosis
- Gastritis
- Gas, Bloating, and Burping
- Irritable Bowel Syndrome (IBS)
- Constipation: Keeping Your Bowels Healthy
- Rectal Problems
- Mild, Moderate, or Severe Diarrhea
- Torn or Detached Nail
- Chronic Constipation
- Gas (Flatus)
- Dyspepsia
- Diverticulosis
- Bowel Obstruction
- Anal Fissure
- Bowel Disease: Caring for Your Ostomy
- Anal Fistulas and Crohn's Disease
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Cancer
- Lung Cancer and Other Lung Problems From Smoking
- Skin Cancer, Non-Melanoma
- Radiation Therapy for Non-Melanoma Skin Cancer
- Colorectal Cancer Test Recommendations
- Breast Cancer Screening: When Should I Start Having Mammograms?
- Lifestyle Changes That May Help Prevent Cancer
- Choosing a Prosthesis After Breast Cancer Surgery
- Hormone Treatment for Breast Cancer
- Cancer Staging and Grading
- Pancreatic Cancer
- Kidney (Renal Cell) Cancer
- Cancer Support: Managing Stress
- Cancer Support: When Your Cancer Comes Back or Gets Worse
- Cancer Support: Dealing With Emotions and Fears
- Cancer Support: Finding Out That You Have Cancer
- Cancer Support: Being an Active Patient
- Cancer Support: Coping With Cancer Treatments
- Cancer Support: Life After Treatment
- Cancer Support: Family, Friends, and Relationships
- Reducing Cancer Risk When You Are BRCA-Positive
- Anal Cancer
- Prostate Cancer: Should I Choose Active Surveillance?
- Lung Cancer Screening
- Basal Cell Skin Cancer: Should I Have Surgery or Use Medicated Cream?
- Tumour Markers
- Does Aspirin Prevent Cancer?
- Cancer
- Lung Cancer
- Oral Cancer
- Colorectal Cancer
- Metastatic Melanoma
- Radiation Treatment for Cancer
- Skin Cancer, Melanoma
- Cervical Cancer Screening
- Hepatitis B and C: Risk of Liver Cancer
- Inflammatory Bowel Disease and Cancer Risk
- Radiation Therapy for Prostate Cancer
- Prostate Cancer
- Cancer: Home Treatment for Mouth Sores
- Skin Cancer Screening
- Breast Cancer: Should I Have Breast Reconstruction After a Mastectomy?
- Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?
- Prostate Cancer Screening
- Side Effects of Chemotherapy
- Breast Cancer: Lymph Node Surgery for Staging Cancer
- Endometrial (Uterine) Cancer
- Cryosurgery for Prostate Cancer
- Breast Cancer
- Cancer: Home Treatment for Nausea or Vomiting
- Cancer: Home Treatment for Pain
- Cancer: Home Treatment for Diarrhea
- Cancer: Home Treatment for Constipation
- Breast Cancer Types
- Cancer: Home Treatment for Sleep Problems
- Cancer: Home Treatment for Fatigue
- Hair Loss From Cancer Treatment
- Body Image After Cancer Treatment
- Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer?
- Breast Cancer, Metastatic or Recurrent
- Cancer Pain
- Leukemia
- Colorectal Cancer, Metastatic or Recurrent
- Thyroid Cancer
- Types of Thyroid Cancer
- Radiation Therapy for Cancer Pain
- Breast Cancer in Men (Male Breast Cancer)
- Breast Cancer Screening
- Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?
- Asbestos and Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Colon Cancer Genetic Testing
- Testicular Cancer Screening
- Skin Cancer: Protecting Your Skin
- Non-Melanoma Skin Cancer: Comparing Treatments
- Bladder Cancer
- Prostate Cancer, Advanced or Metastatic
- Active Surveillance for Prostate Cancer
- Urinary Problems and Prostate Cancer
- Cancer: Controlling Cancer Pain
- Heat and Cold Treatment for Cancer Pain
- Testicular Cancer
- Testicular Cancer: Which Treatment Should I Have for Stage I Non-Seminoma Testicular Cancer After My Surgery?
- Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?
- Cancer: Controlling Nausea and Vomiting From Chemotherapy
- Lymphedema: Managing Lymphedema
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
- Inflammatory Breast Cancer
- Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Family History and the Risk for Breast or Ovarian Cancer
- Breast Cancer: What Should I Do if I'm at High Risk?
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Cold and Flu
- Difference Between Influenza (Flu) and a Cold
- Colds and Flu
- Influenza (Flu) Complications
- Flu Vaccine Myths
- Influenza (Seasonal Flu)
- Whooping Cough (Pertussis)
- Productive Coughs
- Dry Coughs
- Influenza (Flu): Should I Take Antiviral Medicine?
- Flu Vaccines: Should I Get a Flu Vaccine?
- Relieving A Cough
- Colds
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COPD
- Cal's Story: Learning to Exercise When You have COPD
- Conserving Energy When You Have COPD or Other Chronic Conditions
- Nebulizer for COPD Treatment
- COPD Action Plan
- COPD: Help for Caregivers
- COPD: Keeping Your Diet Healthy
- COPD: Using Exercise to Feel Better
- COPD
- COPD Flare-Ups
- Bullectomy for COPD
- COPD and Alpha-1 Antitrypsin (AAT) Deficiency
- COPD and Sex
- Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
- COPD
- Oxygen Treatment for Chronic Obstructive Pulmonary Disease (COPD)
- COPD: Avoiding Weight Loss
- COPD: Avoiding Your Triggers
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Dementia
- Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?
- Alzheimer's and Other Dementias: Coping With Sundowning
- Dementia: Assessing Pain
- Medical History and Physical Examination for Dementia or Alzheimer's Disease
- Alzheimer's and Other Dementias: Making the Most of Remaining Abilities
- Dementia: Helping a Person Avoid Confusion
- Alzheimer's and Other Dementias: Maintaining Good Nutrition
- Dementia: Tips for Communicating
- Agitation and Dementia
- Dementia: Bladder and Bowel Problems
- Dementia: Support for Caregivers
- Dementia: Legal Issues
- Dementia: Understanding Behaviour Changes
- Dementia: Medicines to Treat Behaviour Changes
- Dementia
- Mild Cognitive Impairment and Dementia
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Diabetes
- Diabetes: Blood Sugar Levels
- Diabetes: Counting Carbs if You Don't Use Insulin
- Diabetes: Coping With Your Feelings About Your Diet
- Diabetes: Tracking My Feelings
- Diabetes: Taking Care of Your Feet
- Diabetes: Care of Blood Sugar Test Supplies
- Diabetes: Checking Your Blood Sugar
- Diabetes: Checking Your Feet
- Diabetes: Steps for Foot-Washing
- Diabetes: Protecting Your Feet
- Diabetes: Dealing With Low Blood Sugar From Medicines
- Diabetes: Dealing With Low Blood Sugar From Insulin
- Diabetes: How to Give Glucagon
- Low Blood Sugar Level Record
- Symptoms of Low Blood Sugar
- Diabetes: Preventing High Blood Sugar Emergencies
- Diabetic Ketoacidosis (DKA)
- High Blood Sugar Level Record
- Symptoms of High Blood Sugar
- Diabetes: Using a Plate Format to Plan Meals
- Diabetes: Giving Yourself an Insulin Shot
- Diabetes: Eating Low-Glycemic Foods
- Diabetes and Alcohol
- Continuous Glucose Monitoring
- Quick Tips: Diabetes and Shift Work
- Diabetes: How to Prepare for a Colonoscopy
- Type 2 Diabetes: Can You Cure It?
- Diabetes, Type 2: Should I Take Insulin?
- Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
- Diabetes: Making Medical Decisions as Your Health Changes
- Diabetes Care Plan
- Diabetes: Caregiving for an Older Adult
- Quick Tips: Smart Snacking When You Have Diabetes
- Testing Tips From a Diabetes Educator
- Gloria's Story: Adding Activity to Help Control Blood Sugar
- Andy's Story: Finding Your Own Routine When You Have Diabetes
- Jerry's Story: Take Prediabetes Seriously
- Linda's Story: Getting Active When You Have Prediabetes
- Diabetes
- Tips for Exercising Safely When You Have Diabetes
- Diabetes: Travel Tips
- Type 2 Diabetes
- Type 1 Diabetes
- Care of Your Skin When You Have Diabetes
- Care of Your Teeth and Gums When You Have Diabetes
- Non-insulin medicines for type 2 diabetes
- Metformin for diabetes
- Hypoglycemia (Low Blood Sugar) in People Without Diabetes
- Diabetic Retinopathy
- Laser Photocoagulation for Diabetic Retinopathy
- Diabetic Neuropathy
- Diabetic Focal Neuropathy
- Diabetic Neuropathy: Exercising Safely
- Diabetic Autonomic Neuropathy
- Criteria for Diagnosing Diabetes
- Diabetes-Related High and Low Blood Sugar Levels
- Diabetic Nephropathy
- Diabetes: Counting Carbs if You Use Insulin
- Diabetes: Cholesterol Levels
- Diabetes and Infections
- Diabetes: Tests to Watch for Complications
- Diabetes: Differences Between Type 1 and 2
- Diabetes Complications
- How Diabetes Causes Blindness
- How Diabetes Causes Foot Problems
- Reading Food Labels When You Have Diabetes
- Eating Out When You Have Diabetes
- Breastfeeding When You Have Diabetes
- Diabetes: Staying Motivated
- Sick-Day Guidelines for People With Diabetes
- Diabetes: Amputation for Foot Problems
- Prediabetes
- Prediabetes: Exercise Tips
- Type 2 Diabetes: Screening for Adults
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
- Form for Carbohydrate Counting
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Disease and Disease Prevention
- Diseases and Conditions
- Osgood-Schlatter Disease
- Needle Aponeurotomy for Dupuytren's Disease
- Mitochondrial Diseases
- Disease and Injury Prevention
- Alzheimer's Disease
- Root Planing and Scaling for Gum Disease
- Kawasaki Disease
- Tay-Sachs Disease
- Von Willebrand's Disease
- Hirschsprung's Disease
- Complications of Paget's Disease
- Paget's Disease of Bone
- Celiac Disease
- Peptic Ulcer Disease
- Ménière's Disease
- Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
- Pelvic Inflammatory Disease
- Addison's Disease
- Misdiagnosis of Lyme Disease
- Lyme Disease
- Parkinson's Disease and Freezing
- Parkinson's Disease: Other Symptoms
- Parkinson's Disease: Modifying Your Activities and Your Home
- Parkinson's Disease and Tremors
- Parkinson's Disease and Speech Problems
- Parkinson's Disease
- Disease-modifying antirheumatic drugs (DMARDs)
- Parkinson's Disease: Movement Problems From Levodopa
- Mad Cow Disease
- Handwashing
- Peyronie's Disease
- Stages of Lyme Disease
- Osteotomy and Paget's Disease
- Dupuytren's Disease
- Crohn's Disease
- Crohn's Disease: Problems Outside the Digestive Tract
- Pilonidal Disease
- Acquired Von Willebrand's Disease
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Down Syndrome, Autism and Developmental Delays
- Autism
- Down Syndrome: Helping Your Child Eat Independently
- Down Syndrome: Grooming and Hygiene
- Down Syndrome: Helping Your Child Learn to Walk and Use Other Motor Skills
- Down Syndrome: Helping Your Child Learn to Communicate
- Down Syndrome
- Dyslexia
- Conditions Related to Dyslexia
- Autism: Behavioural Training and Management
- Autism: Support and Training for the Family
- Unproven Treatments for Autism
- Caring for Adults With Autism
- Down Syndrome: Helping Your Child Avoid Social Problems
- Down Syndrome: Training and Therapy for Young People
- Down Syndrome: Helping Your Child Dress Independently
- Down Syndrome, Ages Birth to 1 Month
- Down Syndrome, Ages 1 Month to 1 Year
- Down Syndrome, Ages 1 to 5
- Down Syndrome, Ages 5 to 13
- Down Syndrome, Ages 13 to 21
- Eating Disorders
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Epilepsy
- Absence Epilepsy
- Juvenile Myoclonic Epilepsy
- Temporal Lobe Epilepsy
- Focal Epilepsy
- Epilepsy: Simple Partial Seizures
- Epilepsy
- Epilepsy and Driving
- Epilepsy: Generalized Seizures
- Epilepsy: Generalized Tonic-Clonic Seizures
- Epilepsy: Myoclonic Seizures
- Epilepsy: Atonic Seizures
- Epilepsy: Tonic Seizures
- Epilepsy: Complex Partial Seizures
- Epilepsy Medicine Therapy Failure
- Stopping Medicine for Epilepsy
- Questions About Medicines for Epilepsy
- Epilepsy: Taking Your Medicines Properly
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Fatigue and Sleep
- Sleep Apnea: Should I Have a Sleep Study?
- Sleep and Your Health
- Quick Tips: Making the Best of Shift Work
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
- Sleeping Better
- Sleep Problems
- Doxepin (Sleep) - Oral
- Improving Sleep When You Have Chronic Pain
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- Chronic Fatigue: Changing Your Schedule
- Chronic Fatigue: Getting Support
- Snoring and Obstructive Sleep Apnea
- Coping With Changing Sleep Patterns as You Get Older
- Stages of Sleep
- Sleep Apnea: Fibre-Optic Pharyngoscopy
- Sleep Apnea: Oral Devices
- Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- Sleep Apnea
- Sleep Problems, Age 12 and Older
- Stages of Sleep Apnea
- Sleep Journal
- Shift Work Sleep Disorder
- Snoring
- Sleep Problems: Dealing With Jet Lag
- Insomnia
- Sleep and Your Body Clock
- Weakness and Fatigue
- Insomnia: Improving Your Sleep
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Heart Health and Stroke
- Peripheral Arterial Disease of the Legs
- Bradycardia (Slow Heart Rate)
- Types of Bradycardia
- Cardiac Device Monitoring
- Angioplasty for Peripheral Arterial Disease of the Legs
- Isolated Systolic High Blood Pressure
- Atrial Fibrillation: Should I Try Electrical Cardioversion?
- Change in Heartbeat
- Deep Vein Thrombosis
- Fast Heart Rate
- Heart Failure: Symptom Record
- Heart Failure: Compensation by the Heart and Body
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Activity and Exercise
- Heart Tests: When Do You Need Them?
- Low Blood Pressure (Hypotension)
- Cardiac Arrest
- Heart Failure Daily Action Plan
- Premature Ventricular Contractions (PVCs)
- Heart Rate Problems: Should I Get a Pacemaker?
- Heart Rhythm Problems: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- What to Do if Your Cardiac Device Is Recalled
- Venous Insufficiency
- Carotid Artery Stenting
- ICD: Living Well With It
- Diabetes: Lower Your Risk for Heart Attack and Stroke
- Pacemaker for Heart Failure (Cardiac Resynchronization Therapy)
- Heart Attack: How to Prevent Another One
- Stroke: How to Prevent Another One
- Sex and Your Heart
- Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Carotid Artery Disease
- Giant Cell Arteritis
- High Blood Pressure: Over-the-Counter Medicines to Avoid
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Leg Aneurysm
- Pulmonary Hypertension
- Left Ventricular Hypertrophy (LVH)
- Heart Failure: Checking Your Weight
- Alan's Story: Coping With Change After a Heart Attack
- Coronary Artery Disease: Prevention Myths
- Quick Tips: Taking Charge of Your Angina
- Heart and Circulation
- High Blood Pressure
- Heartburn
- Angioplasty for Coronary Artery Disease
- Coronary Artery Disease
- Implantable Cardioverter-Defibrillator (ICD)
- Aortic Valve Regurgitation
- Aortic Valve Stenosis
- Secondary High Blood Pressure
- Hemorrhagic Stroke
- Stroke: Common Disabilities
- Self-Care After a Stroke
- Stroke: Dealing With Depression
- Stroke: Getting Dressed
- Stroke: Speech and Language Problems
- Stroke: Bladder and Bowel Problems
- Stroke: Preventing Injury in Affected Limbs
- After a Stroke: Helping Your Family Adjust
- Stroke: Behaviour Changes
- Stroke: Changes in Emotions
- Stroke: Perception Changes
- Stroke: Problems With Ignoring the Affected Side
- Stroke: Memory Tips
- Stroke: Your Rehabilitation Team
- Stroke
- Transient Ischemic Attack (TIA)
- Cardiac Rehabilitation: Lifestyle Changes
- Cardiac Rehabilitation: Hospital Program
- Cardiac Rehabilitation: Home Program
- Cardiac Rehabilitation: Outpatient Program
- Cardiac Rehabilitation: Maintenance Program
- Congenital Heart Defects
- Congenital Heart Defects: Caring for Your Child
- Coronary Artery Disease: Should I Have an Angiogram?
- Triggers of Sudden Heart Failure
- Classification of Heart Failure
- Heart Failure: Tips for Easier Breathing
- Heart Failure: Avoiding Colds and Flu
- Heart Failure
- Helping Someone During a Panic Attack
- Aortic Aneurysm
- High Blood Pressure
- Coronary Artery Disease: Family History
- Angina
- Using Nitroglycerin for Angina
- Heartburn: Changing Your Eating Habits
- Angiotensin II receptor blockers (ARBs)
- Beta-blockers
- Heart Rhythm Problems: Diary of Symptoms
- Vagal Manoeuvres for Supraventricular Tachycardia (SVT)
- Electrical Cardioversion (Defibrillation) for a Fast Heart Rate
- Catheter Ablation for a Fast Heart Rate
- Supraventricular Tachycardia
- Home Blood Pressure Log
- Blood Pressure Screening
- Heart Block
- Electrical System of the Heart
- Heart Rhythm Problems and Driving
- Heart Rhythm Problems: Symptoms
- Resuming Sexual Activity After a Heart Attack
- Risk Factors for Coronary Artery Disease
- Pacemaker for Bradycardia
- SPECT Image of the Heart
- Heart Attack and Stroke in Women: Reducing Your Risk
- Ventricular Tachycardia
- Aspirin to Prevent Heart Attack and Stroke
- Temporal Artery Biopsy
- Emergency First Aid for Heatstroke
- Heartburn Symptom Record
- Heart Attack and Unstable Angina
- Congenital Heart Defects in Adults
- Monitoring and Medicines for Heart Failure
- Ventricular Assist Device (VAD) for Heart Failure
- Cardiac Output
- Heart Failure Symptoms
- Heart Failure: Less Common Symptoms
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- High-Output Heart Failure
- Right-Sided Heart Failure
- Heart Failure Complications
- How the Heart Works
- Coronary Arteries and Heart Function
- Heart Failure Types
- Enjoying Life When You Have Heart Failure
- Heart Failure: Tips for Caregivers
- Medicines to Prevent Abnormal Heart Rhythm in Heart Failure
- Cardiac Cachexia
- Heart Failure Stages
- Cardiac Rehabilitation Team
- Cardiac Rehabilitation: Emotional Health Benefits
- Ischemia
- Coronary Artery Disease: Roles of Different Doctors
- Coronary Artery Disease: Helping a Loved One
- Manage Stress for Your Heart
- Intermittent Claudication
- Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
- Heart Failure and Sexual Activity
- Joan's Story: Coping With Depression and Anxiety From Heart Failure
- Rheumatic Fever and the Heart
- Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
- Acute Coronary Syndrome
- Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Heart Failure: Should I Get a Pacemaker ?
- Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- Heart Valve Disease
- Myxoma Tumours of the Heart
- Aortic Dissection
- Heart Attack and Stroke Risk Screening
- High Blood Pressure: Checking Your Blood Pressure at Home
- Hypertensive Emergency
- Stroke Rehabilitation
- Treatment for Stroke-Related Spasticity
- Driving a Car After a Stroke
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Stroke Recovery: Coping With Eating Problems
- Heart Murmur
- High Blood Pressure: Should I Take Medicine?
- Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
- Tyrell's Story: Taking Pills for High Blood Pressure
- Stroke Prevention: Should I Have a Carotid Artery Procedure?
- Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?
- Stroke: Should I Move My Loved One Into Long-Term Care?
- Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?
- Smoking and Coronary Artery Disease
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Hepatitis
- Hepatitis C: Your Risk for Cirrhosis
- Hepatitis E
- Hepatitis B Immune Globulin - Injection
- Heparin - Injection
- Fulminant Hepatitis
- Protect Yourself From Hepatitis A When Travelling
- Hepatitis A
- Viral Hepatitis
- Hepatitis C
- Hepatitis D
- Hepatitis B: How to Avoid Spreading the Virus
- Hepatitis B
- Hepatitis Panel
- Hepatitis B Treatment Recommendations
- Hepatitis B: Should I Be Tested?
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HIV
- HIV Infection
- HIV Viral Load
- HIV: Stages of Infection
- Ways HIV Cannot Be Spread
- HIV and Exercise
- HIV: Giving Support
- HIV: Tips for Caregivers to Avoid Infection
- HIV: Preventing Other Infections When You Have HIV
- HIV Home Care
- Antiretroviral medicines for HIV
- Resistance to HIV Medicines
- HIV: Preventing Infections
- HIV: Antiretroviral Therapy (ART)
- Opportunistic Infections in HIV
- HIV: Taking Antiretroviral Drugs
- HIV: Non-Progressors and HIV-Resistant People
- HIV Screening
- HIV and Weight Loss
- HIV and Fatigue
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Infectious Diseases
- Anthrax
- Avian Influenza
- Avoiding Infections in the Hospital
- Bacterial Infections of the Spine
- Bites and Stings: Flu-Like Symptoms
- Boric Acid for Vaginal Yeast Infection
- Caregiving: Reducing Germs and Infection in the Home
- Central Venous Catheter: Flushing
- Chickenpox (Varicella)
- Chickenpox: Preventing Skin Infections
- Chikungunya Fever
- Complicated Urinary Tract Infections
- Complications of Ear Infections
- Cranberry Juice and Urinary Tract Infections
- Dengue Fever
- Ear Infection: Should I Give My Child Antibiotics?
- Ear Infections
- Ebola or Marburg Virus Infection
- Ebola Virus Disease
- Enterovirus D68 (EV-D68)
- Fever or Chills, Age 11 and Younger
- Fever or Chills, Age 12 and Older
- Fever Seizures
- Fever Temperatures: Accuracy and Comparison
- Feverfew for Migraines
- Fifth Disease
- Flu: Signs of Bacterial Infection
- Fungal Nail Infections
- Giardiasis
- Hand-Foot-and-Mouth Disease
- Kissing Bugs
- Measles (Rubeola)
- Middle East Respiratory Syndrome (MERS)
- Molluscum Contagiosum
- Monkeypox
- Mononucleosis (Mono)
- Mononucleosis Complications
- Mumps
- Nail Infection: Should I Take Antifungal Pills?
- Neutropenia: Preventing Infections
- Non-Surgical Nail Removal for Fungal Nail Infections
- Noroviruses
- Pleurisy
- Pneumonia
- Preventing Tetanus Infections
- Pseudomonas Infection
- Recurrent Ear Infections and Persistent Effusion
- Recurrent Vaginal Yeast Infections
- Respiratory Syncytial Virus (RSV) Infection
- Rotavirus
- Rubella (German Measles)
- Scarlet Fever
- Sexually Transmitted Infections
- Sexually Transmitted Infections: Genital Examination for Men
- Sexually Transmitted Infections: Symptoms in Women
- Sexually Transmitted Infections: Treatment
- Shingles
- Smallpox
- Sore Throat and Other Throat Problems
- Staph Infection
- Strep Throat
- Symptoms of Pelvic Infection
- Thrush
- Tick Bites: Flu-Like Symptoms
- Tinea Versicolor
- Tuberculosis (TB)
- Tuberculosis Screening
- Urinary Tract Infections (UTIs) in Older Adults
- Vaginal Yeast Infection: Should I Treat It Myself?
- Vaginal Yeast Infections
- Valley Fever
- West Nile Virus
- Zika Virus
- Informed Health Decisions
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Injuries
- Trapped Finger, Toe, or Limb
- Blister Care
- Exercises for Heel Pain or Tightness
- Broken Toe
- Broken Nose (Nasal Fracture)
- Preventing Blisters
- Hip Fracture
- Medial Collateral Ligament (MCL) Injury
- Pressure Injuries From Scuba Diving
- Pressure Injuries: Stages
- Pressure Injuries: Prevention and Treatment
- Calf Muscle Injury
- Avulsion Fracture
- Lateral Collateral Ligament (LCL) Injury
- Posterior Cruciate Ligament (PCL) Injury
- Frozen or Stuck Tongue or Other Body Part
- Fifth Metatarsal Jones Fracture
- Animal and Human Bites
- Blisters
- Burns and Electric Shock
- Choking Rescue Procedure: Heimlich Manoeuvre
- Cold Temperature Exposure
- Cuts
- Ear Problems and Injuries, Age 11 and Younger
- Elbow Injuries
- Elbow Problems, Non-Injury
- Facial Injuries
- Facial Problems, Non-Injury
- Fish Hook Injuries
- Toe, Foot, and Ankle Injuries
- Groin Problems and Injuries
- Finger, Hand, and Wrist Injuries
- Anterior Cruciate Ligament (ACL) Injuries
- Safe Hand and Wrist Movements
- Physical Rehabilitation for ACL Injuries
- Marine Stings and Scrapes
- Mouth Problems, Non-Injury
- Nail Problems and Injuries
- Puncture Wounds
- Shoulder Problems and Injuries
- Removing Splinters
- Swallowed Button Disc Battery, Magnet, or Object With Lead
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- How a Scrape Heals
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- Types of Chest Injuries
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- Classification of Spinal Cord Injuries
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Joints and Spinal Conditions
- Osteochondritis Dissecans of a Joint
- Back to Work?
- Moving From Sitting to Standing
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- Hip Injuries, Age 11 and Younger
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- Tennis Elbow
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- Scoliosis In Adults
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- Spinal Cord Injury: Your Rehabilitation Team
- Spinal Cord Injury: Talking With Your Partner About Sex
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- Proper Sitting for a Healthy Back
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- Severity of Back Injuries
- Back Problems: Proper Lifting
- Degenerative Disc Disease
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Kidneys
- Acute Kidney Injury Versus Chronic Kidney Disease
- Nephrotic Syndrome
- Uremia
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- Chronic Kidney Disease
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- Anemia of Chronic Kidney Disease
- End-Stage Kidney Failure
- Tolvaptan (Inherited Kidney Disease) - Oral
- Types of Kidney Stones
- Extracorporeal Shock Wave Lithotripsy (ESWL) for Kidney Stones
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- Kidney Stones
- Advance Care Planning: Should I Stop Kidney Dialysis?
- Kidney Disease: Medicines to Avoid
- Stages of Chronic Kidney Disease
- Medicines That Can Cause Acute Kidney Injury
- Donating a Kidney
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Lung and Respiratory Conditions
- Breathing Problems: Using a Metered-Dose Inhaler
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- COPD: Lung Volume Reduction Surgery
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- Respiratory Problems, Age 11 and Younger
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- Breathing Smoke or Fumes
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- COPD's Effect on the Lungs
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- Lung Function in COPD
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- Sarah's Story: Dealing With the Emotions From COPD
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Multiple Sclerosis
- Multiple Sclerosis: Alternative Treatments
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- Multiple Sclerosis: Bladder Problems
- Multiple Sclerosis (MS)
- Types of Multiple Sclerosis
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- Obesity
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Rehabilitation and Exercise
- Breathing Exercises: Using a Manual Incentive Spirometer
- Sensual Exercises for Erection Problems
- Breastfeeding: Exercise and Weight Loss
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- Kegel Exercises
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- Rotator Cuff Problems: Exercises You Can Do at Home
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- ACL Injury: Exercises to Do Before Treatment
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- Good-Health Attitude
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Sexual, Reproductive Health
- Menopause: Should I Use Hormone Therapy (HT)?
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- Sexual Orientation
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Skin, Nails and Rashes
- Hidradenitis Suppurativa
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- Tazarotene (Psoriasis/Acne) - Topical
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Thyroid
- Hyperthyroidism: Should I Use Antithyroid Medicine or Radioactive Iodine?
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British Columbia Specific Information
In British Columbia, people with dementia and their families have access to information and support to make informed choices about their long-term care. First Link® is an early intervention service designed to connect individuals and families affected by Alzheimer's disease or another dementia with services and support as soon as possible after diagnosis. For more information on First Link® visit Alzheimer Society – FirstLink® form referrals.
The Ministry of Health, in collaboration with physicians and nurses from across B.C., has developed the Best Practice Guideline for Accommodating and Managing Behavioural and Psychological Symptoms of Dementia in Residential Care. The guideline includes a useful algorithm and is intended to support health care providers when they provide care and support to people with Alzheimer’s or other dementia and their families.
If you or a loved one are having difficulty coping with activities of daily living because of a health-related problem such as dementia, A Guide to Your Care (PDF 1.66 MB) may help you. The guide has information about home and community care services to help British Columbians live as independently as possible. For additional information on home and community care services in B.C. including care options and cost, who pays for care, eligibility requirements, and how to arrange care, visit the Home & Community Care website.
For more information about health care service delivery, visit The Alzheimer Society's Guidelines for Care: Person-Centred Care of People with Dementia Living in Care Homes Framework (PDF 526 KB), or the British Columbia Psychogeriatric Association's resource Meeting Seniors' Mental Health Care Needs in British Columbia: A Resource Document (PDF 1.66 MB).
Topic Overview
Is this topic for you?
Alzheimer's disease is the most common cause of dementia. This topic focuses on other conditions that cause dementia. For more information on Alzheimer's, see the topic Alzheimer's Disease.
What is dementia?
We all forget things as we get older. Many older people have a slight loss of memory that does not affect their daily lives. But memory loss that gets worse may mean that you have dementia.
Dementia is a loss of mental skills that affects your daily life. It can cause problems with your memory and how well you can think and plan. Usually dementia gets worse over time. How long this takes is different for each person. Some people stay the same for years. Others lose skills quickly.
Your chances of having dementia rise as you get older. But this doesn't mean that everyone will get it.
If you or a loved one has memory loss that is getting worse, see your doctor. It may be nothing to worry about. If it is dementia, treatment may help.
What causes dementia?
Dementia is caused by damage to or changes in the brain. Things that can cause dementia include:
- Alzheimer's disease.
- Strokes, tumours, or head injuries. This type of dementia is called vascular dementia.
- Diseases, such as Parkinson's disease, dementia with Lewy bodies, and frontotemporal dementia.
What are the symptoms?
Usually the first symptom is memory loss. Often the person who has a memory problem doesn't notice it, but family and friends do. As dementia gets worse:
- You may have more trouble doing things that take planning, like making a list and going shopping.
- You may have trouble using or understanding words.
- You may get lost in places you know well.
Over time, people with dementia may begin to act very differently. They may become scared and strike out at others, or they may become clingy and childlike. They may stop brushing their teeth or bathing.
Later, they cannot take care of themselves. They may not know where they are. They may not know their loved ones when they see them.
How is dementia diagnosed?
There is no single test for dementia. To diagnose it, your doctor will:
- Do a physical examination.
- Ask questions about recent and past illnesses and life events. The doctor will want to talk to a close family member to check details.
- Ask you to do some simple things that test your memory and other mental skills. Your doctor may ask you to tell what day and year it is, repeat a series of words, or draw a clock face.
The doctor may do tests to look for a cause that can be treated. For example, you might have blood tests to check your thyroid or to look for an infection. You might also have a test that shows a picture of your brain, like an MRI or a CT scan. These tests can help your doctor find a tumour or brain injury.
How is it treated?
There are medicines you can take for dementia. They cannot cure it, but they can slow it down for a while and make it easier to live with.
As dementia gets worse, a person may get depressed or angry and upset. An active social life, counselling, and sometimes medicine may help with changing emotions.
If a stroke caused the dementia, there are things you can do to reduce the chance of another stroke. Stay at a healthy weight, exercise, and keep your blood pressure and cholesterol at normal levels. If you have diabetes, keep your blood sugar in your target range. If you smoke, cut back and try to quit.
How can you help a loved one who has dementia?
There are many things you can do to help your loved one be safe at home. For example, get rid of throw rugs, and put handrails in washrooms to help prevent falls. Post reminder notes around the house. Put a list of important phone numbers by the telephone. You also can help your loved one stay active. Play cards or board games, and take walks.
Work with your loved one to make decisions about the future before dementia gets worse. Encourage your loved one to make an advance care plan that states how he or she wants to be treated when the dementia gets worse. And have your loved one name a person who will make care decisions if he or she is no longer able to make them (substitute decision-maker).
Watching a loved one slip away can be sad and scary. Caring for someone with dementia can leave you feeling drained. Be sure to take care of yourself and to give yourself breaks. Ask family members to share the load, or get other help.
Your loved one will need more and more care as dementia gets worse. In time, he or she may need help to eat, get dressed, or use the washroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.
You are not alone. Many people have loved ones with dementia. Ask your doctor about local support groups, or search the Internet for online support groups, such as the Alzheimer Society of Canada. Help is available.
Cause
Dementia is caused by damage to or changes in the brain.
Common causes of dementia are:
- Alzheimer's disease. This is the most common cause of dementia.
- Vascular dementia. This may occur in people who have long-term high blood pressure, severe hardening of the arteries, or several small strokes. Strokes are the second most common cause of dementia.
- Parkinson's disease. Dementia is common in people with this condition.
- Dementia with Lewy bodies. It can cause short-term memory loss.
- Frontotemporal dementia, a group of diseases that includes Pick's disease.
- Severe head injury.
Less common causes of dementia include:
- Huntington's disease.
- Leukoencephalopathies, which are diseases that affect the deeper, white-matter brain tissue.
- Creutzfeldt-Jakob disease, a rare and fatal condition that destroys brain tissue.
- Brain injuries from crashes or boxing.
- Some cases of multiple sclerosis (MS) or amyotrophic lateral sclerosis (ALS).
- Multiple-system atrophy (a group of degenerative brain diseases affecting speech, movement, and autonomic functions).
- Infections such as late-stage syphilis. Antibiotics can effectively treat syphilis at any stage, but they cannot reverse the brain damage already done.
Inherited dementia
Some disorders that cause dementia can run in families. Doctors often suspect an inherited cause if someone younger than 50 has symptoms of dementia. For more information, see the topic Alzheimer's Disease.
Symptoms
Symptoms of dementia vary depending on the cause and the area of the brain that is affected. Symptoms include:
- Memory loss. This is usually the earliest and most noticeable symptom.
- Trouble recalling recent events or recognizing people and places.
- Trouble finding the right words.
- Problems planning and carrying out tasks, such as balancing a chequebook, following a recipe, or writing a letter.
- Trouble exercising judgment, such as knowing what to do in an emergency.
- Trouble controlling moods or behaviours. Depression is common, and agitation or aggression may occur.
- Not keeping up personal care such as grooming or bathing.
Some types of dementia cause particular symptoms:
- People who have dementia with Lewy bodies often have highly detailed visual hallucinations. And they may fall frequently.
- The first symptoms of frontotemporal dementia may be personality changes or unusual behaviour. People with this condition may not express any caring for others, or they may say rude things, expose themselves, or make sexually explicit comments.
Symptoms of dementia that come on suddenly suggest vascular dementia or possibly delirium, which is short-term confusion caused by a new or worsening illness.
It is important to know that memory loss can be caused by conditions other than dementia, such as depression, and that those conditions can be treated. Also, occasional trouble with memory (such as briefly forgetting someone's name) can be a normal part of aging. But if you are worried about memory loss or if a loved one has memory loss that is getting worse, see your doctor.
What Happens
How quickly dementia progresses depends on what is causing it and the area of the brain that is affected. Some types of dementia progress slowly over several years. Other types may progress more rapidly. If vascular dementia is caused by a series of small strokes, the loss of mental skills may be gradual. If it is caused by a single stroke in a large blood vessel, loss of function may occur suddenly.
The course of dementia varies greatly from one person to another. Early diagnosis and treatment with medicines may help for a while. Even without these medicines, some people remain stable for months or years, while others decline rapidly.
Many people with dementia are not aware of their mental decline. They may deny their condition and blame others for their problems. Those who are aware may mourn their loss of abilities and become hopeless and depressed.
Depending on the type of dementia, the person's behaviour may eventually become out of control. The person may become angry, agitated, and combative or clingy and childlike. He or she may wander and become lost. These problems can make it difficult for family members or others to continue providing care at home. Hospice palliative care can offer families a lot of support and assistance, which is why getting hospice palliative care early is so important.
For more information on how hospice palliative care can help people and family coping with dementia, see the topic Hospice Palliative Care.
Even with the best care, people with dementia tend to have a shorter lifespan than the average person their age. The progression varies depending on the disease causing the dementia and whether the person has other illnesses such as diabetes or heart disease. Death usually results from lung or kidney infections caused by being bedridden.
For more information on decisions you may face as your loved one's condition progresses, see the topic Care at the End of Life.
What to think about
Many older people have a slight loss of mental skills (usually recent memory) that doesn't affect their daily functioning. This is called mild cognitive impairment by some. People who have mild impairment may be in the early stage of dementia, or they may stay at their present level of ability for a long time.
What Increases Your Risk
Aging is the main risk factor for all types of dementia. Some diseases that cause dementia (such as early-onset Alzheimer's disease and some frontotemporal dementias) may run in families.
You have a greater chance of developing vascular dementia if you:
- Are male.
- Have high blood pressure.
- Have had a heart attack.
- Have atherosclerosis, a buildup of fat and calcium in the arteries, which can lead to coronary artery disease.
- Have diabetes.
- Have high cholesterol.
- Have had a stroke or transient ischemic attack (TIA).
When should you call your doctor?
Call 9-1-1 or other emergency services immediately if signs of a stroke or transient ischemic attack (TIA) develop suddenly. These may include:
- Numbness, weakness, or inability to move the face, arm, or leg, especially on one side of the body.
- Vision problems in one or both eyes, such as dimness, blurring, double vision, loss of vision, or feeling like a shade is being pulled down over your eyes.
- Confusion, or trouble speaking or understanding.
- Trouble walking, dizziness, or loss of balance or coordination.
- Severe headache with no known cause.
Call a doctor now if a person suddenly becomes confused or emotionally upset or doesn't seem to know who or where they are. These are signs of delirium, which can be caused by a reaction to medicines or a new or worsening medical condition.
Call a doctor if you or a person you are close to has new and troubling memory loss that is more than an occasional bout of forgetfulness. This may be an early sign of dementia.
Watchful waiting
Occasional forgetfulness or memory loss can be a normal part of aging. But any new or increasing memory loss or problems with daily living should be reported to a doctor. Learn the warning signs of dementia, and talk to a doctor if you or a family member shows any of these signs. They include increased trouble finding the right words when speaking, getting lost going to familiar places, and acting more irritable or suspicious than usual.
Examinations and Tests
Doctors diagnose the cause of dementia by asking questions about the person's medical history and doing a physical examination, a mental status examination, and lab and imaging tests.
Tests can help the doctor learn whether the loss of mental abilities is caused by a treatable condition. Even for causes that cannot be treated, knowing the type of dementia a person has can help the doctor prescribe medicines or other treatments that may improve mood and behaviour and help the family.
Medical history
During a medical history and physical examination, the doctor will ask the affected person and a close relative or partner about recent illnesses or other life events that could cause memory loss or other symptoms such as behavioural problems. The doctor may ask the person to bring in all medicines he or she takes. This can help the doctor find out if the problem might be caused by the person being overmedicated or having a drug interaction.
Although a person may have more than one illness causing dementia, symptoms sometimes can distinguish one form from another. For example, early in the course of frontotemporal dementia, people may display a lack of social awareness and develop obsessions with eating.
Mental status examination
A doctor or other health professional will conduct a mental status examination. This test usually involves such activities as having the person tell what day and year it is, repeat a series of words, draw a clock face, and count back from 100 by 7s.
Lab tests
Many medical conditions can cause mental impairment. During a physical examination, the doctor will look for signs of other medical conditions and have lab tests done to find any treatable condition. Routine tests include:
- Thyroid hormone tests to check for an underactive thyroid.
- Vitamin B12 blood test to look for a vitamin deficiency.
Other lab tests that may be done include:
- Complete blood count, or CBC, to look for infections.
- ALT or AST, blood tests that check liver function.
- Chemistry screen to check the level of electrolytes in the blood and to check kidney function.
- Glucose test to check the level of sugar in the blood.
- HIV testing to look for AIDS.
- Erythrocyte sedimentation rate, a blood test that looks for signs of inflammation in the body.
- Toxicology screen, which examines blood, urine, or hair to look for drugs that could be causing problems.
- Antinuclear antibodies, a blood test used to diagnose autoimmune diseases.
- Testing for heavy metals in the blood, such as a lead test.
- A lumbar puncture to test for certain proteins in the spinal fluid. This test may also be done to rule out other causes of symptoms.
Imaging tests
Brain imaging tests such as CT scans and MRI may also be done to make sure another problem isn't causing the symptoms. These tests may rule out brain tumours, strokes, normal-pressure hydrocephalus, or other conditions that could cause a loss of mental abilities.
MRI and CT scans can also show evidence of strokes that may have caused vascular dementia.
Single photon emission CT (SPECT) and PET scan can help identify several forms of dementia, including vascular dementia and frontotemporal dementia.
Other tests
In some cases, electrical activity in the brain may be measured using an electroencephalogram (EEG). Doctors seldom use this test to diagnose dementia, but they may use it to distinguish dementia from delirium and to look for unusual brain activity found in Creutzfeldt-Jakob disease, a rare cause of dementia.
After death
After death, an autopsy may be done to find out for sure what caused dementia. This information may be helpful to family members concerned about genetic causes.
Treatment Overview
Medicines may slow down dementia, but they don't cure it. They may help improve mental function, mood, or behaviour.
Hospice palliative care
Your doctor will work with you and your caregivers to develop a plan to make life easier and more comfortable. This is a good time to ask for information on local hospice palliative care programs.
Hospice palliative care can help improve quality of life for the caregivers and for the person with dementia long before end of life. It's different from care to cure the illness. Its goal is to improve quality of life—not just in body but also in mind and spirit. For more information, see the topic Hospice Palliative Care.
Care may include:
- Tips to help the person be independent and manage daily life as long as possible. For more information, see Home Treatment.
- Medicine. While medicines cannot cure dementia, they may help improve mental function, mood, or behaviour.
- Support and counselling. A diagnosis of dementia can create feelings of anger, fear, and anxiety. A person in the early stage of the illness should seek emotional support from family, friends, and perhaps a counsellor experienced in working with people who have dementia.
Planning for the future
If possible, make decisions while your loved one is able to take part in the decision making. These are difficult but important conversations. Questions include:
- What kind of care does he or she need right now?
- Who will take care of him or her in the future?
- What can the family expect as the disease progresses?
- What kind of financial and legal planning needs to be done?
Education of the family and other caregivers is critical to successfully caring for someone who has dementia. If you are or will be a caregiver, start learning what you can expect and what you can do to manage problems as they arise. For more information, see Home Treatment.
Treatment as dementia gets worse
The goal of ongoing treatment for dementia is to keep the person safely at home for as long as possible and to provide support and guidance to the caregivers.
Routine follow-up visits to a health professional (every 3 to 6 months) are necessary to monitor medicines and the person's level of functioning.
Eventually, the family may have to consider whether to place the person in a care facility that has a dementia unit.
Taking care of a person with dementia is stressful. If you are a caregiver, seek support from family members or friends. Take care of your own health by getting breaks from caregiving. Counselling, a support group, and adult day care or respite care can help you through stressful times and bouts of burnout.
Prevention
Dementia is hard to prevent, because what causes it often is not known. But people who have dementia caused by stroke may be able to prevent future declines by lowering their risk of heart disease and stroke. Even if you don't have these known risks, your overall health can benefit from these strategies:
- Treat or prevent high blood pressure.
- Don't smoke.
- Stay at a healthy weight. This also reduces your risk of diabetes, another risk factor for dementia.
- Keep your cholesterol in the normal range.
- Get plenty of exercise.
- Stay mentally alert by learning new hobbies, reading, or solving crossword puzzles.
- Stay involved socially. Attend community activities, church, or support groups.
- If your doctor recommends it, take aspirin.
Home Treatment
Home treatment for dementia involves teamwork among health professionals and caregivers to create a safe and comfortable environment and to make tasks of daily living as easy as possible. People who have mild dementia can be involved in planning for the future and organizing the home and daily tasks.
Tips for caregivers
Work with the team of health professionals to:
- Make sure your home is safe.
- Keep the person eating well.
- Manage bladder and bowel control problems.
- Manage driving privileges.
The team can also help you learn how to manage behaviour problems. For example, you can learn ways to:
- Make the most of remaining abilities. Reinforce and support the person's efforts to remain independent, even if tasks take more time or aren't done perfectly.
- Help the person avoid confusion.
- Understand behaviour changes.
- Manage agitation.
- Manage wandering.
- Communicate clearly.
Caregivers should remember to seek support from other family and friends. For more information, see the topic Caregiver Tips.
Nursing home placement
Even with the best care, a person with progressive dementia will decline, perhaps to the point where the caregiver is no longer physically, emotionally, or financially able to provide care.
Making the decision about nursing home placement is often very difficult. Every family needs to consider its own financial situation, emotional capacity, and other issues.
Medications
Doctors use medicines to treat dementia in the following ways:
- To maintain mental functioning for as long as possible
- To prevent further strokes in people who have dementia caused by stroke (vascular dementia)
- To manage mood or behaviour problems, such as depression, insomnia, hallucinations, and agitation
Medicine choices
Medicines to help maintain mental function
- Cholinesterase inhibitors such as donepezil, galantamine, and rivastigmine.
- These drugs were developed to treat Alzheimer's disease, but they may be tried in other dementias, especially vascular dementia.
- It is not clear how long these medicines will work.
- Side effects include nausea, vomiting, diarrhea, and weight loss.
- Memantine. This medicine is used to treat symptoms of Alzheimer's disease, but may also help with mild to moderate vascular dementia.
Medicines to help control mood or behaviour problems
Many behaviour problems can be managed without medicines. For more information, see Home Treatment.
In some cases, the doctor may prescribe:
- Antipsychotic drugs , such as olanzapine (Zyprexa) and risperidone (Risperdal).
- Antidepressants, especially selective serotonin reuptake inhibitors.
Medicines to prevent future strokes
- The doctor may prescribe medicines for high blood pressure and high cholesterol, since these conditions are risk factors for vascular dementia. These drugs can't reverse existing dementia, but they may prevent future strokes and heart disease that can lead to further brain damage.
For more information, see the topics:
- High Blood Pressure.
- High Cholesterol.
- Transient Ischemic Attack (TIA).
Other Treatment
- Ginkgo biloba. Many people take ginkgo biloba to improve or preserve memory. But studies have not shown that ginkgo biloba helps improve memory or prevent dementia.footnote 1
- Other medicines. Research is ongoing to look at the usefulness of non-steroidal anti-inflammatory drugs (NSAIDS), cholesterol-lowering drugs (statins), antioxidants, and natural health products such as citicoline. Be safe with medicines. Read and follow all instructions on the label.
- Reality orientation. People who have dementia may benefit from a structured group program that encourages them to focus on a variety of topics and to think creatively within their limits. This type of program, sometimes called reality orientation or cognitive stimulation therapy, is offered in some daycare and residential settings.
- Validation therapy. A person who has dementia may say things that don't make sense. A caregiver's response may be to correct or disagree with him or her. This can be frustrating for everyone. Validation therapy is a way to talk to someone with empathy. It can help to give the person with dementia a feeling of control or calmness. It recognizes his or her feelings and emotions.
- Occupational therapy. Occupational therapists focus on a person's ability to perform daily tasks and take part in social activities.
Related Information
References
Citations
- Birks J, Grimley Evans J (2009). Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews (1).
Other Works Consulted
- Birks J, Grimley Evans J (2009). Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews (1).
- Bourgeois JA, et al. (2008). Delirium, dementia, and amnestic and other cognitive disorders. In RE Hales et al., eds., American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 303–363. Washington DC: American Psychiatric Publishing.
- Butler R, Radhakrishnan R (2012). Dementia, search date July 2011. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
- Drugs for cognitive loss and dementia (2010). Medical Letter on Drugs and Therapeutics: Drugs of Choice, 8(91): 19–24.
- U.S. Preventive Services Task Force (2003). Screening for dementia: Recommendation and rationale. Available online: http://www.uspreventiveservicestaskforce.org/3rduspstf/dementia/dementrr.htm.
Credits
Current as of: June 16, 2021
Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD - Internal Medicine
Donald Sproule MDCM, CCFP - Family Medicine
Kathleen Romito MD - Family Medicine
Peter J. Whitehouse MD - Neurology
Myron F. Weiner MD - Psychiatry, Neurology
Current as of: June 16, 2021
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Donald Sproule MDCM, CCFP - Family Medicine & Kathleen Romito MD - Family Medicine & Peter J. Whitehouse MD - Neurology & Myron F. Weiner MD - Psychiatry, Neurology
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Alzheimer Society of British Columbia: First Link Dementia Helpline
The First Link® Dementia Helpline is for anyone affected by dementia, whether professionally or personally. If you have questions about Alzheimer's disease or other dementias, call the Alzheimer Society of B.C.'s First Link® Dementia Helpline for information and support (toll-free):
- English: 1-800-936-6033 (Monday to Friday, 9 a.m. to 8 p.m.)
- Cantonese and Mandarin: 1-833-674-5007 (Monday to Friday, 9 a.m. to 4 p.m.)
- Punjabi: 1-833-674-5003 (Monday to Friday, 9 a.m. to 4 p.m.)
For more information on First Link® visit: