Dementia or a Curable Memory Problem?

Dementia affects 4-5 million people in the United States today and up to 50% of people aged 85 or older will be diagnosed with some form of dementia. Dementia is the leading reason for placement of patients in nursing homes and greatly affects a persons’ quality of life. Home health care therapists treat many patients diagnosed with dementia. Understandably, most of these individuals are considered poor rehabilitation candidates since many forms of dementia are progressive and symptoms are not reversible. Home health clinicians have an advantage of observing their patient in their natural surroundings with their everyday schedules and activities. They are more inclined to pick up on certain aspects of mind lapses that would give clues to other forms of dementia which may be treatable.

Treatable Memory Conditions

Normal Pressure Hydrocephalus (NPH) has dementia symptoms but can be treated and the symptoms, reversed. Unfortunately, many clinicians are unfamiliar with NPH and it is often overlooked as a potential diagnosis. It is estimated that 5 – 10% of patients diagnosed with dementia actually have NPH.

NPH can occur at any age, but is most common in adults over 60 years old. The symptoms of NPH can be similar to Parkinson disease and Alzheimer disease, which may lead to misdiagnoses. There are three primary symptoms of NPH which home health clinicians would have an advantage in diagnosing given their involvement with the patient in their normal surroundings. The three symptoms are: abnormal gait, urinary incontinence, and dementia. The lower extremities, the bladder, and mental processes such as memory, speech and problem solving are most often affected. The walking problems that occur with NPH occur often as a shuffling gait. The symptoms develop slowly with the walking problem occurring first and the confusion occurring later.Hydrocephalus is a condition where the ventricles enlarge and press on parts of the brain due to an excess cerebral spinal fluid (SCF). CSF circulates around the brain and spinal cord, cushioning and bringing nutrients to the cells of the brain and spinal cord. Normally, excess CSF drains into the bloodstream and fresh CSF is produced. NHP presents similar to hydrocephalus with a slower onset and lower CSF pressure than many forms of hydrocephalus. There is an increase in subarachnoid space volume, but this does not accompany an increase in ventricular volume. Distortion of the central portion of …The dementia from NPH results from the distortion of the periventricular limbic system There are several tests that can be used to determine the diagnosis of NHP. A test including an MRI, CT scan lumbar puncture and cisternography. It is still difficult to diagnosis and a consultation with a neurologist is recommended.