Neurology

Memory and Dementia

Penn neurologists evaluate, diagnose and treat patients with memory and dementia disorders.

Dementia is a term used to describe impairments in thinking that can be caused by various diseases. Alzheimer disease is the most common cause of dementia, but there are many others. One of the most common features of dementia is memory loss. In conjunction with memory loss, other problems usually develop such as impairment of language, vision, judgment and emotional control.

Types of Dementia and Memory Diseases

There are many disorders that cause dementia and cognitive decline.

Common causes of dementia include:

Alzheimer disease

Alzheimer disease is a common cause of dementia that first presents with a change in memory, often occurring in patients 65 and older. Like other dementias, it is caused by the progressive collection of damaging proteins inside of the nerve cells of the brain.

Dementia with Lewy bodies (DLB)

Dementia with Lewy bodies produces changes in judgment and can be accompanied by difficulty with walking and movement. It is caused by the accumulation of Lewy bodies, or proteins that abnormally clump together in brain cells.

Frontotemporal dementia (FTD)

Frontotemporal dementia (FTD) produces changes in language and behavior, and commonly begins at an earlier age (65 or younger). It refers to a group of disorders that causes a progressive loss of brain cells in the frontal and temporal regions of the brain.

Normal pressure hydrocephalus (NPH)

Normal pressure hydrocephalus causes changes in thinking and walking, and can be treated with surgery. It is caused by an increase in fluid in the center of the brain.

Vascular dementia

Vascular dementia is caused by decreased blood supply to the brain due to a blockage or narrowing of arteries. Vascular dementia can develop in those who have suffered a stroke or in individuals with hypertension.

Other, less frequent causes of changes in memory and thinking include genetic diseases, inflammatory conditions, hormonal and vitamin deficiencies, and infections.

Diagnosing Dementia

It is common for those in the early stages of dementia to show few signs and symptoms of the condition. In fact, many people function well and perform everyday tasks as usual. For this reason, dementia can go unnoticed and untreated for several years until significant changes in behavior become apparent. Early diagnosis and intervention is critical because it provides an opportunity to slow the progression of the disease by implementing the latest available treatment options.

There is not one definitive test that confirms whether or not someone has dementia.

A diagnosis is determined through a series of laboratory and imaging tests, a complete medical history and physical examination, and a neuropsychological evaluation. Once a neurologist reviews all of the information and diagnostic testing has been done, a diagnosis can be made.

The following laboratory and imaging tests may be performed to assess whether or not a patient is suffering from dementia:

  • Electroencephalogram (EEG)
  • Genetic testing
  • Lumbar puncture (spinal tap) for examination of cerebrospinal fluid
  • MRI or CT scans of the brain
  • Positron emission tomography (PET)

Treatment for Dementia and Memory Problems

At Penn Neurology, we have one of the largest cognitive neurology groups in the nation offering a level of subspecialty expertise not readily available elsewhere. Our neurologists implement a multi-faceted approach to care, collaborating with other centers and specialists across Penn Medicine to treat the symptoms of dementia.

Those centers include:

At Penn, patients receive individualized treatment plans and the latest treatment options to manage the cognitive and behavioral symptoms caused by dementia.

Treatment options include:

  • Assistance with long-term care planning
  • Caregiver support groups through the Penn Memory Center and FTD Center
  • Medications to slow the progression of Alzheimer and frontotemporal dementia
  • Neurosurgery for normal pressure hydrocephalus
  • Physical and occupational therapy to assist with walking and movement
  • Referral to clinical trials for investigational diagnostic tests and treatments
  • Treatment for the behavioral side effects including disruptions of sleep, disruptions of mood and loss of impulse control

Memory and Dementia Research and Clinical Trials

Our experienced neurologists are physicians, but also are scientists whose research seeks to understand the underlying causes of these diseases and the effects they have on thinking and behavior.

We are committed to optimizing patient outcomes through close collaboration with our affiliated research centers including:

  • The Penn Alzheimer Disease Center (ADC) — The research arm of the Penn Memory Center
  • The Center for Neurodegenerative Disease Research (CNDR) — Promotes and conducts multidisciplinary clinical and basic research studies aimed at increasing our understanding of the causes and mechanisms leading to brain dysfunction and degeneration in:
    • Alzheimer disease (AD), Parkinson disease (PD), and frontotemporal dementia
    • Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
    • Other neurodegenerative disorders that occur more frequently with advancing age
  • Penn Institute on Aging — Research here seeks to improve the health of the elderly by increasing clinical and basic research as well as educational programs that focus on normal aging and age-related diseases
  • Penn Center for Cognitive Neuroscience (CCN) — Researchers at this center are investigating the basic functions of the brain including cognitive and emotional function
  • Frontotemporal Degeneration Center — Conducts research dedicated to the investigation and treatment of early onset neurodegenerative conditions