Dementia

Why Choose UT Southwestern for Dementia Care?

We evaluate and treat people with all types of dementia, from mild cognitive impairment to Alzheimer’s disease. With advanced training and experience, we focus on the unique cognitive, social, and mental health needs of older patients.

We provide compassionate care for the whole person – mind, body, and spirit. Our team includes providers from numerous specialties – neurologists, neuropsychologists, geriatric psychiatrists, psychiatric physician assistants, psychiatric nurse practitioners, and social work therapists – and we can refer patients to physical and occupational therapists and speech/cognitive therapists as needed.

Our team provides outpatient services and treatments for people who have dementia. We offer neuropsychological, psychiatric, and behavioral health care, which includes:

• Comprehensive neuropsychological and psychiatric evaluation and diagnosis
• Medications to treat symptoms of dementia and related conditions

What Are the Types of Dementia UT Southwestern Treats?

Dementia occurs when damage to certain areas of the brain affects thinking functions such as memory, reasoning, and communication, resulting in confusion, difficulty with problem-solving, and other altered judgment states. Types of dementia include:

• Alzheimer’s disease: Alzheimer’s disease disrupts connections between brain cells. It is the most common form of dementia and accounts for 60%-80% of cases. This type is caused by pathological accumulation of amyloid-beta and tau proteins in the brain.
• Vascular dementia: Strokes or other conditions can reduce or block blood flow to the brain, causing various symptoms depending on the area of tissue damage. Vascular dementia makes up about 10% of cases and is the second most common type of dementia.
• Lewy body dementia: An abnormal protein buildup, called Lewy bodies, blocks production of specific brain chemicals that are important for memory, thinking, behavior, and other functions.
• Frontotemporal dementia: The brain’s frontal and temporal (side) lobes shrink, and connections between their nerve cells break down. This type of dementia causes difficulty with language and changes in personality and behavior.
• Mild cognitive impairment: Although not a true dementia, this disorder has similar symptoms that are less severe. People who have mild cognitive impairment can still take care of themselves and do their usual activities.
• Mixed dementia: Some people can have more than one type of dementia.

What Are the Signs and Symptoms of Dementia?

The signs and symptoms of dementia vary depending on the type, cause, and areas of the brain they affect. Dementia often starts with mild symptoms that become worse over time.

Symptoms of early dementia include:

• Difficulty with tasks that require thought but used to come easily, such as paying bills, playing games, and learning new information or routines
• Misplacement of often-used items
• Inability to find their way around in familiar areas
• Loss of interest in activities they used to enjoy
• Language problems, such as difficulty remembering names of familiar objects
• Personality changes and loss of social skills, which can lead to inappropriate behaviors
• Mood changes, which can lead to aggressive behavior
• Poor performance of job duties

In its later stages, dementia can cause signs and symptoms such as:

• More difficulty reading, writing, speaking, and understanding and expressing thoughts, such as using wrong words or repeating questions
• Difficulty with basic tasks, such as preparing meals or choosing clothing
• Forgetfulness about details of current events or events in their own life
• Changes in sleep patterns, such as waking up often during the night
• Poor judgment, confusion, and loss of ability to recognize danger
• Depression and social withdrawal
• Arguments, agitation, and violent behavior
• Hallucinations, delusions, and paranoia
• Problems with balance, coordination, and movement

Signs of severe (late-stage) dementia include:

• Inability to do the activities of daily living, such as eating, dressing, and bathing
• Inability to recognize family members
• Difficulty understanding language
• Loss of bladder and bowel control (incontinence)

How Is Dementia Diagnosed?

It can be challenging to diagnose dementia, because many signs and symptoms are similar among the types. That’s why it’s important for people to see a licensed mental health specialist with experience in diagnosing these disorders. At UT Southwestern, our psychiatrists and psychologists have years of experience in distinguishing the signs to confirm a diagnosis.

We carefully evaluate each patient, beginning with a:

• Discussion of symptoms, personal medical history, and family medical history
• Physical exam
• Cognitive and neuropsychological evaluation to determine thinking abilities such as memory, attention, reasoning, judgment, and orientation to place and time
• Psychiatric evaluation to screen for mental health conditions and assess cognitive and social functioning

Depending on the symptoms, additional diagnostic tests may be needed, such as:

• Lab tests to check the blood or cerebrospinal fluid (CSF, the fluid that surrounds the brain and spine) for physical causes of symptoms
• Neuropsychological evaluation to assess memory, language, visual perception, movement, senses, balance, reflexes, and other abilities
• Computed tomography (CT) scans or magnetic resonance imaging (MRI) to check for signs of brain conditions such as a stroke or tumor
• Positron emission tomography (PET) scans to see patterns of brain activity and check for signs of protein buildup in the brain

How Is Dementia Treated?

Based on test results and our evaluation, we tailor a treatment plan to each patient’s needs. Our team of dementia specialists works closely with patients and their families to monitor and adjust treatments and provide caregiver support.

In some cases, dementia-like symptoms stem from reversible causes that may be treated to restore cognitive function. Some underlying causes of dementia that can be treated include:

• Medication side effects
• Deficiency of certain vitamins, such as some B vitamins, copper, and vitamin E
• Infections
• Thyroid disease or an imbalance of thyroid hormone
• Subdural hematomas (bleeding between the brain’s surface and its covering)
• Brain tumors
• Normal pressure hydrocephalus, a buildup of CSF in the brain’s ventricles (fluid-filled spaces)

Most types of dementia cannot be cured, but treatment can improve patients’ daily functioning and quality of life. Treatment can relieve dementia symptoms for a short time or slow their progression.

Our treatments and services for dementia include:

• Medications for dementia symptoms to improve the activity of brain chemicals involved in memory, thinking, learning, behavior, and other functions
• Medications for other symptoms such as depression, sleep disorders, hallucinations, or agitation
• Psychotherapy for patients with a neurocognitive disorder and their caregivers to improve quality of life
• Support groups for caregiver support and for patients with early dementia to share experiences