Dementia

Abstract

Dementia refers to a group of underlying diseases which result in general symptoms of memory loss, issues with problem solving, and difficulties with language. While memory decline can be a natural part of aging, dementia indicates a progression of memory loss which is more severe than what is considered a normal part of the aging process. The most common cause of dementia symptoms is Alzheimer's disease, though dementia can also be caused by Lewy body disease, Parkinson's disease, and stroke. Dementia can also be mixed, indicating that more than one underlying disease is causing the dementia symptoms. Furthermore, aging populations may be diagnosed with mild cognitive impairment (MCI), which is seen as a stepping‐stone between normal cognitive decline and dementia, though not all who develop MCI will go on to meet the criteria for a dementia diagnosis. These issues create several challenges for clinicians to be able to properly diagnose dementia and underlying causes, which can lead to uncertainty for patients, caregivers, and even clinicians. This becomes further complicated by lack of patient‐centered and effective communication about dementia from the clinician. A timely diagnosis of dementia is important so that patients and their loved ones can engage in advance care planning, and particularly advance care planning that reflects the patients' wishes. Finally, as patient symptoms become more progressed, it is important for clinicians to balance the needs of the caregiver and patient during medical appointments by maintaining patient autonomy but also receiving or confirming correct information from the caregiver.