Skip to main content

Advertisement

SpringerLink
Log in

The Diagnosis and Management of Reversible Dementia Syndromes

  • Dementia (J Pillai, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of Review

This article discusses the diagnostic evaluation and management of reversible dementia syndromes. It highlights clinical syndromes and explores the recent literature implicating certain reversible factors in Alzheimer’s disease pathogenesis.

Recent Findings

The prevalence of fully reversible dementia is low, but there is growing awareness for potentially reversible contributors to neurodegenerative disease. In particular, exposure to anticholinergic medications, obstructive sleep apnea, and depression have emerged as potentially modifiable targets in the pathogenesis of preclinical and early Alzheimer’s disease. Treatment of these factors may not only reverse any direct cognitive effects but also prevent downstream neurodegeneration.

Summary

There is substantial opportunity to improve outcome in patients with dementia due to reversible etiologies. Even in the setting of primary neurodegenerative disease, conscientious effort is required to recognize and address reversible contributors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References and Recommended Reading

  1. Wagner-Jauregg J. The treatment of dementia paralytica by malaria inoculation. 1927.

    Google Scholar 

  2. Clarfield AM. The decreasing prevalence of reversible dementias. 2003;2219–2229.

  3. Sansing LH, Tüzün E, Ko MW, Baccon J, Lynch DR, Dalmau J. A patient with encephalitis associated with NMDA receptor antibodies. Nat Clin Pract Neuro. 2007;3:291–6.

    Article  Google Scholar 

  4. Day GS. Reversible Dementias. CONTINUUM. 2019.

  5. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. Jama Intern Med. 2015;175:401–7.

    Article  Google Scholar 

  6. Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic drug exposure and the risk of dementia. Jama Intern Med. 2019;179:1084–93.

    Article  Google Scholar 

  7. 1 CRB, 2 DP, 2 RP, 1 RN, 1 SB. Alzheimer’s disease and sleep disturbances: a review. 2019;77:815–824.

  8. Y-ES J, Ooms SJ, Sutphen C, Macauley SL, Zangrilli MA, Jerome G, et al. Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain. 2017;140:2104–11.

    Article  Google Scholar 

  9. Lucey BP, Hicks TJ, McLeland JS, Toedebusch CD, Boyd J, Elbert DL, et al. Effect of sleep on overnight cerebrospinal fluid amyloid β kinetics. Ann Neurol. 2018;83:197–204.

    Article  CAS  Google Scholar 

  10. Ancoli-Israel S, Palmer BW, Cooke JR, Corey-Bloom J, Fiorentino L, Natarajan L, et al. Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study. J Am Geriatr Soc. 2008;56:2076–81.

    Article  Google Scholar 

  11. Cooke JR, Ayalon 5; Liat, Palmer PhD 2; BW, Loredo PhD 2; JS, Corey-Bloom 5; Jody, Natarajan 5; Loki, et al. Sustained use of cpap slows deterioration of cognition, sleep, and mood in patients with Alzheimer’s disease and obstructive sleep apnea: a preliminary study. 2009;5:305–9.

  12. Troussière A-C, Charley CM, Salleron J, Richard F, Delbeuck X, Derambure P, et al. Treatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer’s disease. J Neurology Neurosurg Psychiatry. 2014;85:1405.

    Article  Google Scholar 

  13. Ou NY, Tan CC, Shen NX, et al. Blood pressure and risks of cognitive impairment and dementia. Hypertension. 2020;76:217–25.

    Article  CAS  Google Scholar 

  14. Gatchel JR, Donovan NJ, Locascio JJ, Schultz AP, Becker JA, Chhatwal J, et al. Depressive symptoms and tau accumulation in the inferior temporal lobe and entorhinal cortex in cognitively normal older adults: a pilot study. J Alzheimer’s Dis. 2017;Preprint:1–11.

  15. Babulal GM, Ghoshal N, Head D, Vernon EK, Holtzman DM, Benzinger TLS, et al. Mood changes in cognitively normal older adults are linked to Alzheimer disease biomarker levels. Am J Geriatric Psychiatry. 2016;24:1095–104.

    Article  Google Scholar 

  16. Donovan NJ, Locascio JJ, Marshall GA, Gatchel J, Hanseeuw BJ, Rentz DM, et al. Longitudinal association of amyloid beta and anxious-depressive symptoms in cognitively normal older adults. Am J Psychiat. 2018;175:530–7.

    Article  Google Scholar 

  17. Krell-Roesch J, Lowe VJ, Neureiter J, Pink A, Roberts RO, Mielke MM, et al. Depressive and anxiety symptoms and cortical amyloid deposition among cognitively normal elderly persons: the Mayo Clinic Study of Aging. Int Psychogeriatr. 2018;30:245–51.

    Article  Google Scholar 

  18. Gatchel JR, Rabin JS, Buckley RF, Locascio JJ, Quiroz YT, Yang H-S, et al. Longitudinal association of depression symptoms with cognition and cortical amyloid among community-dwelling older adults. Jama Netw Open. 2019;e198964:2.

    Google Scholar 

  19. Komaroff AL. Can Infections Cause Alzheimer Disease? Jama. 2020;324:239.

    Article  Google Scholar 

  20. Itzhaki RF, Golde TE, Heneka MT, Readhead B. Do infections have a role in the pathogenesis of Alzheimer disease? Nat Rev. Neurol. 2020;16:193–7.

    Article  Google Scholar 

  21. Itzhaki RF. Corroboration of a major role for herpes simplex virus type 1 in Alzheimer’s disease. Front Aging Neurosci. 2018;10:324.

    Article  CAS  Google Scholar 

  22. Sechi E, Flanagan EP. Diagnosis and management of autoimmune dementia. Curr Treat Option Ne. 2019;21:11.

    Article  Google Scholar 

  23. Zhou JY, Xu B, Lopes J, Blamoun J, Li L. Hashimoto encephalopathy: literature review. Acta Neurol Scand. 2017;135:285–90.

    Article  CAS  Google Scholar 

  24. Neurosyphilis RAH. New Engl J Med. 2019;381:1358–63.

    Article  Google Scholar 

  25. Finney AK. GR. Reversible dementias. International Review of Neurobiology. 2009:283–302.

  26. Sutter R, Semmlack S, Kaplan PW. Nonconvulsive status epilepticus in adults — insights into the invisible. Nat Rev. Neurol. 2016;12:281–93.

    Article  CAS  Google Scholar 

  27. Isaacs AM, Williams MA, Hamilton MG. Current update on treatment strategies for idiopathic normal pressure hydrocephalus. Curr Treat Option Ne. 2019;21:65.

    Article  Google Scholar 

  28. Engelen M, Westhoff D, Gans J de, Nederkoorn PJ. A 64-year old man presenting with carotid artery occlusion and corticobasal syndrome: a case report. J Medical Case Reports. 2011;5:357.

  29. Asadi-Pooya AA. Transient epileptic amnesia: a concise review. Epilepsy Behav. 2014;31:243–5.

    Article  Google Scholar 

  30. Towne AR, Waterhouse EJ, Boggs JG, Garnett LK, Brown AJ, Smith JR, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. 2000;54.

  31. Miyaji Y, Koyama K, Kurokawa T, Mitomi M, Suzuki Y, Kuroiwa Y. Vascular corticobasal syndrome caused by unilateral internal carotid artery occlusion. J Stroke Cerebrovasc Dis. 2013;22:1193–5.

    Article  Google Scholar 

  32. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Db Syst Rev. 2015;4:CD006489.

    Google Scholar 

  33. Li C, Friedman B, Conwell Y, Fiscella K. Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people. J Am Geriatr Soc. 2007;55:596–602.

    Article  Google Scholar 

  34. Panel B the 2019 AGSBCUE. American Geriatrics Society 2019 Updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67:674–694.

  35. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimer’s Dementia. 2015;11:718–26.

    Article  Google Scholar 

  36. K S MH, R W CJ, T T EC. Speech-language pathologist interventions for communication in moderate–severe dementia: a systematic review. Am J Speech Lang Pathol. 2018;27:836–52.

    Article  Google Scholar 

Download references

Funding

This paper represents independent research in part supported by the National Institute of Health (NIH) grant number P30AG062429.

Author information

Authors and Affiliations

  1. Brain Health and Memory Disorders Clinic, Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, 0949, La Jolla, CA, 92093-0949, USA

    Elizabeth A. Bevins MD, PhD, Jonathan Peters MD & Gabriel C. Léger MD

Authors
  1. Elizabeth A. Bevins MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jonathan Peters MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabriel C. Léger MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabriel C. Léger MD.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Dementia

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bevins, E.A., Peters, J. & Léger, G.C. The Diagnosis and Management of Reversible Dementia Syndromes. Curr Treat Options Neurol 23, 3 (2021). https://doi.org/10.1007/s11940-020-00657-x

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11940-020-00657-x

Keywords

Search

Navigation