“Senior moments” are a lighthearted excuse for memory gaps. Sometimes I think we expect all old people to eventually lose their cognitive function. This doesn't have to be the case. There are many types of dementia, and sometimes early detection and treatment can make all the difference.
Neurodegenerative disorders have limited treatment options, which are primarily focused on managing the symptoms. They tend to progress slowly and inexorably. Immunologically mediated dementias, on the other hand, progress rapidly and are readily treatable. Thus it is very important to get the right diagnosis for yourself or your family members.
Dementia caused by immune processes are divided, somewhat arbitrarily, into two categories: one, those associated with specific antigens and antibodies that have been identified, two, those associated with cellular inflammation, but without clearly identified antigens and antibodies. Specific types include:
1. Hashimoto's encephalopathy. This is associated with antibodies to thyroid products. Patients may have hyperthyroidism, hypothyroidism, or normal thyroid function. Many of them have other autoimmune disease as well.
2. Anti-glutamic acid decarboxylase antibody syndrome. This is associated with diabetes and other disorders, including neurological disease.
3. Gluten-sensitivity dementia. This is one of the manifestations of gluten sensitivity, which improves on a gluten-free diet.
4. Sjogren's encephalopathy. This is associated with some cases of Sjogren's syndrome, which is characterized by dry eyes and dry mouth.
5. Systemic lupus erythematosus. This autoimmune disease is a multi-organ inflammatory condition which includes neurological symptoms in 60-75 percent of patients.
6. Sarcoidosis. About 25 percent of patients have inflammatory neurologic symptoms.
7. Behcet's disease. Neurologic symptoms are reported in five to 50 percent of patients.
8. Primary angiitis of the central nervous system. This is a rare but serious autoimmune disease of the blood vessels in the brain.