I’ve been accused of not playing with a full deck. It has been observed that my elevator may not go all the way to the top. Some have even noted that my grasp on reality is tenuous, at best. One thing I do know is that when "senior moments" become more frequent, we are all concerned. Two conditions come immediately to mind: dementia and delirium. Today we will look primarily at dementia and touch on delirium. Next time, a deeper dive into delirium.

Dementia is defined as a loss of brain function that occurs with certain diseases. Many different diseases can cause the set of symptoms we call dementia. Most dementia is degenerative, which means that it is nonreversible. I urge you to take dementia symptoms seriously. Do all that is possible to treat what is treatable, and slow the progression of the rest. You should know that many of these signs of dementia, which is largely not reversible, are also the symptoms of delirium, which is often very reversible if caught early. Do not take anything that follows as inevitable, but do take it seriously and get to your primary care provider promptly. Even for those who have an underlying condition causing dementia, a sudden worsening of symptoms could be a treatable condition layered on top of dementia.

What causes dementia? Hang on, here comes a list!

Common nonreversible causes of dementia include Alzheimer’s disease, poor blood flow to the brain with or without a stroke (vascular dementia), Huntington’s disease, brain injury, multiple sclerosis, infections (such as HIV/AIDS, syphilis, and Lyme disease) and Parkinson’s disease.

Would you like a bit of good news? Some causes of dementia may be stopped or reversed if they are found soon enough, including: brain injury, brain tumors, long-term alcohol abuse, changes in blood sugar, sodium, and calcium levels, low vitamin B12 level and other vitamin deficiencies, certain medications (the medication itself or levels that are too high), anemia, thyroid disease, and infections.

As with many diseases, early signs are often mild but can become more pronounced as the disease progresses. Subtle changes are a warning. Sudden changes should be seen as emergencies! Don’t assume all is lost. Get an appointment and find out what’s going on!

What type of changes are we talking about? Common early warning signs of emotional, behavioral, or personality changes could progress to hallucinations, delusions, depression, striking out, and violent behavior.

Early stage language difficulties like having trouble finding the name or word can progress to using the wrong word, pronouncing words incorrectly, speaking in confusing sentences, or becoming completely nonverbal. Dementia often first appears as forgetting words or misplacing objects. It can progress to forgetting recent events or conversations, forgetting details about current events, and eventually forgetting events in one's own life history and losing self-awareness.

Thinking and judgment (cognitive skills) would at first be thought of as a function of memory, but these brain activities require not only retrieving the past but also using that information to speculate about the future and make a plan of action. This is a totally different skill and may show up with or without memory problems. Early symptoms could look like taking longer to do tasks that take some thought, but that used to come easily, such as balancing a checkbook, or learning new routines. As dementia progresses there may come difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving, then difficulty with basic activities of daily living, such as eating, dressing, and bathing.

What kind of tests and treatments would you expect if you go to your primary care provider with these symptoms? Remember those two lists of injuries and disease mentioned above that can cause dementia symptoms? Your medical professional will do what you did when you read those lists. They will compare those lists to your history and your symptoms. Then, as appropriate, they will test you for any that look suspicious. If a cause is treatable, that’s the plan.

What else can you do? You know this list: Eat healthy foods; exercise; quit smoking; control high blood pressure; manage diabetes.

Learn more: I suggest going to uhhospitals.org/Healthy-at-UH for more great health articles. I personally recommend "How stress can improve your brain power," but I may be biased.

Prompt attention to warnings coupled with healthy living can help us heal from the things that can be treated and better cope with those things that cannot.

Do you need a primary care provider? Go to uhhospitals.org

Steven Baldridge, RN, is staff educator at University Hospitals Samaritan Medical Center.