Ohio State’s Memory Disorders Clinic provides customized services to both patients and their families, including behavioral neurology and neuropsychiatry.

Dementia means that someone has trouble with memory or thinking to such an extent that he or she needs help with performing daily activities. It may be caused by a number of conditions that affect the brain. Dementia is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as cooking or shopping, using their cell phone or even getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there. Not all dementia disorders will cause all of these symptoms.

Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language. Although dementia is common in very elderly people, it is not part of normal aging.

Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down the disease.

Source: NIH: National Institute of Neurological Disorders and Stroke

Why choose Ohio State for treatment of dementia?

The Memory Disorders Clinic at The Ohio State University Wexner Medical Center, established in 1993, is one of Ohio’s most comprehensive centers for research, evaluation, diagnosis and treatment for patients and families affected by dementia. Strengths that distinguish us include:

Assessment Expertise: We developed the cognitive assessment tool, SAGE, used nationwide to detect the early signs of cognitive disorders.

Download our SAGE Test

Cognitive Specialists: Ohio State has the most fellowship-trained cognitive specialists in Ohio. Our four physicians and nurse practitioner bring a high level of skill to diagnosing and treating dementia and addressing the disease’s effects on patients and families. We are experts in behavioral neurology and neuropsychiatry, as well.

Multidisciplinary Care:

  • Our psychometricians perform cognitive and neuropsychological testing to evaluate the brain’s ability to process information and emotion.
  • Our neuroradiologists are experienced in correlating brain images with a patient’s history to come to a better understanding of brain processes and abnormalities.
  • Our social worker works exclusively with patients with memory disorders and their families to tap resources that help people cope with the challenges of their condition.
  • Our pharmacist assists in proper medication use and dosing for patients with memory disorders.
  • Our research coordinators screen and assess patients in clinical trials and are available to answer research questions.

Research: Ohio State conducts more clinical research and clinical trials for dementia – including Alzheimer’s disease – than any other medical center in Ohio. Our patients have more immediate access to the most promising treatments and diagnostic techniques, often long before they are available to the public.

Additionally, we have high-powered magnetic resonance imaging (MRI) and state-of-the-art positron emission tomography (PET) machines that provide highly defined images for research: the 3 Tesla MRI, 7 Tesla MRI and amyloid and tau PET imaging. This equipment produces crisp, high-resolution images at a remarkable level of accuracy.




Types of Dementia

Types of Dementia

Types of Dementia

Vascular dementia, or stroke

Multiple strokes are a common cause of dementia, after Alzheimer’s disease. Over time, the patient becomes neurologically impaired as more parts of the brain are destroyed by strokes. Usually there is a contributing factor, such as a history of hypertension, heart disease, diabetes or cigarette smoking. Physical symptoms include weakness, tremors and difficulty walking.

Memory suffers, depression is frequent and personality changes may occur. Controlling the risk factors of stroke – such as hypertension, diabetes, being overweight, smoking – is critical.

Parkinson's disease with dementia

Parkinson’s disease affects about 1 million Americans. Dementia is obvious in about 40 percent of patients with the disease, while an additional 50 percent have subtle signs of dementia. Dementia is most common in Parkinson’s patients, with noticeable posture problems and walking difficulties. It is least common in patients with characteristic tremors.

Dementia with Lewy bodies

This form of dementia is characterized by Parkinsonism (stiffness and trouble with gait), memory loss and visual processing difficulties. Fluctuations and visual hallucinations are not uncommon. Mental degradation progresses as in people with Alzheimer’s disease. The disease usually appears after age 60. Lewy bodies are collections of abnormal proteins that accumulate in the brain.

Frontotemporal dementia (FTD)

People with this group of disorders have onset typically between 45 and 70 years of age. The disorders are characterized by early personality changes and impairments in decision-making, problem-solving and using good judgment (also called behavioral variant FTD). Some have prominent difficulties in language skills early in the course of the disorder (e.g., primary progressive aphasia, progressive nonfluent aphasia or semantic dementia). Memory impairments are not as prominent as in Alzheimer’s disease.

Normal pressure hydrocephalus

In this condition, cerebrospinal fluid made in the brain is unable to drain properly and builds up, causing problems with memory, imbalanced and slow gait, falls and urinary incontinence. Early diagnosis can lead to a neurosurgical shunting procedure to reverse many of the symptoms. 


Toxic-metabolic dementia

Prescribed drugs can cause dementia. Looking over the patient’s medication regimen may reveal a reversible cause of dementia. Almost any drug can cause problems with mental function, but drugs in the following categories are particularly likely to cause problems: 

  • Analgesics
  • Anticholinergic drugs
  • Anticonvulsants
  • Benzodiazepines

Alcohol dependence can also cause dementia. As a person with alcoholism loses memory capability, his mental processes slow down and his attention span decreases.

Other causes of toxic-metabolic dementia include:

  • Korsakoff’s syndrome, or thiamine deficiency (more common in people with alcoholism)
  • Intoxication by industrial solvents and heavy metals after prolonged exposure
  • Nutritional deficiencies

Infectious dementia

A number of infectious agents can cause dementia in the elderly including bacterial meningitis and Herpes encephalitis. Dementia can also occur with illnesses such as AIDS and Lyme disease.

Depression and dementia

Certain patients with depression may show symptoms similar to dementia. The onset of dementia is gradual, and it is reversible with the successful treatment of the mood disorder. Symptoms include a depressed mood, anxiety or agitation at times, and a slowing of mental processes and forgetfulness. Yet, a patient’s memory usually isn’t affected like that typical of Alzheimer’s patients.

Diagnosis

Diagnosing Dementia

Ohio State has developed the Self-Administered Gerocognitive Exam (SAGE), which is designed to detect early signs of cognitive, memory or thinking impairments. The 15-minute pen and paper test is best completed at the doctor’s office but can be taken anywhere and then submitted to your doctor for scoring. SAGE does not diagnose any specific condition, but the results help your doctor know if further evaluation is necessary. Other diagnostic tools we use include:
  • Mental status testing
  • Neuropsychiatric and neuropsychological assessment
  • Blood and other laboratory tests
  • Imaging studies providing detailed images of the brain to help rule out other conditions with similar symptoms:
    • Computed tomography (CT)
    • Magnetic resonance imaging (MRI)
    • Positron emission tomography (PET) scan, which uses a radioactive substance called a tracer to look for disease or injury in the brain. It also shows how the brain and its tissues are working
  • Physical exam
  • Medical history
  • Interviews with patient and family members

Sometimes medications prescribed for other conditions contribute to dementia. Our physicians are skilled at identifying these drugs and finding alternate treatments that do not cause memory impairment. Sometimes medications prescribed for other conditions contribute to dementia. Our physicians are skilled at identifying these drugs and finding alternate treatments that do not cause memory impairment.

Sometimes medications prescribed for other conditions contribute to dementia. Our physicians are skilled at identifying these drugs and finding alternate treatments that do not cause memory impairment.

Treatment

Treating Dementia

Treatment varies depending on the type of dementia. The Ohio State Memory Disorders team of cognitive neurologists, neuropsychiatrists, nurses, social workers, pharmacists, psychometricians and research coordinators, in association with neuropsychologists and psychiatrists, will create an individualized treatment plan.

Some patients with dementia benefit from medication to prevent symptoms such as declining memory and mental functioning from worsening. Medications we prescribe include:

  • Cholinesterase inhibitors, which help with memory and thinking by slowing the breakdown of an important brain chemical involved in memory functions (e.g., Aricept® [donepezil], Razadyne® [galantamine] and Exelon® [rivastigmine]).
  • NMDA (N-methyl D-aspartate) receptor antagonists specifically memantine, which helps to regulate the abnormal activity of glutamate in the brain, a chemical important for learning and memory (e.g., Namenda®).
  • Antioxidants, such as vitamin E, to boost the body’s natural defense mechanisms against brain cell damage.
  • Medications to help reduce the risk of a stroke.
  • Treatments for those with Parkinsonian symptoms.
  • Medications to help control abnormal behaviors commonly seen in many dementia conditions.

Our pharmacist in the Memory Disorders Clinic can further discuss these medications with you, and our social worker can provide assistance in working with pharmaceutical companies when a patient is unable to afford medicines.

Many people with dementia develop behavioral problems such as agitation, depression, sleep disturbances, restlessness, anxiety, false beliefs and hallucinations. We treat these with medication or environmental and behavioral modification techniques that can lessen and sometimes eliminate these disturbances. We also spend time with caregivers and patients to discuss techniques to reduce stress and conflict with a person who has dementia.

Our social worker specializes in helping people with memory disorders by linking patients and family members to community resources and to options with assisted living, nursing homes and daycare facilities. 

Research

Research

Research at the Ohio State Memory Disorders Research Center is unparalleled in the region for clinical trials in Alzheimer’s, dementia and cognitive issues. Multiple studies are currently underway, sponsored either by Ohio State, the National Institutes of Health or pharmaceutical companies.

Although we have several studies focused solely on Alzheimer’s disease, we have many others geared specifically to other dementing conditions:

Dementia with Lewy bodies genetic study: Ohio State is looking for new genetic markers that will help identify people at risk for developing the disease. This knowledge will be beneficial as treatments are developed to prevent the disease.

Dementia with Lewy bodies treadmill study: Our researchers are investigating whether people with Lewy body disease can improve balance and gait by walking on a treadmill.

Dementia with Lewy bodies diagnostic study: To date, there is no easy way to diagnose Lewy body disease. We are evaluating cognitive performance, physical abilities, sleep study results and neuroimaging findings in participants and analyzing the data to aide in establishing an earlier diagnosis so more effective treatments can be prescribed.

Normal pressure hydrocephalus study: Our neurologists and neurosurgeons are looking for better ways to diagnose this condition, which can develop into a dementia condition. We also are collecting information to determine which patients will do best with surgery to resolve the condition.

PET scan study: Our neuroradiologists are examining how to use lower doses of radioactive material and still obtain the same quality as scans achieved with higher radiation doses.

Enroll in a clinical trial

Studies for Alzheimer’s disease that may eventually have applications for people with dementia include:

  • Deep brain stimulation in the Center for Neuromodulation: Ohio State neurosurgeons were first in the United States to implant a pacemaker in the brain of an Alzheimer’s patient to determine whether it can stimulate certain areas of the brain to improve thinking and behavior. The deep brain stimulation implant is similar to a cardiac pacemaker device with the exception that the pacemaker wires are implanted in the brain rather than the heart. Rather than focusing on the more-rapidly deteriorating areas of the brain’s temporal lobes, the pacemaker is targeting areas that govern problem-solving, decision-making and judgment. The hope is to stimulate nerve cells that are still healthy. Up to 10 patients with early or mild Alzheimer’s will be enrolled in the study.
  • Medication study for behaviors: Researchers are testing a medicine targeted at relieving agitation and extreme restlessness in patients with Alzheimer’s.
  • Diagnostic studies: Investigators are looking for new biomarkers in spinal fluid and blood to predict who might have or develop dementia conditions.
  • Therapeutic studies: Our clinical research neurologists are teaming with pharmaceutical companies to test the safety and effectiveness of the newest disease- modifying therapies available for Alzheimer’s disease and other dementia conditions.

Over the last 20 years, the Ohio State Memory Disorders Research Center had conducted more than 100 dementia related multicenter and investigator-initiated clinical trials sponsored by industry and the National Institutes of Health (NIH). We collaborate with other academic centers to enroll patients for clinical trials, propelling us more rapidly toward better treatments.

Our Doctors

Additional Information

Please bring or send in advance any brain scans, records or reports from your referring physicians. We also will send paperwork in advance for you to complete and bring with you to your appointment. 

Preparing for your visit

Share this Page