Cognitive impairment reversible causes

Since that time, we ve found that some causes of dementia can be treated. In addition, other treatable conditions as noted earlier cause cognitive impairment that resembles dementia (pseudodementia). Treatment aimed at dementia reversal depends on a careful assessment to identify those patients who have these potentially reversible conditions. 

For any patient with cognitive impairment, it is important to rule out reversible causes and to exclude alternative diagnoses that may present with similar symptoms. Once cognitive impairment is confirmed, the underlying cause should be determined that is, the subtype of cognitive impairment should be defined since this will influence prognosis and treatment. 

Carvacrol also improves cognitive activity. Azizi et al. [100] examined the effect of carvacrol and thymol in two rat models of dementia deficits caused by amyloid p and by scopolamine. The method they used was the Morris water maze test and they also assessed the acute toxicity of both carvacrol and thymol. The result showed that both substances could reverse and alleviate the induced cognitive impairments, for example, the escape latency and reduction in target quadrant entries. Both substances also were shown to be relative safe, with LD50s of thymol (565.7 mg/kg) and carvacrol (471.2 mg/kg) that were significantly higher than the therapeutic concentration. The authors also suggest that the antioxidative, antiinflammatory, and anti-choUnesterase activity could be involved in these activities. 

This screens for reversible causes of cognitive impairment and vascular risk factors (Table 30.2). 

Synaptic Loss is a Potentially Reversible Cause of Cognitive Impairment... 

The spectrum of cognitive deficits associated with chronic alcohol use extends to the extreme of Wernicke s encephalopathy and Korsakoff s psychosis. Wernicke s encephalopathy is an acute neurologic syndrome caused by thiamine deficiency. Symptoms include mental confusion, ophthalmoplegia, and ataxia. Many of these symptoms reverse with administration of thiamine however about 50% of patients are left with some degree of ataxia. Left untreated, Wernicke s encephalopathy can progress to stupor, coma, and death. Approximately 80% to 90% of alcoholics treated for Wernicke s encephalopathy are left with Korsakoff s psychosis, a syndrome of impaired learning and recent memory produced by lesions of the medial dorsal nuclei of the thalamus. 

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