Co-morbidity and dementia

Poor control of or acute exacerbation of conditions such as congestive heart failure, coronary artery disease, or chronic obstructive pulmonary disease may adversely affect the cognitive function of patients with dementia. Thus, attention to and aggressive treatment of co-morbidity is an important part of the care plan. As the dementia progresses, treatment goals vary, depending on patient-family values, quality of life, and symptoms and burden of proposed interventions. In the late stages of dementia, a more purely palliative or hospice care plan may call for treatment of other medical conditions only if they are producing symptoms. 

Considerations in the treatment of co-morbidity
Abrupt changes in clinical status for patients with dementia usually signal an intercurrent illness, which is often treatable (eg, urinary tract infection, pneumonia, malnutrition, constipation). Appropriate steps should be taken to identify and treat the underlying problem.

• Pain, dyspnea, agitation, depression, and other symptoms should be treated. Sometimes this can best be accomplished by treating the underlying condition (eg, treating congestive heart failure or chronic obstructive pulmonary disease to relieve dyspnea). At other times, symptomatic measures may be more appropriate (eg, morphine for dyspnea).