Dementia is often viewed as a disease of the mind, an illness that erases treasured memories but leaves the body intact.
But dementia is also a physicial illness, too - a progressive, terminal disease that shuts down the body as it attackes the brain. Although the early stages can last for years, the life expectancy of a patient with advanced dementia is similar to that of a patient with advanced cancer.
The lack of understanding about the physical toll of dementia means that many patients near the end of life are subjected to aggressive treatment that would never be considered with another terminal illness. People with advanced dementia are often given dialysis and put on ventilators; they may even get preventive care that cannot possibly help them, like colonoscopies and drugs for osteoporosis or high cholesterol.
"You can go to an intensive-care unit in most places," said Dr. Greg A. Sachs, chief of general internal medicine and geriatrics at Indiana University School of Medicine, "and you'll find people with dementia getting very aggressive treatment."