Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia.
Dementia is a general term for symptoms affecting memory, communication, and thinking. Although the likelihood of having dementia increases with age, it is not a normal part of aging.
About dementia
Dementia is not a single disease; it’s an
overall term — like heart disease — that covers a wide range of specific medical
conditions, including Alzheimer’s disease. Disorders grouped under
the general term “dementia” are caused by abnormal brain changes. These changes
trigger a decline in thinking skills, also known as cognitive abilities, severe
enough to impair daily life and independent function. They also affect
behavior, feelings and relationships.
Alzheimer's disease accounts for 60-80% of cases. Vascular dementia, which occurs because of
microscopic bleeding and blood vessel blockage in the brain, is the second most
common cause of dementia. Those who experience the brain changes of multiple
types of dementia simultaneously have mixed dementia. There are
many other conditions that can cause symptoms of dementia, including some that
are reversible, such as thyroid problems and vitamin deficiencies.
Dementia is often incorrectly referred to as "senility" or
"senile dementia," which reflects the formerly widespread but
incorrect belief that serious mental decline is a normal part of aging.
Types and
- Alzheimer’s disease
- vascular dementia
- Lewy body dementia, which may occur with Parkinson’s disease
- fronto temporal dementia
- mixed dementia
Experts
may refer to these as Alzheimer’s disease and Alzheimer’s disease-related
dementias.
This
article discusses the potential causes of dementia, the various types, and any
available treatment options.
Dementia symptoms
Symptoms of dementia depend
on the type a person has, but they typically include:
- memory problems
- asking the same question
repeatedly
- difficulty finding or
understanding words
- feeling confused in an
unfamiliar environment
- problems dealing with money and
numbers
- anxiety and withdrawal
- difficulty planning and
carrying out tasks
- mood changes
- personality and behavioral
changes
- sleep disturbances
- changes in social awareness,
such as making inappropriate jokes
- obsessive tendencies
The symptoms tend to become more severe over
time. The person may notice some symptoms themselves, but their family members
or caregivers may notice others.
Dementia
stages
The
Early stage
At this stage, it may not seem that a person
has dementia. They may:
- become more
forgetful
- lose track of
time
- feel lost in
familiar locations
Middle stage
At this stage, the symptoms become more
noticeable and include:
- forgetting names
and recent events
- feeling lost
when at home
- difficulty
communicating
- behavioral
changes
- repeatedly
asking questions
- needing help
with personal care
Late stage
At this stage, a person needs full-time
assistance, as the impact of the symptoms typically becomes more severe. The
person may:
- be unaware of
where they are
- be unaware of
time
- have difficulty
recognizing loved ones
- find it hard to
walk
- experience
behavioral changes, which may include aggression
Dementia types
There are several types of dementia. They include but are not limited to the following.
Alzheimer’s disease
Alzheimer’s disease is the most common cause
of dementia, accounting for
A person may have short-term memory problems, difficulty finding words and making decisions, and difficulty seeing things in three dimensions.
Lewy body dementia
Lewy body dementia
In
the early stages, there may be fluctuations in alertness, hallucinations, and
difficulty judging distance. The impact on short-term memory may be less severe
than it is with Alzheimer’s disease.
People with Parkinson’s disease may also have Lewy bodies. Although doctors often consider Parkinson’s disease a disorder of movement, symptoms of dementia can also appear.
Front temporal dementia
This condition involves damage to the
Depending
on the part of the brain the condition affects, the person may have difficulty with behavior, speech and
communication, or both.
Huntington’s disease is
an inherited genetic condition. The main symptoms are uncontrolled movements, but dementia
can also occur.
Early
symptoms
When this happens, a person has a diagnosis of two or three types together. For instance, a person may have both Alzheimer’s disease and vascular dementia at the same time.
Early symptoms of dementia vary between types but
typically include:
- forgetfulness
- mood changes
- anxiety, anger,
or depression
- difficulty
finding the right words
- apathy
- confusion
- repeating speech
or actions
- difficulty
following a storyline or recounting a story
- difficulty
completing everyday tasks
- a reduced sense
of direction
- difficulty
adapting to changes
- leaving everyday items in unusual places
However,
dementia can also result from head injuries, stroke, brain tumors, and other causes. A
stroke, for example, can stop blood and oxygen from reaching brain cells,
resulting in damage and cell death. Receiving a blow to the head can damage
brain cells directly.
Some
types of traumatic brain injury — particularly if repetitive, which can happen
in some sports — may increase the risk of certain types of dementia later
in life.
Some
other factors and conditions with
- the use of some
drugs
- some infections,
such as HIV or neurosyphilis
- depression
- vitamin B12 or E
deficiency
- thyroid problems
Assessment usually involves a number of questions and tasks. The
following sections will explore these in more detail.
Experts established the dementia tests that doctors currently use in the 1970s.
A doctor may ask questions such as:
- What is your
age?
- What is the
time, to the nearest hour?
- What is your
address?
- What is the
year?
- What is your
date of birth?
The doctor may also take into account observations by family members and
caregivers.
If the results suggest memory loss, the doctor may carry out blood tests
and a CT brain scan to investigate further and rule out other possible causes.
Another test, called the mini-mental
state examination — which has also been in use since the 1970s
— measures:
- orientation to
time and place
- word recall
- language
abilities
- attention and
calculation
- visuospatial
skills
It can help diagnose dementia due to Alzheimer’s disease. It can also
rate its severity and assess whether or not drug treatment is appropriate.
The doctor may also carry out a test known as the Mini-Cog test. This involves the following steps:
- The doctor will
take three words from a specific set, “banana, sunrise, chair,” and ask
the person to repeat them. The person can have three attempts at this.
- If the person
cannot do this, the doctor will ask them to draw a clock face, fill in the
numbers, and set the hands to a specific time. The person should do this
within 3 minutes.
- If the
individual cannot complete the clock task in time, the doctor will ask
them to recall and repeat the three words from the first task.
There will be a maximum of 10 points. If the person scores fewer than 3–4 points, the doctor will consider dementia as a possible diagnosis.
There
is currently no cure for most types of dementia, as it is not yet possible to
reverse brain cell death. However, treatment may help manage symptoms.
Some
medications may help reduce the symptoms of Alzheimer’s disease.
- donepezil
(Aricept)
- galantamine
(Reminyl)
- rivastigmine
(Exelon)
Cholinesterase
inhibitors can also help manage behavioral symptoms of Parkinson’s disease.
A
person may also use memantine (Namenda), which is an NMDA receptor antagonist,
either alone or with a cholinesterase inhibitor.
If the symptoms result from an injury, medication use, or a vitamin deficiency, it may be possible to prevent further damage.
In
most cases, it is not possible to prevent dementia. However, the
- exercising
regularly
- avoiding smoking
- limiting alcohol
consumption
- maintaining a
moderate weight
- eating a healthy
diet
- seeking
treatment for conditions such as high blood pressure, high cholesterol
levels, and high blood sugar levels
Wearing protective headgear during contact sports may also lower the risk of sustaining repeated head injuries, which could be a risk factor for dementia.
