The A-Z Of Dementia

"Remember, the dementia patient is not giving you a hard time. The dementia patient is having a hard time."

What is Dementia?

Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several diseases can cause dementia. This is different from the normal decrease in short-term memory most people experience as they age. Dementia is caused by changes in the brain which impact cognitive function. It is a decline in memory or brain function that impacts an individual's daily life.

Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia, although it's often one of the early signs of the condition.

Is it Dementia or just old age?

Dementia effects 47.5 million elderly people worldwide with varying symptoms depending on their condition. While it may be difficult to distinguish dementia versus aging, there is some distinction to determine whether or not a patient has dementia. Know more below:

There are many variables associated with dementia symptoms and there isn't a consistent pattern to the way individuals are impacted by dementia. A person is impacted by their condition may include factors like decreased focus, lack of motivation, or decreased memory. Suffering from these symptoms doesn't always point to dementia. In fact, many dementia symptoms can be a completely normal part of aging, or can be signs of other afflictions like depression. In understanding dementia, one of the most important first steps is learning what distinguishes regular cognitive changes from dementia.

Most people experience mild cognitive changes and memory loss as they begin to move into their 50s. One of the clearest indicators of dementia is the speed of progression. Regular mental decline associated with aging is usually a slow and gradual loss of memory or attention span. Dementia, however, is often characterized by rapid, sudden, and severe changes in memory and cognitive ability.?

There are distinguishing factors that can help understand whether or not these are regular changes. These can include:

Speech skills: Occasionally forgetting words is usually a sign of normal cognitive changes, while frequent pauses in speech, difficulty understanding speech, or tendency to call things by the wrong name can be a sign of dementia.

Memory loss: Those with regular aging-related memory loss will usually be able to recall specific instances in which their memory has failed, and may complain about increasing forgetfulness. Those with dementia-related memory loss will be unable to recall specific instances of memory loss, and may not acknowledge they have memory loss unless they are prompted or asked.

Short-term memory changes: Significant declines in short-term memory, such as an inability to remember recent conversations or events, are not a normal sign of aging and can indicate dementia.

Trouble with familiar tasks: Normal cognitive decline can cause trouble with directions or with remembering how to get somewhere, but getting lost in familiar, frequently visited locations or forgetting the way home could be signs of dementia.

Social skills: Loss of social skills isn't a normal part of aging - lack of interest in socializing, decreased ability to speak to others, or increased socially inappropriate behavior can be a sign of dementia.

What Causes Dementia?

It is generally caused by damage to or disruptions of brain cells, particularly in the cerebral cortex (the part of the brain which controls memory, perception, consciousness, and language). In some cases, this damage or disruption isn't permanent, causing reversible dementia conditions that can be slowed or cured with proper treatment.

Dementias are often grouped by what they have in common, such as the protein or proteins deposited in the brain or the part of the brain that's affected. Some diseases look like dementias, such as those caused by a reaction to medications or vitamin deficiencies, and they might improve with treatment.

What are the types of Dementia?

Progressive dementias are types of dementias that progress and aren't reversible, they include:

Alzheimer's disease - This is the most common cause of dementia. Although not all causes of Alzheimer's disease are known, experts do know that a small percentage are related to mutations of 3 genes, which can be passed down from parent to child. While several genes are probably involved in Alzheimer's disease, one important gene that increases risk is apolipoprotein E4 (APOE).

Vascular dementia - It is caused by damage to the vessels that supply blood to your brain. Blood vessel problems can cause strokes or affect the brain in other ways, such as by damaging the fibers in the white matter of the brain.

Lewy body dementia - They are abnormal balloon like clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease. This is one of the more common types of progressive dementia.

Frontotemporal dementia - This is a group of diseases characterized by the breakdown of nerve cells and their connections in the frontal and temporal lobes of the brain. These are the areas generally associated with personality, behavior and language.?

Parkinson's disease - Many people with Parkinson's disease eventually develop dementia symptoms (Parkinson's disease dementia).

Some causes of dementia or dementia-like symptoms can be reversed with treatment. They include:

Infections and immune disorders - Dementia-like symptoms can result from fever or other side effects of your body's attempt to fight off an infection. Multiple sclerosis and other conditions caused by the body's immune system attacking nerve cells also can cause dementia.

Metabolic problems and endocrine abnormalities - People with thyroid problems, low blood sugar (hypoglycemia), too little or too much sodium or calcium, or problems absorbing vitamin B-12 can develop dementia-like symptoms or other personality changes.

Nutritional deficiencies - Not drinking enough liquids (dehydration); not getting enough thiamin (vitamin B-1), which is common in people with chronic alcoholism; and not getting enough vitamins B-6 and B-12 in your diet can cause dementia-like symptoms. Copper and vitamin E deficiencies also can cause dementia symptoms.

Medication side effects - Side effects of medications, a reaction to a medication or an interaction of several medications can cause dementia-like symptoms.

Subdural hematomas - Bleeding between the surface of the brain and the covering over the brain, which is common in the elderly after a fall, can cause symptoms similar to those of dementia.

Normal pressure hydrocephalus - This condition, which is caused by enlarged ventricles in the brain, can result in walking problems, urinary difficulty and memory loss.

The 7 Stages Of Dementia

With an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once.

The progression of dementia can be divided into 7 distinct, identifiable stages. Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner its treatment can start.

As per the Global Deterioration Scale for Assessment of Primary Degenerative Dementia

Stage 1: No Cognitive Decline

This stage is classified as the normal functioning stage. At this stage of dementia development, a patient generally does not exhibit any significant problems with memory, or any cognitive impairment.?

Stage 2: Age Associated Memory Impairment

This stage features occasional lapses of memory such as -

• Forgetting where one has placed an object
• Forgetting names that were once very familiar

This mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing.?

Stage 3: Mild Cognitive Impairment

Clear cognitive problems begin to manifest during this stage, some of them maybe -?

• Getting lost easily
• Noticeably poor performance at work
• Forgetting the names of family members and close friends
• Difficulty retaining information read in a book or passage
• Losing or misplacing important objects
• Difficulty concentrating

Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

Stage 4: Mild Dementia

In this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen here. Behaviors to look for include -?

• Decreased knowledge of current and/or recent events
• Difficulty remembering things about one's personal history
• Decreased ability to handle finances, arrange travel plans, etc.
• Disorientation
• Difficulty recognizing faces and people

Individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.

Stage 5: Moderate Dementia

Individuals need some assistance in order to carry out their daily lives. The main sign is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves.

Stage 6: Moderately Severe Dementia

When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering this stage and will need full time care. Patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for these signs -?

• Delusional behavior
• Obsessive behavior and symptoms
• Anxiety, aggression, and agitation
• Loss of willpower

Patients may begin to wander, have difficulty sleeping, and in some cases may experience hallucinations.

Stage 7: Severe Dementia

Along with the loss of motor skills, patients will progressively lose the ability to speak during the final stage, the brain seems to lose its connection with the body. Severe dementia frequently involves the loss of all verbal and speech abilities. Family members and caregivers will need to help the individual with walking, eating, and using the bathroom.

By identifying the earliest stages of dementia as they occur, you may be able to seek medical treatment quickly and delay the onset of later stages. The more aware you are of these stages, the quicker you will be able to react and seek help, either for yourself or for a loved one.

With inputs from: https://www.dementia.org/ |?https://www.mayoclinic.org/?

Disclaimer: This information should not be construed as a medical advice. Reader discretion is recommended.