Dementia

What Is Dementia?

Dementia, also known as major neurocognitive disorder and mild cognitive disorder, does not refer to one specific condition but instead describes symptoms from several possible causes.

It interferes with a person’s ability to perform simple daily activities and limits their ability to have a normal life.

Types of Dementia

Neurodegenerative disorders are the most common form of dementia, which include:

• Alzheimer’s Disease: This is the most common form of dementia, especially in older individuals. Some causes of Alzheimer’s disease are genetic and are more common in families. Individuals with Alzheimer’s disease have brains that have abnormal plaques, tangles, and clumps of a protein called beta-amyloid. These abnormalities injure brain cells and their connections.
• Lewy Body Dementia: Lewy bodies are abnormal, balloon-like clumps of protein that damage the brain, causing symptoms such as hallucinations, difficulty focusing, memory problems, abnormal movements, shaking, and stiffness.
• Frontotemporal Dementia: These disorders involve a breakdown of nerve cells and their connections to specific brain regions. There are changes in behavior, personality, emotions, language, and thinking.
• Vascular Dementia: This form of dementia is caused by a poor blood supply to the brain and can happen from a stroke or hardening of the arteries. People with this form of dementia have trouble solving problems, difficulty focusing, organizational issues, and memory loss.
• HIV Dementia: This can happen in the later stages of HIV.
• Mixed Dementia: This condition occurs when two or more types of dementia are present.

Dementia stages and dementia symptoms may vary from person to person.

Other Conditions Related to Dementia

Various conditions can produce symptoms similar to dementia, but their cause is different. Some conditions mimicking dementia are:

• Traumatic Brain Injury (TBI): TBIs are usually caused by head trauma, such as seen in boxing, auto accidents, football, and combat. The individual may have memory loss, agitation, depression, and speech problems.
• Creutzfeldt-Jakob Disease: This condition is caused by the accumulation of infectious proteins in the brain and is occasionally genetic.
• Huntington’s Disease: This genetic condition occurs when certain nerve cells deteriorate, leading to degeneration of the brain and spinal cord.
• Parkinson’s Disease: Parkinson’s disease is a movement disorder of the central nervous system that eventually may result in dementia.

A careful history and physical examination help differentiate dementia from these other entities.

Symptoms and Signs of Dementia

Various symptoms and signs are present in dementia, such as:

• Memory loss
• Confusion
• Difficulty doing tasks
• Problems communicating
• Trouble reasoning
• Difficulty in planning things
• Poor coordination
• Getting lost, even in familiar surroundings
• Depression
• Hallucinations
• Agitation
• Personality changes
• Anxiety
• Paranoia
• Misplacing objects
• Repeating the same thing multiple times
• Apathy

While these symptoms and signs can be quite troubling when noticed in your loved one, they can also be easy to overlook as a loved one ages.

Early Signs of Dementia

Dementia patients start to have a characteristic presentation, which can include:

• Forgetting recently learned facts
• Unable to navigate known surroundings
• Forgetting how to use common words
• Difficulty in managing finances
• Confusion about time and day
• Avoiding social situations
• Losing interest in reading
• Difficulty with visual and spatial perception
• Always losing things
• Changes in personality

These early actions usually progress and make dementia care very challenging.

How to Recognize Dementia in a Loved One

Because dementia is progressive, the onset of this condition may be mild and easy to miss.

As dementia progresses, it becomes easier to recognize and identify. As time progresses, memory problems and behavioral difficulties become more prominent and need a loved one’s intervention. It is common for the person with dementia to gradually need more assistance with their activities of daily living.

How to Help A Loved One

Because Alzheimer’s disease is a progressive condition, eventually a caregiver will have to provide more help as time goes on. This support should be structured and may include:

• Helping the person with dementia maintain a consistent daily routine.
• Planning activities that the person enjoys.
• Helping the individual write down future events.
• Assisting the person with dressing and bathing, while allowing them to do as much as they can.
• Making a list of reminders, especially if they are taking medication.
• Buying loose-fitting clothing that has Velcro or snaps.
• Installing safety equipment, such as a shower chair, and helping when navigating stairs.
• Being kind and patient in this difficult time.

Helping a person with Alzheimer’s disease is a difficult task, and burnout for a caregiver is common. As dementia progresses, caregivers may need to explore other support options, like hiring a professional caregiver or looking into long-term care.

Can Dementia Be Reversed?

Although dementia can’t be reversed, there are some symptoms related to dementia that can be managed, including:

• Infections: Temperature elevations and immune conditions can confuse and mimic true dementia. Treating the infection and lowering the body temperature may improve the mental status.
• Side Effects of Medicines: Adverse reactions to certain medicines may cause symptoms similar to dementia. Stopping or decreasing these medicines usually helps the situation.
• Tumors or Bleeding in the Brain: Brain damage caused by tumors or bleeding may mimic dementia.
• Normal-Pressure Hydrocephalus: A buildup of fluid in the brain’s ventricles can cause memory impairment, trouble walking, and other signs common to dementia.
• Decreased Levels of Some Body Substances: Low blood sugar, dehydration, decreased sodium levels, and vitamin deficiencies, such as B1, B6, and B12, may cause dementia-like symptoms.
• Endocrine Disorders: Individuals with thyroid conditions can develop personality changes similar to those seen in dementia.

At present, there are no proven methods to reverse dementia.

Can Dementia Be Prevented?

There is no way to prevent dementia, but there are certain factors that might help reduce the risk, such as:

• Lifestyle: Following a healthy lifestyle may lower cognitive decline. Exercise, healthy eating, participating in social interactions, avoiding large amounts of alcohol, and not smoking may help lower the risks for dementia.
• Cardiovascular Health: Obesity, high cholesterol, hypertension, and elevated blood sugar are key factors to monitor and regulate.
• Hearing and Vision: Abnormalities in these two functions may increase the risk and worsen dementia.
• Depression: Adult depression is a risk factor for dementia and is a treatable condition.
• Air Pollution: Exposure to air pollution creates an increased risk of dementia.
• Head Trauma: Individuals with previous head trauma are at a higher risk of dementia.
• Avoid Certain Medications: Some sleep aids, certain allergy medications, and certain sedatives may have adverse effects on memory.

Fortunately, dementia prevention is an area that many scientists are currently exploring. In the meantime, focusing on healthy lifestyle choices can help reduce one’s risk.

Local Services and Support

As a person’s dementia progresses, more assistance is necessary, and the caregiver’s task becomes more stressful. The following are resources and services that can help ease the strain of this responsibility:

• Research organizations like The Alzheimer’s Association, the Alzheimer’s and Related Dementia Education and Referral Center, and Alzheimer’s Foundation of America
• Daycare and respite care offer short-term support to caregivers, helping to alleviate burnout. Agencies such as Meals on Wheels can also deliver food to the home.
• Long-term care at home allows family members to rotate help and decrease the burden for the primary caretaker. Home care services are also available from nursing agencies.
• Residential care, like assisted living facilities and nursing homes, may be necessary as conditions deteriorate.
• End-of-life care and comfort care are available both at home and at medical centers if needed.

Fortunately, many services provide help for caregivers. Through resources like those listed above, help with legal and financial planning, skills training, and access to support groups is available to help those with dementia and those who support them be more at ease as they navigate this new season of life.