Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. There are many different causes of dementia, and many different types. Many individuals often get confused about the difference between Alzheimer’s disease and dementia. Alzheimer’s disease is a type of dementia and, together with vascular dementia, makes up the majority of cases of dementia. Depending on the cause, some dementia symptoms might be reversible.
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 is not a specific disease, but several diseases can cause dementia.
Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone does not mean you have dementia, although it is often one of the early signs of the condition. About five to eight percent of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age.
What are the types of dementia?
Dementias are often broken down into two main categories — Alzheimer type or non-Alzheimer type. Dementias of the Alzheimer’s disease type are defined by the symptoms of memory loss plus impairment in other brain functions such as language function (aphasia); inability to move the muscles associated with speech (lips, tongue and jaw; apraxia); or perception, visual or other inabilities to recognize speech or name objects (agnosias).
Non-Alzheimer dementias include the frontotemporal lobar degenerations which are further broken down into two main types. One type primarily affects speech. An example is primary progressive aphasia syndromes. The other type is defined by changes in behaviour, including lack of feeling, emotion, interest or concern (apathy); loss of a “social filter” (disinhibition); personality change and loss of executive functions (such as the ability to organise and plan ahead).
What causes dementia?
Dementia is caused by damage to the brain. The causes of dementia can be generally grouped as follows:
• Degenerative neurological disorders, such as Alzheimer’s disease, frontotemporal lobar dementia, Parkinson’s disease dementia and Huntington’s disease
• Vascular disorders, such as multi-infarct dementia, which is caused by multiple strokes in the brain
• Infections that affect the central nervous system, such as HIV dementia complex
• Long term drug or alcohol use
• Depression
• Certain types of hydrocephalus, a buildup of fluid within the brain that can result from developmental abnormalities, infections, injury, or brain tumors
Alzheimer’s disease accounts for 50 percent to 70 percent of all dementias.
What are the symptoms of dementia?
Early symptoms of dementia include:
• Forgetting recent events or information
• Repeating comments or questions over a very short period of time
• Misplacing commonly used items or placing them in usual spots
• Not knowing the date or time
• Having difficulty coming up with the right words
• Experiencing a change in mood, behaviour or interests
Signs that dementia is getting worse include:
• Ability to remember and make decisions further declines
• Talking and finding the right words becomes more difficult
• Daily complex tasks, such as brushing teeth, making a cup of coffee, working a TV remote, cooking, and paying bills become more challenging
• Rational thinking and behaviour and ability to problem solve lessen
• Sleeping pattern change
• Anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression increase
• More help with activities of daily living – grooming, toileting, bathing, eating – is needed
• Hallucinations (seeing people or objects that are not there) may develop
Why it is important to get a diagnosis
Although there is no cure for dementia at the moment, an early diagnosis means its progress can be slowed down in some cases, so the person may be able to maintain their mental function for longer.
A diagnosis helps people with dementia get the right treatment and support. It can also help them, and the people close to them, to prepare for the future.
With treatment and support, many people are able to lead active, fulfilled lives with dementia.
How is dementia diagnosed?
Confirming the diagnosis of dementia can be very difficult due to the many diseases and conditions that cause it, as well as because its symptoms are common to many other illnesses. Experienced doctors are able to make the diagnosis based on the results of personal medical history, review of current symptoms, neurological (brain) and cognitive (thinking) tests, laboratory tests, imaging tests and by interacting with the patient. Dementia can be difficult to diagnose, especially if your symptoms are mild.
If your doctor has been able to rule out other causes for your symptoms, he/she might refer you to a healthcare professional that specialises in diagnosing dementia, such as a neurologist, psychiatrist or geriatrician.
Treatment
All or almost all forms of dementia are treatable in that medication and supportive measures are available to help manage symptoms in patients with dementia. However, most types of dementia remain incurable or irreversible and treatment results in only modest benefits. Some dementias disorders, however, may be successfully treated with patient returning to normal after treatment.
Can dementia be prevented?
Although dementia cannot be prevented, living a health-focused life might influence risk factors for certain types of dementia. Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, controlling blood sugar, staying at a healthy weight – basically, staying as healthy as one can – can keep the brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:
• Stop smoking
• Follow a diet filled with whole grains, vegetables, fruits, fish, nuts, beans, olive oil and only limited amounts of red meats.
• Exercise. Get at least 30 minutes of exercise most days of the week.
• Keep your brain engaged. Solve puzzles, play word games, and try other mentally stimulating activities. These activities may delay the start of dementia.
• Stay socially active. Interact with people; discuss current events; keep your mind, heart, and soul engaged.
Conclusion
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 is not a specific disease, but several diseases can cause dementia. Alzheimer’s disease is the most common cause of a progressive dementia in older adults, but there are a number of other causes of dementia. Depending on the cause, some dementia symptoms might be reversible. Early diagnosis can help to manage symptoms of dementia. Make an appointment with your doctor if you or your friends and family see changes in: memory, mental functioning, and ability to perform everyday tasks, behaviour and personality.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field is ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
