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Dementia

Dementia is a collection of symptoms including memory loss, personality change, and impaired intellectual functions resulting from disease or trauma to the brain. These changes are not part of normal aging and are severe enough to impact daily living, independence, and relationships. While Alzheimer’s disease is the most common type of dementia, there are also many other forms, including vascular and mixed dementia.

With dementia, there will likely be noticeable decline in communication, learning, remembering, and problem solving. These changes may occur quickly or very slowly over time.

The progression and outcome of dementia vary, but are largely determined by the type of dementia and which area of the brain is affected. Diagnosis is possible through advanced brain imaging, clinical examinations, and diagnostic testing.

Common signs and symptoms of dementia

  • Memory loss
  • Impaired judgment
  • Difficulties with abstract thinking
  • Faulty reasoning
  • Inappropriate behavior
  • Loss of communication skills
  • Disorientation to time and place
  • Gait, motor, and balance problems
  • Neglect of personal care and safety
  • Hallucinations, paranoia, agitation

Normal memory changes vs. dementia

The inevitable changes of aging can be both humbling and surprising. Skin wrinkles, hair fades, bodies chill, and muscle mass wanes. In addition, the brain shrinks, working memory goes on strike, and mental speed slows. But while many people do experience mild and gradual memory loss after age 40, severe and rapid memory loss is definitely not a part of normal aging. In fact, many people preserve their brainpower as they get older by staying mentally and physically active and making other healthy lifestyle choices.

The most common forms of mental decline associated with aging are:

  • Slower thinking and problem solving – The speed of learning slows down; short-term memory takes longer to function; reaction time increases.
  • Decreased attention and concentration – More distractedness. All of the interruptions make learning more difficult.
  • Slower recall – A greater need for hints to jog the memory.

Distinguishing between normal memory loss and symptoms of dementia is not an exact science but there are some clues to look for:

Normal Memory Changes or Dementia Symptoms?

Typical Aging:

  • Complains about memory loss but able to provide detailed examples of forgetfulness
  • Occasionally searches for words
  • May have to pause to remember directions, but doesn't get lost in familiar places
  • Remembers recent important events; conversations are not impaired
  • Interpersonal social skills are at the same level as they've always been

Symptoms of Dementia:

  • May complain of memory loss only if asked; unable to recall specific instances
  • Frequent word-finding pauses, substitutions
  • Gets lost in familiar places and takes excessive time to return home
  • Notable decline in memory for recent events and ability to converse
  • Loss of interest in social activities; may behave in socially inappropriate ways

What causes Dementia and Its Symptoms?

In a healthy brain, mass and speed may decline in adulthood, but this miraculous machine continues to form vital connections throughout life. However, when connections are lost through inflammation, disease, or injury, neurons eventually die and dementia may result. The prospect of literally losing one's self can be traumatic, but early intervention can dramatically alter the outcome. Understanding the causes of dementia is the first step.

In the past 20 years, scientists have greatly demystified the origins of dementia. Genetics may increase your risks, but scientists believe a combination of hereditary, environmental, and lifestyle factors are most likely at work.

Dementia can be Caused by:

  • Medical conditions that progressively attack brain cells and connections, most commonly seen in Alzheimer's disease, Parkinson's disease, or Huntington's disease.
  • Medical conditions such as strokes that disrupt oxygen flow and rob the brain of vital nutrients. Additional strokes may be prevented by reducing high blood pressure, treating heart disease, and quitting smoking.
  • Poor nutrition, dehydration, and certain substances, including drugs and alcohol. Treating conditions such as insulin resistance, metabolic disorders, and vitamin deficiencies may reduce or eliminate symptoms of dementia.
  • Single trauma or repeated injuries to the brain. Depending on the location of the brain injury, cognitive skills and memory may be impaired.
  • Infection or illness that affects the central nervous system, including Creutzfeldt-Jakob disease and HIV. Some conditions are treatable, including liver or kidney disease, depression-induced pseudo dementia, and operable brain tumors.

Can Dementia be Prevented or Delayed?

Recent research suggests that good health habits and mental stimulation may prevent dementia altogether or at least delay its onset. Just as physical exercise keeps you physically fit, exercising your mind and memory can help you stay mentally sharp, no matter how old you are.

Strategies to improve mental clarity and keep your brain functioning optimally:

  • Exercise consistently
  • Eat a brain-healthy diet
  • Challenge your mind
  • Get regular and restful sleep
  • Minimize stress
  • Avoid smoking and limit drinking

Types of Dementia

All dementias involve cognitive decline that impacts daily living. However, it's important to pinpoint the specific type of dementia in order to optimize treatment. More than 50 conditions involve dementia, but the most common types of dementia are Alzheimer's disease and vascular dementia.

Alzheimer's Disease

Alzheimer's disease is the most common form of dementia, accounting for up to two-thirds of all diagnosed cases. If your dementia symptoms are the result of Alzheimer's disease, medications can delay the onset of more debilitating symptoms. Early diagnosis can prolong independence and is the first step towards treatment, management, and living life fully.

10 Warning Signs of Alzheimer’s Disease

  1. Memory loss sufficient to Disrupt Daily Life – such as forgetting recently learned information, important dates or events, asking for the same information over and over, relying more and more on memory aides or family members.
  2. Problem-solving Difficulties – An inability to follow plans, work with numbers, follow recipes, or keep track of bills.
  3. Trouble completing familiar daily Tasks – Driving to a familiar location, remembering rules to a game, completing assignments at work.
  4. Confusion over Time or Place – Losing track of dates and seasons, or forgetting where you are or how you got there.
  5. Difficulty understanding visual images – Trouble reading, judging distances, colors, or contrast, or recognizing your own reflection.
  6. Problems with spoken or written words – Difficulties following a conversation, finding the right word, or calling things by the wrong name.
  7. Misplacing Things – Putting things in unusual places, unable to retrace steps, accusing others of stealing.
  8. Poor judgment – Decline in decision making, giving away large sums of money, paying less attention to personal grooming.
  9. Withdrawal from work or social activities – Trouble remembering how to complete a work project or favorite hobby, avoiding sports or social events.
  10. Changes in Mood – Becoming confused, depressed, suspicious, fearful, or anxious. Easily upset when out of comfort zone.

Vascular Dementia

Vascular dementia results from a series of small strokes or changes in the brain's blood supply. Sudden onset of symptoms may be a sign of this dementia. Vascular dementia severely impacts memory and cognitive functioning. However, there are ways to prevent and reduce its severity.

Mixed Dementia

Mixed dementia is a condition in which Alzheimer's disease and vascular dementia occur simultaneously. The combination of the two types of dementia most commonly occurs in people of an advanced age, often indicated by cardiovascular disease and dementia symptoms that get worse slowly over time.

Less common forms of Dementia

  • Pick's Disease – Pick's disease affects personality, orientation and behavior. It may be more common in women and occurs at an early age.
  • Creutzfeldt-Jakob Disease – The disease progresses rapidly along with mental deterioration and involuntary movements.
  • Huntington's Disease – Huntington's is an inherited, degenerative disease. The disease causes involuntary movement and usually begins during mid-life.
  • Parkinson's Dementia – Parkinson's is a progressive disorder of the central nervous system. In later stages of Parkinson's disease, some patients develop dementia.
  • Lewy Body Dementia – This disease causes symptoms similar to Alzheimer's disease. Individuals with Lewy Body dementia experience hallucinations and can become fearful.

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