Dementia is a broad term used to describe a loss of mental functions and various symptoms of cognitive decline. It is group of various underlying conditions and brain disorders. Dementia can affect:
- Visual perception
- Language skills
- Ability to focus and pay attention
Dementia is severe enough to interfere with the daily life activities. It is actually not a disease but caused by a variety of impaired abilities to remember, think, or make decisions and may range from mild to severe. It may also affect personality changes.
Some dementias are intense which may get worse over time. While, some dementias are treatable and even reversible. Experts limit the term dementia to irreversible mental degeneration.
How common is dementia?
There were about 5.0 million adults with dementia in 2015 of mostly 65 years of age. Now it is projected to be estimated 14 million by 2060.
Signs and symptoms of Dementia
Major symptoms of dementia depend on its causes and stages. Some general symptoms include:
- Forgetfulness, which is often observed by someone else
- Lack of communication or finding words
- Being repetitive
- Difficulty with visual perceptions and spatial abilities especially getting lost while driving
- Inability of reasoning or problem-solving
- Not coping well with change
- Unable to handle complex tasks
- Lack of planning and organizing skills
- Not able to coordinate functionally
- Difficulty in motor functions
- Confused sense of direction
- Changes in mood
- Annoying behavior
- Struggling to follow storylines
- Personality changes
These symptoms may show experiencing a severe decline in memory and mental ability. A large number of people with dementia are unable to control their emotions and may become apathetic. As a result, they may not hold their inhibitions and stop considerate about other peoples’ feelings.
Who is at risk for dementia?
Certain factors can increase the risk for dementia, such as:
- Aging– This is the strongest risk factor for dementia, with majority cases affecting people more than 65 years.
- Traumatic brain injury- Head or cerebral injuries (especially when they are severe or occur repeatedly) may raise the risk of dementia.
- Family history- Those with family history of dementia are more likely to experience it themselves.
- Race– African Americans of older age are twice more likely to develop dementia than whites.
- Poor heart health
- High cholesterol
- Uncontrolled diabetes
- High blood pressure
- Drinking too much alcohol
Stages of Dementia
Dementia may not progress same in everyone as in most cases, it can be severe getting worse with time. Yet, most people deal with mild cognitive impairment along with early, moderate, and late stages. Below there is a detail discussion of these stages.
Mild cognitive impairment
Older adult individuals may develop mild cognitive impairment (MCI). They may never progress to dementia or any other mental impairment in their lives but most commonly face trouble recalling words, forgetfulness, and short-term memory problems.
At this stage, people may experience early dementia signs which may not hint that a person has dementia. Symptoms include:
- Personality changes, like anger or depression
- Feel more forgetful
- Inability to complete complex tasks or solve problem
- Lose track of time
- Difficulty in expressing emotions or ideas
- Become lost in familiar locations
At this middle stage, dementia starts interfering life activities, so these kinds of people may require special care from a loved one. The signs become more noticeable such as:
- Forgetting recent events
- More confusion and frustration
- Significant personality changes
- Poor judgment
- Feeling lost even at home
- Difficulty in communication
- Behavioral changes
- Asking questions more often
- Needing help with personal care like dressing and bathing
At this late stage, not only mental signs but physical symptoms also continue to a decline. Affected person requires full-time care, as the effects of the symptoms start becoming worse. Some symptoms include:
- Difficulty maintaining bodily functions, such as walking and eventually swallowing and controlling bladder
- Not aware of where they are
- Increased chances for infections
- Having no idea of time
- Facing difficulty recognizing loved ones
- Finding it hard to move faster
- Experiencing intense behavioral changes, which may include aggression
A better understanding of these stages can help diagnosing dementia.
Types of Dementia
Several certain types of dementia may also cause complications with balance and movement. These forms can be partially manageable, but aren’t reversible:
- Alzheimer’s disease
- Huntington’s disease
- Dementia from Parkinson’s disease
- Vascular dementia
- Alcoholism related dimentia
- Dementia with Lewy bodies
- Creutzfeldt-Jakob disease
- Frontotemporal dementia (Pick’s disease)
- Mixed dementia
Dementia can be divided into two groups on the basis of which part of the brain is affected.
Alzheimer’s and Creutzfeldt-Jakob disease are the main forms of cortical dementia. It happens because of complications in the cerebral cortex, the outside layer of the brain. They play a significant part in memory and language. Cortical dementias may affect the severe memory loss and people can’t remember words or visualize.
Parkinson’s disease, HIV, and Huntington’s disease can cause subcortical type of dementia. It happens when serious problems develop in the parts of the brain beneath the cortex. Usually, people with this dementia tend to fluctuate in their speed of start activities and ability to think speedily. They may not experience forgetfulness and language issues.
Some forms of dementia may affect both brain parts, such as; Lewy Body dementia is both cortical and subcortical.
How is dementia diagnosed?
For the purpose of diagnosis of dementia, a health care provider must recognize the pattern of the difficulty of skills and function and check out the ability what a person is still able to do. Doctor should examine a medical history and symptoms to carry out a physical examination test. Asking someone close to that person about symptoms can also find helpful in diagnosing dementia.
Doctors are likely to perform several tests that can help finding out the problem. They can include:
- Cognitive and neuropsychological tests
- Neurological evaluation
- Electroencephalogram (EEG)
- Brain scans including MRI, PET, or CT
- Laboratory tests like blood tests, chest X-ray, spinal fluid analysis, and genetic tests
- Psychiatric evaluation
Treatments for dementia
There is no exact cure for most types of dementia, but treatments may help to improve mental functions, manage severe symptoms, and slow down the vulnerability of the disease. They may include:
These can only improve memory temporarily and slow down dementia decline and can manage symptoms like depression, hallucinations, parkinsonism, agitation. sleep problems, and muscle stiffness. Following medicines are used commonly:
- Cholinesterase inhibitors
- EGb 761
- Antidepressants such as selective serotonin reuptake inhibitors (SSRIs)
These medications help slowing down the progression of cognitive changes and may lower the effects of medicines and prevent eventual worsening of the underlying conditions.
Several nondrug therapies have been seen improving dementia symptoms. Behavior problems, primarily, are treated initially using these therapies, like:
- Occupational therapy
- Light exercise
- Speech therapy
- Massage therapy
- Pet therapy
- Music or art therapy
- Modifying the surrounding environment
Alongside medications and therapies, leading a healthy lifestyle, like healthy eating regular exercise, and maintaining social contacts can decrease the chances of developing severe dementia stage.
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