Dementia
Dementia is a loss of thinking, remembering, and reasoning skills. Dementia isn’t a single disease or condition. Instead, it’s an umbrella term used to describe memory loss and a decline in cognitive function.
Is dementia the same thing as Alzheimer's disease?
Alzheimer’s disease is the most common type of dementia. Alzheimer’s disease progresses over time and continues to cause a decline in memory, language, and thought.
What functions are impaired with dementia?
To be considered dementia, at least two brain functions must be impaired, including:
- Behavior.
- Judgment.
- Language.
- Memory.
- Thinking.
Some dementias worsen over time while others are treatable.
Symptoms of dementia
Dementia symptoms involve two areas of change: cognitive and psychological. Common signs and symptoms include:
Cognitive changes
- Confusion and disorientation.
- Difficulty communicating or finding words.
- Difficulty handling complex tasks.
- Difficulty reasoning or problem-solving.
- Difficulty with coordination and motor functions.
- Difficulty with planning and organizing.
- Difficulty with visual and spatial abilities, such as getting lost while driving.
- Memory loss, often noticed by someone else.
Psychological changes
- Agitation.
- Anxiety.
- Depression.
- Hallucinations.
- Inappropriate behavior.
- Paranoia.
- Personality changes.
Diagnosing dementia
Diagnosing dementia requires your doctor to do two things: first, determine the loss of cognitive function and two, assess what a person is still able to do. This requires a number of tests.
To start, your doctor will review your medical history and symptoms and then conduct a physical examination. Because people with dementia might not recognize their own cognitive decline, your doctor will also likely ask someone close to you about your symptoms as well.
Cognitive, neurological and neuropsychological tests
These tests examine both physical and mental capacity, including attention, balance, judgment, language skills, memory, orientation, reasoning, reflexes, senses, thinking skills, visual perception and other areas.
Brain scans
CT or MRI. These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus.
PET scans. These can show patterns of brain activity and whether deposits of the amyloid or tau protein are in the brain.
Laboratory tests
Simple blood work is taken to look for physical reasons for decline in brain function, like vitamin B-12 deficiency or an underactive thyroid gland. Spinal fluid can also be looked at for infection, inflammation or markers of conditions like dementia.
Psychiatric evaluation
A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms.
Treatments for dementia
Since there is no cure for most types of dementia, treatments mostly focus on ways to manage symptoms with the right blend of medications and therapies to give the best quality of life.
Medications
Doctors might prescribe these medications to temporarily improve dementia symptoms.
- Cholinesterase inhibitors. These help increase levels of a chemical messenger linked to memory and judgment.
- Memantine. Often prescribed along with a cholinesterase inhibitor, memantine governs the function of glutamate, a chemical messenger in the brain that impacts learning and memory.
Your doctor might prescribe additional medications that treat other symptoms or conditions, including agitation, depression, hallucinations, parkinsonism, and sleep disturbances.
Therapies
Your doctor might decide to treat your dementia symptoms with approaches that don’t use medication, including:
- Occupational therapy. An occupational therapist can show you how to avoid falls and other accidents, deal with behavior and ready yourself for the progression of dementia.
- Modifying the environment. For dementia patients, simpler is better. Reduce noise and clutter as much as possible to boost their focus and function.
- Simplifying tasks. Make tasks as easy as possible to follow and focus on successful outcomes.
Frequently asked questions (FAQs) about dementia
Many factors can eventually contribute to dementia, some of which can be changed while others cannot.
Some risk factors that can’t be changed:
- Age. As you age, especially after age 65, your risk rises.
- Family history. While a family history of dementia increases your likelihood of developing the condition, it’s not a guarantee you’ll develop symptoms. Conversely, many people without a family history do.
Not at this time. Although no cure has yet been identified for dementia, your doctor can offer treatments to slow its progression, ease your symptoms, and help improve the quality of your life.
Not directly. As the disease progresses, overall health declines. So, when someone with dementia dies, it’s usually the result of another condition or an acute illness like pneumonia.
While there is no cure for dementia, research has shown there are some practical steps you can take to reduce your risk factors for getting dementia. They include:
- Attend check-ups. When you and your family members are screened regularly, there is a better chance that any abnormalities can be found and treated early.
- Don’t drink or smoke. Avoiding these may prevent you from contracting respiratory illnesses, along with many other diseases.
- Eat a healthy diet. Get the proper vitamins and nutrients in your diet from foods like leafy greens and berries.
- Exercise. Even light exercise like walking or swimming can be beneficial.
- Monitor blood pressure. Ensure your blood pressure is always at a healthy level and avoid high sodium foods.
- Pay attention to your overall health. Go to the doctor when you experience a strange pain or something that concerns you.
- Down Syndrome and Alzheimer’s disease.
- Frontotemporal dementia.
- Huntington’s disease.
- Korsakoff Syndrome.
- Lewy body dementia.
- Mixed dementia.
- Normal pressure hydrocephalus.
- Parkinson’s disease dementia.
- Posterior cortical atrophy.
- Vascular dementia.
An MRI can help identify markers associated with mild cognitive impairment (MCI) and predict who may eventually develop dementia.
Lewy body dementia (LBD) adversely affects brain cells over time, causing a type of progressive dementia that deteriorates the ability to think and reason and severely impedes independent function.
Parkinson’s disease is known more as a physical disorder that impacts movement. As it progresses, however, Parkinson’s disease can cause cognitive problems, including memory loss and dementia.
People with dementia tend to have problems sleeping, with up to half of patients with severe dementia experiencing sleep disturbances. As the dementia progresses, so too does the severity of their sleep disturbances.
One of the most common reasons why dementia patients have trouble sleeping is a phenomenon called “sundowning.” Taking place in the evening or during the night, people with dementia who are experiencing sundowning might feel confused, restless, agitated, anxious and aggressive.
Here are several additional reasons why people with dementia might have trouble sleeping at night:
- A need for less sleep, which is common among older adults.
- Changes in the body clock.
- Disorientation.
- Mental and physical exhaustion at the end of the day.
- Reduced lighting and increased shadows, which can cause people with dementia to become confused and afraid.
References
Center for Disease Control and Prevention (CDC). What Is Dementia? (https://www.cdc.gov/aging/dementia/index.html)
National Institute of Aging (NIA). What Is Dementia? Symptoms, Types, and Diagnosis (https://www.nia.nih.gov/health/what-is-dementia)
National Institute on Aging (NIA). What Is Dementia? (https://www.alzheimers.gov/alzheimers-dementias/what-is-dementia)