Dementia

 

Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — to such an extent that it interferes with a person’s daily life and activities. Some people with dementia cannot control their emotions, and their personalities may change. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.

 

 

• Alzheimer’s disease: This is the most common type of dementia. Two abnormal proteins build up in your brain: tau and amyloid proteins. These proteins disrupt communication between nerve cells in your brain. Nerve cells die, starting in one area and spreading as more nerve cells die in other areas. Symptoms include short-term memory loss, confusion, personality and behavior changes. Trouble talking, remembering distant memories and issues with walking happen later in the disease. Alzheimer’s disease mainly affects adults who are older — up to 10% of those over age 65 and about 50% of people older than 85 have the disease. Family history is an important risk factor. Approximately 60% to 80% of people with dementia have this type.

 

• Vascular dementia: This is the second most common type of dementia. It’s caused by conditions such as strokes or atherosclerosis, which block and damage blood vessels in your brain. Symptoms include memory problems, confusion and trouble concentrating and completing tasks. The decline may appear suddenly (following a major stroke) or in steps (following a series of mini strokes). Risk factors include high blood pressure, diabetes and high cholesterol levels. About 15% to 25% of people with dementia have vascular dementia.

 

• Lewy body dementia: This condition involves the buildup of clumps of proteins — called Lewy bodies — in your brain’s nerve cells. Lewy bodies damage nerve cells. Symptoms include movement and balance problems, changes in sleep patterns, memory loss, planning and problem-solving difficulties, and visual hallucinations and delusions. About 5% to 10% of dementias are Lewy Body dementia.

• Frontotemporal dementia (FTD): This dementia results from damage to the frontal and temporal lobes of your brain. The damage is caused by the buildup of abnormal proteins in these areas. It causes changes in social behavior, personality, and/or loss of language skills (speaking, understanding or forgetting the meaning of common words) or motor coordination. FTD is a common cause of early dementia, often occurring in people between the ages of 45 and 64. Between 5% and 6% of all dementias are FTD.

 

• Mixed dementia: This is a combination of two or more types of dementia. The most common combination is Alzheimer’s disease with vascular dementia. It’s most common in people 80 years of age and over. It’s often hard to diagnose because symptoms of one dementia may be more obvious and/or many symptoms of each type overlap. The decline is faster in people who have mixed dementia compared with those who only have one type.

 

• Huntington’s disease: A single defective gene causes this brain disorder. The disease causes a breakdown in your brain’s nerve cells, which causes body movement control problems, as well as thinking, decision-making and memory trouble, and personality changes.

 

• Parkinson’s disease: Many people in the later stages of Parkinson’s disease develop dementia. Symptoms include trouble with thinking and memory, hallucinations and delusions, depression and trouble with speech.

 

• Creutzfeldt-Jakob disease: This rare infective brain disease affects about only 1 in 1 million people. An abnormal protein in your brain called prions causes the disease. These prions clump together and cause nerve cell death in your brain. Symptoms include problems with thinking, memory, communication, planning and/or judgment, confusion, behavior changes, agitation and depression.

 

• Wernicke-Korsakoff syndrome: This brain disorder is caused by a severe thiamine (vitamin B1) deficiency. This can result in bleeding in key areas related to memory in your brain. It’s most commonly caused by alcohol use disorder but can also be due to malnutrition and chronic infection. Symptoms include double vision, loss of muscle coordination, and difficulty processing information, learning new skills and remembering things.

 

• Traumatic brain injury: Repeated blows to your head can cause this injury. It’s most often seen in football players, boxers, soldiers and people who’ve had a vehicle accident. Dementia symptoms, which appear years later, include memory loss, behavior or mood changes, slurred speech and headaches.

 

 

Dementia symptoms vary depending on the cause, People may experience some of these common signs and symptoms which include:

• Cognitive: mental decline, confusion in the evening hours, disorientation, inability to speak or understand language, making things up, mental confusion, or inability to recognise common things

• Behavioural: irritability, personality changes, restlessness, lack of restraint, or wandering and getting lost.

• Mood: anxiety, loneliness, mood swings, or nervousness

• Psychological: depression, hallucination, or paranoia

• Muscular: inability to combine muscle movements or unsteady walking

Also common: memory impairment, falling, paraphasia, or sleep disorder.

 

 

Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected.

 

Dementias are often grouped by what they have in common, such as the protein or proteins deposited in the brain or the part of the brain that’s affected. Some diseases look like dementias, such as those caused by a reaction to medications or vitamin deficiencies, and they might improve with treatment.

 

Is dementia treatable?

First, it’s important to understand the terms “treatable,” “reversible” and “curable.” All or almost all forms of dementia are treatable, in that medication and other measures can help manage your symptoms. However, most types of dementia can’t be cured or reversed, and treatments provide only modest benefits.

 

 

• Side effects of medications, illicit drugs or alcohol.

• Tumors that can be removed.

• Subdural hematoma (a buildup of blood beneath the outer covering of your brain that’s caused by a head injury).

• Normal pressure hydrocephalus (a buildup of cerebrospinal fluid in your brain).

• Metabolic disorders, such as a vitamin B12 deficiency.

• Hypothyroidism, a condition that results from low levels of thyroid hormones.

• Hypoglycemia (low blood sugar).

• Depression.

 

• Alzheimer’s disease.

• Multi-infarct (vascular) dementia.

• Dementias associated with Parkinson’s disease and similar disorders.

• AIDS dementia complex.

• Creutzfeldt-Jakob disease.

 

 

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