Dementia

Overview

Dementia is a term used to describe a group of symptoms affecting memory, thinking, and social abilities. It refers to a decline in cognitive function and daily life skills caused by damage to or loss of nerve cells and their connections in the brain. Dementia is not a specific disease, but rather a broad category that includes various conditions that can cause dementia symptoms. Alzheimer's disease is the most common cause of dementia. Other causes include frontotemporal dementia, vascular dementia, Lewy body dementia, and mixed dementia. Symptoms may include memory loss, cognitive changes, problems with communication and visual/spatial abilities, trouble with reasoning and problem-solving, and psychological changes such as personality changes, depression, anxiety, and paranoia. If you or a loved one is experiencing memory problems or other dementia symptoms, it's important to see a healthcare professional to determine the cause, as some medical conditions that cause dementia symptoms can be treated.

Understanding the disease

Symptoms

Dementia is a term used to describe a group of symptoms affecting memory, thinking, and social abilities. Common symptoms of dementia include memory loss, difficulty communicating or finding words, problems with visual and spatial abilities, issues with reasoning or problem-solving, and trouble performing complex tasks. Other symptoms can include problems with planning and organizing, poor coordination and control of movements, confusion and disorientation, and psychological changes such as personality changes, depression, anxiety, agitation, inappropriate behavior, paranoia, and hallucinations. If you or a loved one is experiencing these symptoms, it's important to see a healthcare professional to determine the cause, as some dementia-causing conditions can be treated or managed.

Risk Factors

Risk factors for developing dementia include cardiovascular risk factors such as obesity, high blood pressure, high cholesterol, and atherosclerosis; diabetes and smoking; late-life depression; and air pollution exposure. Other risk factors that can't be changed are age and family history. However, adopting a healthy lifestyle may help lower the risk of cognitive decline, including engaging in a Mediterranean-style diet, regular exercise, cognitive training, and social activities. Excessive alcohol consumption, poor sleep patterns, and certain lifestyle factors associated with heart disease may also increase the risk of dementia.

Development

Dementias develop due to damage to or loss of nerve cells and their connections in the brain. The symptoms depend on the area of the brain that's damaged. Dementias can be classified based on the protein or proteins deposited in the brain or by the part of the brain that's affected. Some diseases may have symptoms similar to dementia, and certain medications or vitamin/mineral deficiencies can also cause dementia symptoms. Progressive dementias, such as Alzheimer's disease and frontotemporal dementia, worsen over time and are not reversible. The development of Alzheimer's disease is influenced by genetic factors, with a small percentage being related to changes in three genes that can be passed down from parent to child. The disease is characterized by the presence of plaques and tangles in the brain, which damage healthy brain cells and the fibers connecting them.

Assessment and Diagnosis

Triage

It is advisable to see a healthcare professional if you or a loved one experiences memory problems or other dementia symptoms. This is important to determine the cause of these symptoms, as some medical conditions that lead to dementia can be treated. The symptoms include memory loss, difficulty communicating or finding words, trouble with visual and spatial abilities, problems with reasoning or problem-solving, trouble performing complex tasks, planning and organizing issues, poor coordination and control of movements, confusion and disorientation, psychological changes, personality changes, depression, anxiety, agitation, inappropriate behavior, suspiciousness (paranoia), and hallucinations.

Diagnosis

To diagnose dementia, a healthcare professional will begin by reviewing your medical history and symptoms, and conducting a physical and neurological exam. This may include tests of memory and thinking skills. Blood and imaging tests, such as a CT scan or PET scan, may also be performed to rule out other potential causes of the symptoms and better identify the disease causing dementia. No single test can diagnose dementia, and a number of tests may be needed to pinpoint the problem.

Management and Treatment

Complications

Dementia can lead to several complications, affecting various body systems and functions. Some of the potential complications include:

1. Poor nutrition: Many people with dementia may reduce or stop eating, affecting their nutrient intake.
2. Pneumonia: Difficulty swallowing increases the risk of choking, leading to aspiration and potential pneumonia.
3. Inability to perform self-care tasks: As dementia progresses, individuals may struggle with activities of daily living, such as bathing, dressing, and using the toilet.
4. Lack of exercise: Reduced mobility and decreased motivation can contribute to a sedentary lifestyle.
5. Obesity: Inactivity and poor dietary choices can lead to weight gain and obesity.
6. Smoking or exposure to secondhand smoke: Both smoking and secondhand smoke exposure can increase the risk of various health problems.
7. High blood pressure: Uncontrolled high blood pressure can further complicate dementia management.
8. High cholesterol: Elevated cholesterol levels can contribute to cardiovascular issues.
9. Poorly controlled type 2 diabetes: Unmanaged diabetes can exacerbate dementia symptoms and increase the risk of related health complications. It is essential to address these modifiable risk factors and promote a healthy lifestyle to manage dementia more effectively.

Preparing for medical consultation

To prepare for an appointment for dementia, here are some steps you can follow:

1. Make a list of symptoms: Note down any symptoms related to memory loss or cognitive decline, including those that may seem unrelated. Also, include when these symptoms began.
2. Gather personal information: Prepare a list of any major stresses, recent life changes, and your family medical history.
3. List medications and supplements: Create a list of all the medications, vitamins, and supplements you take, including dosages.
4. Bring a support person: Consider bringing a family member, friend, or caregiver to the appointment for support and assistance in understanding the information provided.
5. Write down questions: Prepare a list of questions to ask the healthcare professional during the appointment. Some basic questions to ask include the cause of symptoms, possible alternative explanations, necessary tests, the nature and duration of the condition, and the best course of action.
6. Participate in caregiver education programs: If you are a caregiver or care partner for someone with dementia, learn about the disease and participate in caregiver education programs to better understand the condition and provide appropriate support.
7. Utilize supportive services: Seek out available supportive services in your community, such as respite care or adult care, to help ease the physical and emotional demands of caregiving.
8. Take care of your health: Ensure that you also prioritize your own physical, emotional, and spiritual well-being. Reach out to friends, family, or support groups for help, and don't hesitate to ask questions of healthcare professionals and other care providers involved in the care of your loved one.