Dementia, Facts and Things you should know

 Dementia a condition characterized by progressive or persistent loss of intellectual functioning, especially with impairment of memory and abstract thinking, and often with personality change, resulting from organic disease of the brain.

Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several diseases can cause dementia.

Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia, although it's often one of the early signs of the condition.

A group of thinking and social symptoms that interferes with daily functioning.

Not a specific disease, dementia is a group of conditions characterised by impairment of at least two brain functions, such as memory loss and judgement.

Symptoms include forgetfulness, limited social skills and thinking abilities so impaired that it interferes with daily functioning.

Medication and therapies may help manage symptoms. Some causes are reversible.

Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of other causes of dementia. Depending on the cause, some dementia symptoms might be reversible.

Types of dementia include: Alzheimer's disease, the most common dementia diagnosis among older adults.

It is caused by changes in the brain, including abnormal buildups of proteins known as amyloid plaques and tau tangles. Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia.

Dementia is not a single disease; it’s an overall term — like heart disease — that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings and relationships.

Alzheimer's disease accounts for 60-80% of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. Those who experience the brain changes of multiple types of dementia simultaneously have mixed dementia. There are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

 Common Types of Dementia, What is Alzheimer's?

Know the 10 signs

Find out how typical age-related memory loss compares to early signs of Alzheimer's and other dementias.

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Symptoms and signs of dementia

Signs of dementia can vary greatly. Examples include problems with:

• Short-term memory.
• Keeping track of a purse or wallet.
• Paying bills.
• Planning and preparing meals.
• Remembering appointments.
• Traveling out of the neighborhood.

Many conditions are progressive, which means that the signs of dementia start out slowly and gradually get worse. If you or someone you know is experiencing memory difficulties or other changes in thinking skills, don't ignore them.

 See a doctor soon to determine the cause. Professional evaluation may detect a treatable condition. And even if symptoms suggest dementia, early diagnosis allows a person to get the maximum benefit from available treatments and provides an opportunity to volunteer for clinical trials or studies. It also provides time to plan for the future.

 10 Warning Signs, Stages of Alzheimer's 

Causes

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.

The brain has many distinct regions, each of which is responsible for different functions (for example, memory, judgment and movement). When cells in a particular region are damaged, that region cannot carry out its functions normally.

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Different types of dementia are associated with particular types of brain cell damage in particular regions of the brain. For example, in Alzheimer's disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other.

The brain region called the hippocampus is the center of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That's why memory loss is often one of the earliest symptoms of Alzheimer's.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed:

• Depression.
• Medication side effects.
• Excess use of alcohol.
• Thyroid problems.
• Vitamin deficiencies.

Diagnosis of dementia

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. Doctors can determine that a person has dementia with a high level of certainty. But it's harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnose "dementia" and not specify a type. If this occurs, it may be necessary to see a specialist such as a neurologist, psychiatrist, psychologist or geriatrician.

 Memory Tests

Dementia help and support are available If you or someone you know has been diagnosed with dementia, you are not alone. The Alzheimer's Association is one of the most trusted resources for information, education, referral and support. Dementia treatment and care

How common is dementia?

Of those at least 65 years of age, there is an estimated 5.0 million adults with dementia in 2014 and projected to be nearly 14 million by 2060.

Isn’t dementia part of normal aging?

No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:

• Occasionally misplacing car keys
• Struggling to find a word but remembering it later
• Forgetting the name of an acquaintance
• Forgetting the most recent events

Normally, knowledge and experiences built over years, old memories, and language would stay intact.

What are the signs and symptoms of dementia?

Because dementia is a general term, its symptoms can vary widely from person to person. People with dementia have problems with:

• Memory
• Attention
• Communication
• Reasoning, judgment, and problem solving
• Visual perception beyond typical age-related changes in vision

Signs that may point to dementia include:

• Getting lost in a familiar neighborhood
• Using unusual words to refer to familiar objects
• Forgetting the name of a close family member or friend
• Forgetting old memories
• Not being able to complete tasks independently

What increases the risk for dementia?

• Age
• The strongest known risk factor for dementia is increasing age, with most cases affecting those of 65 years and older
• Family history
• Those who have parents or siblings with dementia are more likely to develop dementia themselves.
• Race/ethnicity
• Older African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.
• Poor heart health
• High blood pressure, high cholesterol, and smoking increase the risk of dementia if not treated properly.
• Traumatic brain injury
• Head injuries can increase the risk of dementia, especially if they are severe or occur repeatedly.

How is dementia diagnosed?

A healthcare provider can perform tests on attention, memory, problem solving and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI can help determine an underlying cause.

What are the most common types of dementia?

• Alzheimer’s disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimer’s disease increases the risk of developing it by 10 to 30 percent.
• Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
• Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations (seeing people, objects or shapes that are not actually there).
• Fronto-temporal dementia. This type of dementia most often leads to changes in personality and behavior because of the part of the brain it affects. People with this condition may embarrass themselves or behave inappropriately. For instance, a previously cautious person may make offensive comments and neglect responsibilities at home or work. There may also be problems with language skills like speaking or understanding.
• Mixed dementia. Sometimes more than one type of dementia is present in the brain at the same time, especially in people aged 80 and older. For example, a person may have Alzheimer’s disease and vascular dementia. It is not always obvious that a person has mixed dementia since the symptoms of one type of dementia may be most prominent or may overlap with symptoms of another type. Disease progression may be faster than with one kind of dementia.
• Reversible causes. People who have dementia may have a reversible underlying cause such as side effect of medication, increased pressure in the brain, vitamin deficiency, and thyroid hormone imbalance. Medical providers should screen for reversible causes in patients who are concerning for dementia.

How is dementia treated?

Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimer’s disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.

Leading a healthy lifestyle, including regular exercise, healthy eating, and maintaining social contacts, decreases chances of developing chronic diseases and may reduce number of people with dementia.

What to do if a loved one is suspicious of having dementia?

• Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
• Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
• Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.