Dementia

Dementia is not one specific disease. Instead, it’s a term that describes a wide range of symptoms of cognitive decline. These may include problems with memory, thinking and social abilities. To be diagnosed as dementia, these conditions must represent a change from someones previous level of function, and be severe enough to interfere with activities of daily life.

The terms “senile” or “senile dementia” have been replaced with the terms dementia or major neurocognitive disorder. The symptoms of dementia are no longer considered to be a normal part of aging, rather they are symptoms of an underlying disease.

Alzheimer’s disease is the most common cause of dementia, accounting for up to 60 to 80 percent of cases. There are many other conditions that can cause symptoms of dementia. Some of these conditions are potentially reversible, such as nutritional deficiencies or other physical health problems.

Unfortunately, most types of dementia can’t be cured. However, the Memory Center at Seton Healthcare Family offers a program to diagnose and to help people manage symptoms of dementia.

Wellness & Prevention

There is no sure way to prevent dementia. However, there are steps that may be beneficial for the elderly and the young alike. Research suggests that physical activity and mental stimulation may help by delaying the onset of dementia and reducing its symptoms:

  • Physical activity such as aerobic exercises and resistance training may help maintain overall health while also improving blood flow to the brain.
  • Social activity and interaction is associated with better mental function. This can mean visiting with friends and family, working or volunteering.
  • Mental stimulation in the form of puzzles and word games may delay the symptoms of dementia. Learning new skills and abilities may also have a protective effect on the mental function of the brain.
  • Healthy diets can help improve brain function and blood flow in the body. Studies suggest that a balanced diet with the inclusion of omega-3 fatty acids may preserve brain function and reduce dementia symptoms.

Risk Factors

Some risk factors for dementia, such as age and family history, cannot be changed. However, other factors such as physical fitness and diet may be addressed to reduce the risk of dementia.

  • Aging greatly increases the risk of dementia and other mental disorders. This is especially true after the age of 65. Dementia is not a part of normal aging.
  • Family history and genetics can influence your risk of dementia. It’s important to note that a family history of dementia does not guarantee that you will get it as well. While there are genetic tests to help determine the risk of developing dementia, they have limitations and are not recommended as part of a routine health screening.
  • Alcohol, smoking and drug use can contribute toward loss of mental function and other health problems, including dementia.
  • Lifestyle factors like obesity and heart disease can increase your chances of getting dementia.
  • Depression is thought to have a connection to Alzheimer’s-related dementia.

Diagnosis

Because of the many different causes of dementia, it is very important to conduct a thorough health exam before a diagnosis is made.

Causes of dementia include:

Alzheimer’s Disease

Alzheimer’s disease is a degenerative disorder that affects brain neurons. It results in memory loss, loss of thinking skills and behavioral changes serious enough to interfere with daily life. Alzheimer’s is the sixth leading cause of death in the United States.

Lewy Body Dementia

This is the second most common type of dementia after Alzheimer’s disease. In addition to a decline in cognition, visual hallucinations commonly occur in patients with Lewy Body Dementia. These patients can also have rigid muscles and slowed movement, which can appear similar to Parkinson’s disease.

Vascular Dementia

Vascular dementia is a general term describing problems with mental function caused by brain damage from vascular disease in the brain. Vascular dementia can develop after a stroke blocks an artery in the brain. However, strokes do not always cause this type of dementia. This condition can also result from bleeding in the brain and other disorders that damage cerebral blood vessels.

Frontotemporal Dementia

Frontotemporal dementia, sometimes referred to as Pick’s disease, is a general term for a group of disorders that mainly affect the frontal and temporal lobes of the brain. These areas are generally associated with personality, behavior, and language. Signs and symptoms of this dementia vary, depending on the portion of the brain most affected.

Mild Cognitive Impairment

Mild cognitive impairment (also known as MCI) is an intermediate stage of mental decline. This falls between the expected decline of normal aging and the more serious decline of dementia. It can often involve problems with memory. These problems are greater than normal age-related impairments. However, they are not usually significant enough to interfere with day-to-day life and activities.

To properly diagnose dementia, a careful review of the individual’s medical history and symptoms will be done, including daily functions and behaviors. Doctors may also order a number of lab tests and brain scans to rule out other conditions that may affect brain health. Sensation and strength checks can test brain health, as well as reflex and coordination tests.

Different brain imaging scans may be used to get photos of the brain and check for strokes, bleeding or tumors:

  • Magnetic Resonance Imaging (MRI): An MRI is an image of the brain that’s taken using a magnetic field and computers.
  • Computerized Tomography (CT): A CT scan is a cross-section of the brain that’s created using X-rays.
  • Positron Emission Tomography (PET): PET scans can test brain functioning and detect certain brain proteins that are associated with types of dementia like Alzheimer’s disease.

Laboratory tests can also be performed to check for physical problems that may be causing or making brain conditions worse.

Symptoms

Symptoms of dementia vary depending on the cause and may be different for each person. Common symptoms and signs of dementia include:

  • Memory loss
  • Communication and language impairment
  • Difficulty with complex tasks
  • Inability to focus or disorientation
  • Difficulty with reasoning and judgment
  • Difficulty with motor function and coordination
  • Difficulty controlling mood or behaviors
  • Depression and paranoia

Treatments

Dementia has no known cure, but doctors may recommend certain behavioral and medical treatments that can reduce any symptoms that may be present:

  • Use of medications to increase brain chemicals that are thought to have an effect on thinking skills and judgment.
  • Modifying the environment to decrease clutter and noise. This may help people living with dementia focus better and experience less confusion.
  • Dividing tasks into simple steps and focusing on completion of goals. This can create structure and positive reinforcement.
  • Modifying caregiver responses to better handle the mood swings and changes that can occur with dementia

Many treatment therapies for dementia involve creating better routines for the individual. Managing the environment has been shown to be helpful in increasing a dementia patient’s quality of life.

Aftercare

Managing dementia can be a struggle for both patients and caregivers alike. People with dementia will often forget where they are and become confused, creating difficult situations that require care and support to handle.