All You Need to Know About Dementia

What is dementia?

Dementia is a term that describes a decline or a fall in cognitive ability. To be diagnosed, the affected individual must be mentally impaired in at least 2 brain functions. This condition affects the following functions:

• Thinking
• Memory
• Behavior
• Language
• Judgment

Many people mistake dementia for a disease. No, it is not. Dementia may be caused by many injuries or illnesses. The status of a mentally impaired person may range from mild to severe. Dementia also causes changes in an individual’s personality. Some forms of dementia are progressive. What this means is that they worsen over time. Do you know that some forms of dementia can be treated or even reversed? Yes! A certain school of thought reserves the term dementia for irreversible deterioration of mental function.

What are the symptoms?

During the early stages of dementia, the patient may experience the following symptoms:

• Inability to cope with change: The patient may find it difficult to accept environmental or schedule changes.
• Subtle alterations in short-term memory: The patient can recall events that took place long ago, but cannot remember recent events.
• Inability to reach for the right words: There’s difficulty in word association or word recollection.
• The constant act of repetitiveness: patients that suffer dementia may repeat the same questions over and over again, perform the same task, and repeat the same story many times.
• Poor sense of direction: The patient fails to recognize “familiar” places. He or she may also find it hard to identify or recognize driving routes that he or she has used for years because it now looks very strange.
• Difficulty in following storylines: It becomes difficult for the patient to follow a story or description.
• Frequent mood changes: Frustration, depression, anger, are common in demented patients.
• Lack of interest: Apathy is common in people with dementia. The individual loses interest in activities or hobbies that he or she once enjoyed.
• Confusion: A person with dementia may start to see familiar places, events, or people, as being unfamiliar. You might be unable to remember people that know you.
• Inability to complete daily tasks: You may struggle to recall the number of tasks that you’ve done for years.

You should also note that having memory problems doesn’t mean that a person has dementia.

What are the stages of dementia?

Dementia is a progressive condition. This means that it worsens over time. The progress differs in everyone. However, the following stages are experienced by most sufferers:

Mild cognitive impairment

Elderly people may develop a mild form of cognitive impairment, but then, this may never progress to dementia. People who have mild cognitive impairment usually find it hard to recall words, they are always forgetful, and they struggle with short-term memory problems.

Mild dementia

People at this stage may be able to function without depending on anyone. Symptoms include:

• Short-term memory lapses
• Changes in individual personality e.g. depression or anger
• Struggling to express ideas or emotions
• Difficulty with problem-solving or complex tasks
• Forgetfulness or misplacing things

Moderate dementia

People who have the moderate form of this condition may require assistance from a friend or a care provider. The reason for this is because dementia interferes with daily activities and tasks. Symptoms include:

• Poor judgment
• Increasing frustration and confusion
• Memory loss that further penetrates the past
• Requiring assistance with simple tasks like bathing and dressing
• Significant changes in personality

Severe dementia

This is the late stage of the condition. It involves a continuous decline in the physical and mental symptoms of the condition. Symptoms of severe dementia include:

• Poor communication
• Inability to maintain body functions (bladder control, swallowing, etc.)
• High risk of infections
• Need for full-time assistance

Note that the rate at which patients pass through the different stages of dementia differs.

Causes of dementia

Many factors contribute to the onset of dementia including brain diseases. Generally, it results from the death or degeneration of nerve cells (neurons) in the brain.

Common causes of dementia are vascular dementia and Alzheimer’s disease.

Neurodegenerative means gradual cessation or loss of function of neurons.

This affects the synapses (connections between neurons). This disconnection can cause a series of dysfunctions.

Other factors that contribute to dementia include:

• Infections or tumors in the brain
• Vascular dementia
• Alzheimer’s disease
• Chronic alcoholism
• Side effects of some medications

Another factor that contributes to this condition is frontotemporal lobar degeneration. This is a general term for conditions that damage the temporal and frontal lobes of the brain. These conditions include:

• Pick’s disease
• Frontotemporal dementia
• Corticobasal degeneration
• Supranuclear palsy

Other factors that contribute to this condition include:

• Disorders of the brain structure such as subdural hematoma and normal-pressure hydrocephalus
• Metabolic disorders like vitamin B-12 deficiency, liver and kidney disorders, and hypothyroidism.
• Lead, and other toxins

Types

Most times, dementia could be a symptom of a disease. Different diseases trigger different types of dementia. The major types include:

• Alzheimer’s disease: This is the most common. Studies show that at least 60-80% of dementia cases are from Alzheimer’s disease.
• Vascular dementia: It is caused by poor blood flow to the brain. It may be caused by a buildup of plaques in the brain’s arteries or maybe a stroke.
• Lewy body dementia: Deposits of proteins in neurons prevents transmission of chemical signals by the brain. This results in delayed reactions, lost messages, and loss of memory.
• Parkinson’s disease: Individuals at the advanced stage of Parkinson’s disease may develop the condition. This type of dementia is characterized by symptoms such as problems with judgment and reasoning, increased irritability, depression, and paranoia.
• Frontotemporal dementia: This is an umbrella term for several types of dementia. Each type is affected by changes in the side and front parts of the brain. Symptoms include behavioral and language difficulty, as well as the loss of inhibition.

There are other types though, but they are not as common. Studies show that there is a particular type of dementia that affects just one in one million people.

Test for dementia

Several tests are used to confirm a dementia diagnosis. These include:

• Medical history of the patient
• A physical exam
• Lab tests
• Evaluation of symptoms, such as memory changes, as well as changes in brain function, and behavior.

A doctor can almost accurately predict if an individual or his loved one is experiencing symptoms of the condition. But then, he or she may not be able to determine the exact type of dementia. Most times, there’s an overlap of the symptoms, and so it becomes difficult to distinguish between two types of dementia.

Treatment

There are two forms of treatment: drug therapy and non-drug therapy.

Under drug therapy, two important kinds of medications are used. They are:

• Cholinesterase inhibitors
• Memantine

Cholinesterase inhibitors increase the concentration of acetylcholine. Acetylcholine improves judgment and helps with memory formation. Memantine delays the onset of behavioral and cognitive symptoms in individuals with moderate or severe dementia. Both drugs may be prescribed together.

Non-drug therapy

These therapies can alleviate some of the complications of the condition or reduce symptoms. They include:

• Occupational therapy
• Modifying your environment
• Modifying certain tasks

Can dementia be prevented?

Yes! There are certain risk factors that increase a person’s chances of developing this condition. Tackling these risk factors with intervention or treatment could reduce the risk. The risk factors include:

• Midlife hypertension
• Illiteracy
• Midlife obesity
• Loss of hearing
• Physical inactivity
• Diabetes
• Social isolation
• Smoking
• Late-life depression

Tonika Bruce

Tonika Bruce, MSN, RN, MBA. is an accomplished nurse leader, published author, and personal development expert passionate about advancing healthcare management and quality patient outcomes.

She taps into the years of experience in healthcare management to produce credible and easy-to-understand health and leadership content. Her exceptional work has been featured in reputable publications, including Forbes, Recruiter, Inc, and the Color of Wellness magazine.

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