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. 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.
• 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.
• Vascular dementia, a form of dementia caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain
• Lewy body dementia, a form of dementia caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies, which may occur with Parkinson’s disease
• Frontotemporal dementia, a rare form of dementia that tends to occur in people younger than 60. It is associated with abnormal amounts or forms of the proteins tau and TDP-43.
• Mixed dementia, a combination of two or more types of dementia.
The World Health Organization (WHO) divides dementia into roughly three stages: early, middle, and late.
▪︎ Early stage
At this stage, it may not seem that a person has dementia. They may:
• become more forgetful
• lose track of time
• feel lost in familiar locations
▪︎ Middle stage
At this stage, the symptoms become more noticeable and include:
• forgetting names and recent events
• feeling lost when at home
• difficulty communicating
• behavioral changes
• repeatedly asking questions
• needing help with personal care
▪︎ Late stage
At this stage, a person needs full-time assistance, as the impact of the symptoms typically becomes more severe. The person may:
• be unaware of where they are
• be unaware of time
• have difficulty recognizing loved ones
• find it hard to walk
• experience behavioral changes, which may include aggression
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
▪︎ Cognitive changes
• Memory loss, which is usually noticed by someone else
• Difficulty communicating or finding words
• Difficulty with visual and spatial abilities, such as getting lost while driving
• Difficulty reasoning or problem-solving
• Difficulty handling complex tasks
• Difficulty with planning and organizing
• Difficulty with coordination and motor functions
• Confusion and disorientation
▪︎ Psychological changes
• Personality changes
• Inappropriate behavior
The most common causes of dementia include:
▪︎ Degenerative neurological diseases.
• Alzheimer’s disease
• Parkinson’s disease
• Huntington’s disease
• Some types of multiple sclerosis.
These diseases get worse over time.
▪︎ Vascular disorders.
These conditions affect the blood circulation in your brain.
• Traumatic brain injuries caused by car accidents, falls, concussions, etc.
• Infections of the central nervous system. These include meningitis, HIV, and Creutzfeldt-Jakob disease.
• Long-time alcohol or drug use
• Certain types of hydrocephalus, a buildup of fluid in the brain
Risk Factors –
Certain physical and lifestyle factors can raise your chances of dementia, including:
• Dementia in your family
• Illnesses including diabetes, Down syndrome, multiple sclerosis, heart disease, and sleep apnea
• Smoking, heavy alcohol use, poor diet, and lack of exercise
• Brain injury
• Infection of the brain (for example, meningitis and syphilis)
Dementia can affect many body systems and, therefore, the ability to function. Dementia can lead to:
• Poor nutrition.
Many people with dementia eventually reduce or stop eating, affecting their nutrient intake. Ultimately, they may be unable to chew and swallow.
Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia.
• Inability to perform self-care tasks.
As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently, and taking medications as directed.
• Personal safety challenges.
Some day-to-day situations can present safety issues for people with dementia, including driving, cooking, and walking and living alone.
The doctor will review the patient’s history and perform a physical exam and cognitive testing. Further testing might happen depending on the history and physical.
This testing might include:
• Blood and urine tests
• Chest X-ray
• Brain scanning (MRI or CT scanning)
• Electroencephalogram (EEG)
• Spinal fluid analysis
They use certain criteria to diagnose dementia. These include:
• impairment of attention
• Language, motor, and spatial skills and function. (By definition, dementia is not due to major depression or schizophrenia.)
There is currently no cure for most types of dementia, as it is not yet possible to reverse brain cell death. However, treatment may help manage symptoms.
Some medications may help reduce the symptoms of Alzheimer’s disease. Three drugs, known as cholinesterase inhibitors, have approval for use. They are:
• donepezil (Aricept)
• galantamine (Reminyl)
• rivastigmine (Exelon)
Cholinesterase inhibitors can also help manage behavioral symptoms of Parkinson’s disease.A person may also use memantine (Namenda), which is an NMDA receptor antagonist, either alone or with a cholinesterase inhibitor.
If the symptoms result from an injury, medication use, or a vitamin deficiency, it may be possible to prevent further damage.
▪︎ Other forms of care
Some lifestyle strategiesTrusted Source that may help manage dementia include making sure the person:
• follows a healthy diet
• gets regular exercise
• attends all medical appointments
• takes their medication as prescribed
• has regular sleep habits
• has a safe living space
• has support from family members and caregivers, as needed
There’s no sure way to prevent dementia, but there are steps you can take that might help. More research is needed, but it might be beneficial to do the following:
• Keep your mind active.
Mentally stimulating activities, such as reading, solving puzzles and playing word games, and memory training might delay the onset of dementia and decrease its effects.
• Be physically and socially active.
Physical activity and social interaction might delay the onset of dementia and reduce its symptoms. Aim for 150 minutes of exercise a week.
• Quit smoking.
Some studies have shown that smoking in middle age and beyond might increase your risk of dementia and blood vessel conditions. Quitting smoking might reduce your risk and will improve your health.
• Get enough vitamins.
Some research suggests that people with low levels of vitamin D in their blood are more likely to develop Alzheimer’s disease and other forms of dementia. You can get vitamin D through certain foods, supplements and sun exposure.
It’s a good idea to make sure you get adequate vitamin D. Taking a daily B-complex vitamin and vitamin C also might help.
• Manage cardiovascular risk factors.
Treat high blood pressure, high cholesterol and diabetes. Lose weight if you’re overweight.High blood pressure might lead to a higher risk of some types of dementia. More research is needed to determine whether treating high blood pressure may reduce the risk of dementia.
• Treat health conditions.
See your doctor for treatment for depression or anxiety.
• Maintain a healthy diet.
A diet such as the Mediterranean diet — rich in fruits, vegetables, whole grains and omega-3 fatty acids, which are commonly found in certain fish and nuts — might promote health and lower your risk of developing dementia. This type of diet also improves cardiovascular health, which may help lower dementia risk.
• Get good-quality sleep.
Practice good sleep hygiene, and talk to your doctor if you snore loudly or have periods where you stop breathing or gasp during sleep.
• Treat hearing problems.
People with hearing loss have a greater chance of developing cognitive decline. Early treatment of hearing loss, such as use of hearing aids, might help decrease the risk.
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