What is Dementia? Dementia is a comprehensive category of brain diseases that cause a long-term and often progressive decrease in the ability to think and remember that is prominent enough to affect a person’s everyday functioning. Other general symptoms of dementia include emotional problems, troubles with language, and a reduction in motivation.
A person’s consciousness is ordinarily not affected. A dementia diagnosis needs a change from a person’s normal mental functioning and a greater drop than one would expect due to ageing. These conditions also have a notable effect on a person’s caregivers.
The various common nature of dementia is Alzheimer’s disease, which presents up to 50% to 70% of cases. Other common types of dementia include vascular dementia (25%), Lewy body dementia (15%), and frontotemporal dementia. Scarce common causes of dementia include normal pressure hydrocephalus, Parkinson’s disease dementia, Creutzfeldt–Jakob disease and syphilis. A little proportion of cases run in families. In the DSM-5, dementia was reclassified as a neurocognitive disorder, with variable degrees of severity. Diagnosis is normally based on the history of the illness and cognitive testing with medical imaging and blood tests done to rule out other potential causes. Efforts to prevent dementia combine trying to reduce the risk factors such as high blood pressure, diabetes, smoking, and obesity.
There is no known cure for dementia. Donepezil is a cholinesterase inhibitor are often practise and may be beneficial in mild to the moderate disorder of dementia. There are various measures that can enhance the quality of life of people with dementia and their caregivers. Cognitive and behavioural interventions may be suitable. Educating and implementing emotional support to the caregiver is necessary. Exercise programs may be advantageous with respect to the activities of everyday living and possibly improve outcomes. Treatment of behavioral difficulties with antipsychotics is common but not normally prescribed due to the little benefit and side effects, including a risen risk of death.
Dementia affected approximately 46 million people in 2015, globally. Roughly 10% of people develop dementia at some point in their lives. It grows more common with age. Approximately 3% of people between the ages of 65–74 become dementia, 19% within 75 and 84 and nearly 50% of those over 85 years of age. While 2013 dementia resulted in about 1.7 million deaths pressing from 0.8 million in 1990. As more people are living longer, dementia is one of the most common causes of disability among the old. It is assumed to result in economic losses of 604 billion USD a year.
Symptoms of Dementia
Dementia is not a condition itself but somewhat a gathering of symptoms that happen from damage to the brain induced by different conditions, such as Alzheimer’s. These manifestations vary according to the portion of the brain that is damaged.
Common Early Symptoms of Dementia
Different prototypes of dementia can affect people individually, and everyone will endure symptoms in their own way. Though, there are some typical early symptoms that may develop sometime before a diagnosis of dementia. These typical dementia symptoms combine:
- Memory loss.
- Difficulty concentrating.
- Finding it troublesome to carry out familiar daily duties, such as becoming confused over the exact change when shopping.
- Striving to follow a conversation or find the right word.
- Being confused about time and place.
- Mood changes.
These manifestations are often mild and may get serious only very gradually. It’s usually termed “mild cognitive impairment” (MCI) as the symptoms are not critical enough to be diagnosed as dementia. In some people, these signs will remain the same and not worsen. But some people with MCI will go on to manifest dementia. Dementia is not a natural part of ageing. This is why it’s necessary to talk to your physicians sooner.
Symptoms Specific to Alzheimer’s Disease
The most prevalent cause of dementia is Alzheimer’s disease. Alzheimer’s disease common symptoms include:
Memory problems – typically forgetting recent events, names, and faces.
Increasing problems with tasks and activities that need organization and planning.
Asking questions repetitively.
Becoming confused in unfamiliar environments.
The difficulty with numbers and/or handling money in shops.
Difficulty finding the right words.
Becoming more anxious.
Symptoms Specific to Vascular Dementia
Vascular dementia is the second prevalent cause of dementia, following Alzheimer’s disease. Some personalities have both vascular dementia and Alzheimer’s disease, often termed as “mixed dementia”.
Manifestations of vascular dementia are alike to Alzheimer’s disease, although memory loss may not be as obvious in the early stages.
Symptoms can sometimes happen fast and quickly get worse, but they can further develop gradually over many months or years. Specific symptoms can include:
Stroke-like symptoms that may including muscle weakness or temporary paralysis on one side of the body.
Movement problems like difficulty in walking or a change in the way a person walks.
Thinking problems may be becoming difficulty with attention, planning, and reasoning.
Mood changes like depression and an inclination to become more emotional.
Symptoms Specific to Dementia with Lewy bodies
Dementia among Lewy bodies has many of the manifestations of Alzheimer’s disease, and people with dementia with Lewy bodies typically also experience:
- Visual hallucinations.
- Periods of being alert or drowsy, or varying levels of confusion.
- Becoming slower in their physical movements.
- Sleep disturbances.
- Repeated falls and fainting.
Symptoms Specific to Frontotemporal dementia
Although Alzheimer’s disease is the most common type of dementia in somebody under 65, a higher portion of people in this age group may occur frontotemporal dementia than older people. Most problems are diagnosed in people aged 45-65.
Early manifestations of frontotemporal dementia may combine:
- Personality changes like diminished sensitivity to others’ feelings, getting people to seem cold and unfeeling.
- Language problems like trouble finding the right words.
- Lack of social awareness that making unsuitable jokes or showing a lack of tact, though some personalities may become very withdrawn and apathetic.
- Becoming obsessive such as evolving trends for unusual foods, overeating, and drinking.
Symptoms in the Later Stages of Dementia
Being dementia progresses, memory loss and struggles with communication oftentimes become severe. In the later stages, the person is prone to neglect their own health, and need constant care and attention. The Common Symptoms of Advanced Dementia include:
Memory problems –In this stage, people may not recognize close family and friends or memorize where they live or where they are.
Communication problems – some personalities may ultimately lose the ability to speak altogether. Working non-verbal means of communication, such as facial expressions, touch, and gestures, can support.
Mobility problems – many personages become less efficient to move about unaided. Some may finally become unable to walk and require a wheelchair or be restricted to bed.
Behavioural problems – a notable number of people will develop behavioural and psychological symptoms of dementia. These may involve increased agitation, depressive symptoms, anxiety, wandering, aggression or sometimes hallucinations.
Bladder incontinence is obvious in the later stages of dementia, and some also experience bowel incontinence.
Appetite and weight loss are common in advanced dementia. Many people have difficulty eating or swallowing, and this can commence to choking, chest infections and other difficulties.
Dementia Types
Dementia is described by severe changes in the brain that generate memory loss. Various disorders and factors provide for the progress of dementia. Neurodegenerative disorders result in gradual and irreversible damage to neurons and brain functioning. These changes further make it tough for people to perform basic daily activities. In most personalities, dementia causes changes in behaviour and personality. Dementia changes three areas of the brain:
- Language
- Memory
- Decision-making
Most circumstances of dementia are caused by a disease and can’t be reversed. Alcohol and drug misuse can sometimes induce dementia. In those cases, it can be likely to reverse the damage in the brain.
Types of Dementia-
- Alzheimer’s disease
- Vascular dementia
- Parkinson’s disease
- Dementia with Lewy Bodies
- Frontotemporal dementia
- Creutzfeldt-Jakob disease
- Wernicke-Korsakoff syndrome
- Normal pressure hydrocephalus
- Mixed dementia
- Huntington’s disease
- Down Syndrome and Alzheimer’s Disease
- HIV-associated dementia (HAD)
- Posterior Cortical Atrophy
Causes of Dementia
Dementia isn’t a single disease. Dementia symptoms that occur when there’s a decline in brain function. Dementia is ordinarily caused by degeneration in the cerebral cortex, the part of the brain capable of thoughts, memories, actions, and personality. Death of brain cells leads to the cognitive impairments that characterize dementia.
Several different conditions can induce dementia. Many of these diseases are linked with an abnormal build-up of proteins in the brain. This build-up produces nerve cells to function less well and ultimately die. As the nerve cells die, various areas of the brain shrink. Some dementias, that caused by a reaction to medications or vitamin deficiencies, might better with treatment.
Alzheimer’s disease
The Alzheimer’s Association estimates that Alzheimer’s causes 50 to 70 percent of all dementia. The cause of Alzheimer’s isn’t known, plaques and tangles are often discovered in the brains of people with Alzheimer’s disease. The buildup of two unusual structures in the brain called amyloid plaques and neurofibrillary tangles are common in Alzheimer’s disease.
Amyloid plaques are clumps of beta-amyloid, that is a piece of a protein that is seen in the normal brain. While these beta-amyloid proteins clump contemporaneously, they make plaques that can interfere with communication between nerve cells and induce brain inflammation. People with Alzheimer’s disease have an abundance of these plaques in the hippocampus, the part of the brain involved in memory. The transfer of short-term memories into long-term memories is often disrupted in Alzheimer’s disease.
Neurofibrillary tangles are fibrous tangles of an abnormal protein designated as a tau. Tau is an essential fibre-like protein that keeps microtubules in the brain stable. Microtubules move nutrients, molecules, and information to different cells. While tau is harmfully altered, possibly due to genetic mutation, the fibers get twisted up mutually. This produces the microtubules unstable and makes them disintegrate. This result can collapse the whole neuron transport system.
In people age 65 and older, Alzheimer’s is the most common cause of dementia.
Some genetic factors might make it more likely that people will develop Alzheimer’s. Some people develop Alzheimer’s disease as young as their early 30s and 40s. This is described as early-onset Alzheimer’s disease.
There are three discovered gene mutations considered to be part of the formation of the amyloid plaques in an early-onset Alzheimer’s disease. These three gene mutations do not play a role in the common type of Alzheimer’s disease, which is sometimes regarded as late-onset Alzheimer’s disease.
Causes of Vascular Dementia
Vascular dementia is precipitated by diminished blood flow to the brain. Vascular dementia is the second most common type of dementia occurs as a result of damage to the vessels that supply blood to your brain. Blood vessel problems can be caused by stroke or other blood vessel conditions.
Nerve cells in the brain need oxygen and nutrients from the blood to survive. While the blood supply to the brain is decreased, the nerve cells function less well and eventually die.
Reduced blood flow can be caused by:
Narrowing of the small blood vessels deep inside the brain is the main cause of vascular dementia and this type of dementia is common in people who smoke or have high blood pressure or diabetes.
Stroke where the blood supply to part of the brain is suddenly cut off, usually as a result of a blood clot that induces post-stroke dementia.
Numbers of “mini-strokes” that provoke widespread injury to the brain and this type of dementia known as multi-infarct dementia.
Not everyone that had a stroke will go on to manifest vascular dementia.
Causes of Dementia with Lewy bodies
Lewy body dementia is a distinct common variety of progressive dementia. Lewy bodies are small clumps of a protein called alpha-synuclein that can grow inside brain cells. They’re located in the brain’s outer layer, described the cortex. The cortex is capable of thinking, perceiving, producing, and understanding language.
Lewy bodies are too often found in various parts of the brain stem and the substantia nigra. Here, nerve cells release essential neurotransmitters that support control movement and the coordination.
These clumps damage the cells work and communicate with each other, and the cells ultimately die.
Dementia with Lewy bodies is intimately related to Parkinson’s disease and frequently has some of the same manifestations, including difficulty with movement and a bigger risk of fall.
Frontotemporal Dementia
Frontal lobe dementia causes significant changes in behavior or language capability. It’s usually diagnosed between the ages of 45 and 65. It’s sometimes perceived as frontotemporal dementia.
Frontal lobe dementia is created by an abnormal clumping of proteins, including tau, in the frontal and temporal lobes of the brain.
The clumping of these proteins destroys nerve cells in the frontal and temporal lobes, making brain cells to die. This commences with the shrinking of these areas of the brain.
Frontotemporal dementia is anticipated to run in families and have a genetic link than other, more common causes of dementia.
Pick’s disease is a frontal lobe dementia with a definite genetic component. With pick’s disease, your brain has abnormal structures named Pick bodies, made chiefly of the protein tau, inside the neurons. Brain cells filled with Pick bodies favor to balloon up in size and then die. This leads to the typical shrinkage, or atrophy, in the frontotemporal areas of the brain.
Traumatic Brain Injury
Traumatic brain injury is caused by repetitious head trauma, such as undergone by boxers, football players or soldiers.
Depending on the part of the brain that’s damaged, this condition can cause dementia signs and symptoms, such as depression, memory loss, explosiveness, uncoordinated movement, impaired speech, slow movement, tremors, and rigidity. Symptoms might not develop until years after the trauma.
Probably Reversible Conditions Dementia
Numerous causes of dementia may be reversible if they’re detected early enough and if proper treatment is given. Some common reversible conditions include:
Insufficiencies of thiamine (vitamin B-1) often occur from chronic alcoholism and can severely diminish mental abilities, individually memories of recent events.
Severe vitamin B-6 deficiencies can create a multisystem illness, identified as pellagra, that may constitute dementia.
Vitamin B-12 insufficiencies have been connected to dementia in some cases.
Vulnerability to lead or other poisonous substances can lead to symptoms of dementia. These manifestations may or may not resolve following treatment, depending upon how severely the brain was damaged.
Hypoglycemia can cause confusion or personality changes.
Thyroid problems can commence to apathy, depression, or symptoms that resemble dementia.
Too little or too high sodium or calcium can trigger mental changes.
Prescribed medications called delirium that mimics dementia. These dementia-like outcomes can happen from drug interactions. They may have a rapid onset or they may develop slowly over time.
Illegal drug usage can further lead to delirium that resembles similar to dementia.
Chronic lung disease or heart difficulties that inhibit the brain from getting enough oxygen can starve brain cells and commence to the symptoms of delirium that mimic dementia.
Meningitis and encephalitis, that are infections of the brain or the membrane that covers the brain, can cause confusion, impaired judgment, or memory loss.
Untreated syphilis can damage the nervous system and cause dementia.
In a few cases, Lyme disease can cause memory or thinking difficulties.
People in the advanced stages of AIDS may exhibit a form of dementia.
Dementia Diagnosis
Diagnosing dementia and discovering what type it is can be challenging. There is no one test to determine if someone becomes dementia. Doctors diagnose Alzheimer’s and other varieties of dementia based on an accurate medical history, a physical examination, laboratory tests, and the typical alterations in thinking, day-to-day function, and behaviour linked with each type. An examination of dementia needs that at least two core mental functions be diminished enough to conflict with daily living. They are the memory, language skills, ability to reason and problem-solve, ability to focus and pay attention, and visual perception.
In some instances, a doctor may diagnose “dementia” and not define a type. If this happens it may be important to see a professional such as a neurologist or gero-psychologist.
Neurological Evaluation
Physicians assess your memory, visual perception, language, attention, problem-solving, movement, senses, balance and reflexes.
Cognitive and Neuropsychological Tests
Physicians will assess your reasoning (cognitive) function. A number of examinations measure thinking abilities such as memory, language skills, orientation, reasoning and judgment, and attention.
Psychiatric Evaluation
A mental health professional can ascertain whether depression or another mental health status is providing to your symptoms.
Brain Scans
CT or MRI scans can observe for confirmation of stroke or bleeding or tumour or hydrocephalus.
PET scans can show patterns of brain activity and if the amyloid protein, a symbol of Alzheimer’s disease, has signified deposited in the brain.
Laboratory Tests
Simple blood tests such as vitamin B-12 deficiency or an underactive thyroid gland can detect physical problems that can affect brain function. Sometimes the spinal fluid is analyzed for infection, inflammation or markers of any degenerative diseases.
Dementia Treatment
Early determination of dementia is the first step in understanding and handling the condition. Treatment of dementia depends on its cause. In some instance of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that decreases or prevents its progress. But there do some drug treatments that may temporarily develop symptoms.
Cholinesterase inhibitors including rivastigmine (Exelon), donepezil (Aricept), and galantamine (Razadyne) are work by boosting levels of a chemical messenger linked in memory and judgment. Although Cholinesterase inhibitors used to treat Alzheimer’s disease, these medications might also be guided for other dementias, including vascular dementia, Lewy body dementia, and Parkinson’s disease dementia. Side effects can comprise nausea, vomiting, and diarrhoea.
Memantine (Namenda) works by regulating the action of glutamate, another chemical messenger linked in brain functions, such as learning and memory. In some circumstances, memantine is prescribed among a cholinesterase inhibitor. Dizziness is the common side effect of memantine.
Your physician might prescribe medications to treat other symptoms, such as depression, sleep disturbances or agitation.
Dementia Alternative Treatment
An occupational therapist can teach how you make your home safer and influence coping behaviours. The objective is to check accidents, such as falls; manage behaviour, and qualify you for dementia progress. Diminishing clutter and noise can create it easier for someone with dementia. You might require to hide objects that can threaten safety, such as knives and car keys. Observing systems can inform you if the person with dementia wanders.
While communicating with your loved one, maintain eye contact. Speak gently in simple sentences, and don’t hurry the response.
Exercise helps everyone, including personalities with dementia. The main advantages of exercise include enhanced strength and cardiovascular health. There is developing evidence that exercise also preserves the brain from dementia, particularly when combined with a healthy diet including treatment for risk factors for cardiovascular illness.
Some research determines that physical activity decrease the progression of impaired thinking in people with Alzheimer’s disease. Furthermore, it can diminish the symptoms of depression.
