Dementia: Symptoms, Causes, Types, and Treatment

No ‘one’ illness causes dementia. It is a general phrase used to characterise a group of symptoms that people with many illnesses, including Alzheimer’s disease, may encounter. Disorders that fall under the umbrella term “dementia” are brought on by aberrant alterations in the brain. The symptoms of dementia cause cognitive capacities, or thinking skills, to deteriorate to the point where it interferes with day-to-day functioning and independent living. They also have an impact on relationships, emotions, and behaviour. Between 60% and 80% of instances are caused by Alzheimer’s disease. The second most prevalent type of dementia is vascular dementia, which is brought on by microscopic bleeding and blood vessel obstruction in the brain.

Mixed dementia occurs when a person has the brain abnormalities of many different forms of dementia at the same time. Cognitive impairment symptoms can be caused by a wide range of diseases that are not dementia, including those that can be reversed, like vitamin shortages and thyroid issues. Many people mistakenly refer to dementia as “senility” or “senile dementia,” reflecting the once common but false notion that significant mental decline is a typical aspect of ageing.

Let’s talk about primary dementia.

Primary dementia

Primary dementia comes in various forms, such as:

Alzheimer’s Disease

The most prevalent kind of dementia is Alzheimer’s disease. Your brain accumulates tau and amyloid proteins, two aberrant proteins. These proteins interfere with your brain’s nerve cells’ ability to communicate with one another. As nerve cell death spreads beyond the initial area, symptoms such as short-term memory loss, disorientation, and changes in behaviour and personality emerge. In later stages, individuals may experience difficulties with walking, speaking, and recalling distant events. Up to 10% of those over 65 and roughly 50% of those over 85 suffer from Alzheimer’s disease. One significant risk factor is family history. This type affects between 60% and 80% of dementia patients.

Vascular Dementia

The second most prevalent kind of dementia is vascular dementia. It is brought on by diseases including atherosclerosis and strokes that obstruct and harm blood arteries in the brain. Memory issues, disorientation, and difficulty focusing and finishing tasks are some of the symptoms. The deterioration may occur gradually (after a string of minor strokes) or abruptly (after a big stroke). High blood pressure, diabetes, and elevated cholesterol are risk factors. Vascular dementia affects 15% to 25% of dementia patients.

Lewy body Dementia

Lewy body dementia is caused by the accumulation of protein clusters, or Lewy bodies, in the nerve cells of your brain. Nerve cells are harmed by Lewy bodies. Movement and balance issues, altered sleep patterns, memory loss, trouble with planning and problem-solving, and visual hallucinations and delusions are some of the symptoms. Lewy Body dementia accounts for 5–10% of dementia cases.

Frontotemporal Dementia

Damage to the frontal and temporal lobes of the brain causes frontotemporal dementia (FTD). The accumulation of aberrant proteins in these regions is what causes the harm. Language abilities (saying, understanding, or forgetting the meaning of common words) or physical coordination are lost, and social behaviour and personality changes may result. FTD frequently affects individuals between the ages of 45 and 64 and is a prominent cause of early dementia. FTD accounts for 5–6% of all dementias.

Mixed dementia

A mix of two or more dementia types is known as mixed dementia. Vascular dementia and Alzheimer’s disease are the most prevalent combo. People 80 years of age and older are most likely to have it. Because many symptoms of each form of dementia overlap or because the symptoms of one dementia may be more visible than those of another, diagnosis is frequently challenging. Those with mixed dementia experience a faster deterioration than those with just one form.

What are some early signs of dementia?

• Forgetting current information or happenings
• Repeating remarks or enquiries in brief bursts
• Putting frequently used objects in odd locations or misplacing them
• Not being aware of the month, year, or season
• Struggling to think of the appropriate words
• Seeing a shift in one’s interests, behaviour, or mood
• Your memory and decision-making skills continue to deteriorate
• It gets harder to talk and find the correct words
• Complex daily tasks including cooking, paying bills, making coffee, brushing your teeth, and operating a TV remote become increasingly difficult
• Reduction in your capacity for problem-solving and logical thought and behaviour
• Sleeping habits shift
• Anxiety, frustration, perplexity, agitation, suspicion, and melancholy that worsens or increases

What are the Causes?

Brain injury can cause dementia. The nerve cells in your brain are impacted by dementia, which impairs your brain’s capacity to communicate with its different regions. Blocking blood flow to the brain can potentially cause dementia by depriving it of essential nutrients and oxygen. Brain tissue dies in the absence of oxygen and nutrition.

Depending on whatever part of your brain is damaged, different symptoms can arise. Certain types of dementia are irreversible and will deteriorate with time. Other medical disorders that likewise impact the brain are the cause of other dementias. Symptoms similar to dementia can be caused by a different set of medical conditions. The symptoms of dementia can be reversed, and many of these disorders are curable.

Is it possible to treat dementia?

First, it is essential to understand the terms “treatable,” “reversible,” and “curable.” Most types of dementia are treatable, meaning symptoms can be managed with medication and other strategies. However, the majority of dementia types are neither curable nor reversible, and treatment benefits are often limited. Fortunately, some forms of dementia caused by treatable factors can be successfully reversed. These types of dementia are triggered by:

• Adverse effects of alcohol, illegal substances, or prescription pharmaceuticals
• Tumours that are excisable
• A subdural haematoma is an accumulation of blood beneath the outer layer of the brain brought on by a head injury
• An accumulation of cerebrospinal fluid in the brain is known as normal pressure hydrocephalus
• Metabolic conditions, like a lack of vitamin b12
• A disorder called hypothyroidism is brought on by low thyroid hormone levels
• Low blood sugar, or hypoglycaemia
• Depression
• Medication used to address memory loss or behavioural issues may still have some effect on dementias that cannot be reversed

Is it possible to avoid Dementia? 

Living a health-focused lifestyle may lower risk factors for some types of dementia, even if dementia cannot be prevented. To support brain health, focus on maintaining healthy blood vessels. This means avoiding cholesterol buildup, managing blood pressure and blood sugar levels, maintaining a healthy weight, and adopting a lifestyle that promotes overall wellness. Keeping your brain well-nourished with oxygen and nutrients can help it function at its best. Here are some specific healthy actions you can take:

• Give up smoking: Consume a diet rich in whole grains, fruits, vegetables, nuts, legumes, fish and shellfish, olive oil, and little to no red meat. This is known as a Mediterranean diet. 
• Work out: On most days of the week, get at least 30 minutes of exercise.
• Keep your brain active and stimulated by playing word games, solving puzzles, or participating in mentally challenging activities. Regular engagement in such tasks may help delay the onset of dementia.
• Continue to be socially active. Engage your head, heart, and soul by interacting with others.

What increases the chance of Dementia?

Among the risk factors for dementia are:

The greatest risk factor is age. As you age, your risk of dementia rises. People over 65 are affected in the majority of cases.

Family history: You are at a higher risk of developing dementia if you have siblings or biological parents who have the disease.
Down syndrome: By middle age, people with Down syndrome are susceptible to early-onset Alzheimer’s disease.
Poor heart health: You are more likely to get dementia if you smoke, and have high blood pressure, high cholesterol, or atherosclerosis. Your blood vessels are impacted by diabetes and certain medical conditions. Strokes and decreased blood flow can result from damaged blood arteries. 

What Potential Side Effects Might Dementia Cause?

Every bodily function is managed by your brain. Your general health eventually becomes vulnerable as your brain functions deteriorate. Dementia can arise in a variety of diseases and ailments.

Consequences of Dementia could include: 

• Malnutrition and dehydration. 
• Pressure ulcers, or bedsores. 
• Falls-related injuries and bone fractures. 
• Strokes. 
• Heart attacks. 
• Renal failure. 
• Pneumonia and aspiration pneumonia, which is an infection caused by food particles 
• Infection, or sepsis. 

Therapies other than medication may be used to address several dementia symptoms and behavioural issues in the beginning. These could consist of:

Occupational therapy:

An occupational therapist can teach you coping strategies and help make your home safer by reducing risks like falls. The therapy also supports managing behaviour and prepares you for the next stages of dementia. Modifying the environment can make a big difference. Reducing clutter and noise can help a person with dementia focus and perform everyday tasks more easily. Safety hazards, like knives and car keys, may need to be hidden. If the person tends to wander, monitoring systems can alert you. Breaking tasks into smaller, manageable steps and focusing on accomplishments rather than failures can also be a helpful approach.

Medications

The symptoms of dementia can be momentarily alleviated by the following:

• Inhibitors of cholinesterase: These medications function by increasing the amounts of a chemical messenger that is important in judgement and memory. These consist of galantamine (Razadyne ER), rivastigmine (Exelon), and donepezil (Aricept, Adlarity).
• These medications may be used for different dementias even though their primary usage is to treat Alzheimer’s disease. People with Lewy body dementia, Parkinson’s disease, dementia, and vascular dementia may be prescribed them.
• Diarrhoea, vomiting, and nausea are possible side effects. Sleep issues, fainting, and a slowing heart rate are further potential adverse effects.
• Memantine: Memantine (Namenda) functions by controlling glutamate activity. Another chemical messenger that plays a role in memory and learning is glutamate. Cholinesterase inhibitors are occasionally administered alongside memantine.

Conclusion

Recognizing a dementia diagnosis early allows both you and your family to make informed decisions, ensuring a meaningful quality of life while organizing healthcare, financial, and legal goals. Your healthcare team, which includes social workers, clinicians, hospice workers, and pastoral care providers, is there to educate, support, and care for you or your loved one.

Additionally, it’s important to seek out dementia support groups in your area. These groups offer valuable opportunities to share caregiving tips, find emotional support, and connect with others who understand your experiences.

FAQs

Here are answers to your questions:

1. What is the difference between Alzheimer’s and dementia?

Dementia is a general term for a decline in mental ability that affects daily life, and it encompasses various symptoms such as memory loss, confusion, and personality changes. Alzheimer’s disease is a specific form of dementia and the most common type, characterized by plaques and tangles in the brain that affect memory, thinking, and behaviour. While all Alzheimer’s is dementia, not all dementia is Alzheimer’s.

2. What age does dementia start?

Dementia can affect people at different ages, but the risk increases with age. Most cases occur in people over the age of 65, and the likelihood of developing dementia doubles every five years after the age of 65. Early-onset dementia can occur in people as young as their 40s or 50s, but this is much less common.

3. What is the 2-finger test in dementia?

The 2-finger test is a simple assessment used to test spatial awareness and hand-eye coordination in individuals with dementia. The person is asked to touch the thumb and index finger of one hand with the corresponding fingers of the other hand. Difficulty performing this task may be an indication of cognitive impairment, although it is not a definitive test for dementia.

4. What are the six habits that reduce dementia?

Six habits that may help reduce the risk of dementia include:

1. Staying physically active: Regular exercise supports brain health and overall well-being.
2. Eating a balanced diet: A diet rich in fruits, vegetables, whole grains, and healthy fats can support cognitive function.
3. Engaging in mental exercises: Solving puzzles, reading, and learning new skills can keep the brain active.
4. Getting enough sleep: Quality sleep is crucial for memory and cognitive function.
5. Managing stress: Chronic stress can negatively impact the brain, so practising relaxation techniques is beneficial.
6. Staying socially connected: Engaging in social activities helps maintain mental health and cognitive function.

5. How does your body warn you that dementia is forming?

Answer: Early warning signs of dementia can vary, but common symptoms may include:

• Memory loss: Difficulty remembering recent events or conversations.
• Disorientation: Confusion about time, place, or familiar surroundings.
• Difficulty with tasks: Struggling to perform routine activities that were once easy.
• Language problems: Trouble finding the right words or following conversations.
• Personality changes: Becoming more withdrawn, anxious, or depressed.
• Judgment problems: Making poor decisions or showing a lack of insight into situations.

If you or someone you know experiences these changes, it’s important to seek medical advice for an assessment and early intervention.