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- What is Dementia?
- Diagnosing Dementia
- What Causes Dementia?
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What is Dementia?
Dementia is a condition characterized by a progressive decline of mental abilities, resulting in the restriction of a person’s daily functioning.
Different areas of the brain control different skills and abilities. When mental functions such as memory, language, orientation, or judgment deteriorate, this may be a direct result of the way dementia has affected the brain.
The brain can be affected by various diseases and conditions which can lead to dementia. These include Alzheimer’s disease, strokes, head injuries, and other neurodegenerative conditions.
Although your risk of developing dementia increases with age and is most commonly seen in the elderly (about 5% of people over the age of 65, and 20% of those over the age of 80 years have dementia to a certain degree) dementia is possible at any age, depending on the cause.
What Happens as Dementia Progresses?
Depending on the causes of dementia, the condition advances at different rates. It may be progressive, static, or remitting. With some types of dementia (i.e. dementia linked to infections like meningitis) recovery is possible, depending on the cause and the timely application of effective treatment. Other forms of dementia (i.e. dementia linked to Alzheimer’s) are progressive, and cognitive functioning will decline over time.
Often an individual with dementia may not even be aware that he or she is suffering with the condition. Their memory and ability to recognize people, places, and objects begins to diminish over time. Often, they experience problems with language and abstract thinking.
Forgetfulness is commonly the first symptom. It may be difficult to remember certain things or to complete a task. Behavioral and personality changes also affect people suffering from dementia, many of whom also struggle with anxiety and depression.
Later, they may become disruptive and display erratic behavior quite out of character. Caring for dementia is a long-term process, and it can be a very challenging period for families to cope with.
Health care practitioners use various criteria to diagnose dementia. A full examination and evaluation is important to rule out other conditions such as infection, depression, or vitamin B12 deficiency.
Since dementia can have a huge effect on memory, reasoning, and judgment, it is very important for the health care practitioner to consult with family members as well, because they may be the only ones able to give an accurate history and assessment of the person’s ability to cope with daily life.
Steps in Making the Diagnosis of Dementia
Steps towards making a final diagnosis of dementia include the following:
A detailed medical history including illnesses, medications, and operations must be provided.
A full physical examination is important to identify any medical conditions that may be causing the dementia.
A neurological examination will test the patient’s motor and sensory functions, reflexes, and other neurological systems such as balance, hearing, and vision.
Cognitive and neuropsychological tests
Administered by a trained professional, there are tests available to measure memory, language and math skills, and other abilities related to mental functioning. These tests are designed to help with accurate diagnosis. A screening test called the Mini-Mental State Examination (MMSE) is used to preliminarily assess cognitive skills in people with suspected dementia.
The most common types of brain scans are computed tomography (CT) scans and magnetic resonance imaging (MRI). A CT scan of the brain is commonly used when examining a patient with suspected dementia.
Laboratory tests include a complete blood count, blood glucose test, urinalysis, drug and alcohol tests (toxicology screen), cerebrospinal fluid analysis (to rule out specific infections that can affect the brain), and analysis of thyroid hormone levels.
Psychiatric and Psychological evaluation
Psychiatric and psychological evaluation can determine if depression or another psychiatric disorder may be a contributing factor or one of the causes of dementia-like symptoms experienced.
Recognizing the Symptoms of Dementia
Recent memory loss
Most of us forget certain things, but remember them at a later stage. A person with dementia may forget things, and never remember them at all. A loss of recent memory, for example, forgetting what you did the day before, is often one of the first signs of the onset of dementia. Long-term memory is often unaffected until much later.
Difficulty performing familiar activities
A person with dementia might forget that he or she has completed a specific activity like cooking, shopping, watering the garden, or can’t remember how to operate a commonly used appliance like the washing machine.
Problems with language
A person suffering from dementia often forgets simple words and then uses the incorrect terminology or vocabulary, making it difficult for others to understand them.
Problems with time and place
People with dementia are often confused and disorientated about time and place. They may not remember the day, week, month, or year. Familiar places (even their own homes) might seem completely foreign to them.
When a person with dementia struggles to remember recent events, it affects his or her judgment. This person will make poor judgment calls such as driving when they shouldn’t, giving away huge amounts of money, or wearing very little clothing in cold weather.
Problems with abstract thinking
Those with dementia have difficulty reasoning and understanding abstract concepts. Doing simple calculations and recognizing numbers is a challenge for people suffering from dementia.
The individual suffering from dementia will leave things in inappropriate places, such as sugar in the fridge or socks in a pot.
Mood or behavioral changes
People with dementia often become unusually emotional and agitated, and may experience angry outbursts and aggressive behavior. Depression and anxiety are also very common.
Pronounced personality changes occur suddenly or over a period of time in the person with dementia. Confusion, fear, suspicion, anger, nervousness, and dependence are some of the changes likely to take place.
Loss of initiative
Individuals often lose interest and enthusiasm for things that once brought joy to them such as hobbies, sports, and social interaction. They become passive and lack motivation.
What Causes Dementia?
One of the most common causes of dementia is Alzheimer’s disease.
Other causes include:
- Degenerative diseases such as Parkinson’s and Huntington’s disease
- Medical conditions such as vascular disease (hardening of the arteries), brain tumors, strokes, severe head injuries
- Infections that affect the brain and spinal cord such as AIDS dementia complex and Creutzfeldt-Jakob disease
- Excessive drug and alcohol abuse
- Nutritional deficiencies such as folate and Vitamin B12 deficiency
Help for Dementia
The true aim of treatment is to control the symptoms of dementia, and an early diagnosis helps both the patient and caregiver make more informed treatment and management choices.
Most symptoms of dementia can be treated successfully using a combination of the available treatment methods including medication, alternative therapy, psychotherapy, and environmental modifications.
Often people are not aware that treatment options other than traditional drug therapy are available. Alternative treatments, including natural remedies, can offer a safe and effective treatment approach.
These alternative treatments are free of chemicals and propose a much lower risk of side effects, and can be safely incorporated into the broader treatment plan.
Drug Therapies for Dementia
Many forms of dementia cannot be cured, but medication can alleviate certain symptoms and improve brain function.
The most commonly prescribed drugs for dementia include sleeping tablets, tranquillizers, and anti-depressants. These are given in an effort to treat or alleviate some of the symptoms or behavior problems that arise during the long course of the disease.
Older people tend to have more long-term, chronic illnesses such as diabetes, heart disease, high blood pressure, and arthritis. It is common for them to take a cocktail of many different drugs. Because of their age and the presence of other conditions, they are more susceptible to the side effects of prescription medications, often ending up with further drugs being prescribed to alleviate the side effects of another drug.
How can Therapy Help?
There are various alternative treatment options available for patients with dementia. These alternative options include:
- Counseling and psychotherapy
- Music therapy
Together with healthy lifestyle choices, these treatments can be extremely successful in caring for dementia. Remember that a healthy diet, regular exercise, controlling your blood pressure and cholesterol, and stimulating your mind can minimize your risk of dementia.
More Information on Dementia
Tips for Prevention
The following tips can help prevent dementia:
- Eat a healthy diet low in cholesterol and high in dietary fiber.
- Ensure you have adequate Vitamin B12 (organ meats, oysters, brewer’s yeast, sardines, eggs, cheese) and folic acid (green vegetables, beans, oranges, and whole grains) in your diet.
- Exercise regularly.
- Engage in social activities with friends and family.
- Stimulate your brain by reading, learning to play an instrument, doing crossword puzzles, or having stimulating discussions.
- Quit smoking.
- Limit your alcohol intake.
- Control hypertension and high blood pressure.
- Reduce stress by meditating, listening to music, or doing yoga.
How to Care for a Dementia Sufferer
Caring for a person suffering from dementia is extremely difficult, and often the caregiver feels overwhelmed and helpless.
Here are some coping strategies to help you deal with this challenging situation:
- Be affectionate and supportive of the patient.
- Modify your home into a safe environment.
- Maintain a positive attitude.
- Accept that the patient has limited capabilities.
- Manage behavioral problems.
- Encourage family and friends to be involved from the onset. Enlist their help in caring for the patient as the disease progresses.
- Join a support group for caregivers. Support and encouragement from people in similar situations can be life saving.
- Focus on activities that the patient enjoys.
- Spend time outdoors with the patient.
- Take time for yourself.
- Consider hiring a qualified caregiver or placing the patient in a nursing facility if the situation at home becomes unmanageable.