What is dementia?

A common misconception is that Dementia is a specific disease or disorder. Dementia is not a disease but is a term used to describe a wide group of signs and symptoms.The symptoms are associated with a decline in memory or other thinking skills. The decline gradually becomes severe enough to effect a person’s ability to perform their everyday activities. The number of people developing dementia is increasing as the number of people now living into later years is steadily increasing.

 

Symptoms of dementia

The symptoms of dementia can vary greatly. The common difficulties that those with dementia present with are likely to be:
a) Problems with memory. They find it difficult to remember things, this includes things that have happened recently or things from their past. The person may forgot what they ate a few hours earlier or even forget that they had eaten. They may forget who familiar people are, including friends and family. They may also forget the day and time.
b) Difficulties with communication and language. They may find it difficult to remember the meaning of words or struggle to use the right words to explain things.
c) Difficulty with reasoning or judgement. Problem solving can become difficult.
d) Difficulty focussing and paying attention. They may have difficulty with carrying out tasks that require concentration and several steps in sequence. A common problem is developing difficulties with day to day activities such as cooking because of the steps involved.

Depending on the cause of the dementia, the symptoms can vary and each person is unique they will experience symptoms in different ways. The biggest differences in how people present are in the the early stages. As dementia progresses the decline and changes become more consistent. How others respond to the person, and how supportive or enabling the person’s surroundings are, also greatly affect how well someone can live with dementia.

 

What causes dementia?

In simple terms dementia is when the brain cells do not communicate with each other as they should. This is because the brain cells themselves are damaged or because the system for communicating by the cells is damaged. The brain has several different areas. Each area is associated with a specific function. If there is a problem with one of these areas then the function the area is responsible for is affected.

The area of the brain that is responsible for learning and memory is known as the hippocampus. This area of the brain is often the first to be affected, which is why memory loss is one of the earliest signs of dementia. Depending on the cause, the cells in different areas of the brain are affected which gives rise to different symptoms.

Types of Dementia

Alzheimer’s disease accounts for 60 to 80 percent of cases of dementia. In Alzheimers disease there is an abnormal deposit of protein in the cells. These protein deposits are known as amyloid plaques and are believed to be the main reason for the cells not functioning normally.

Vascular dementia is the second commonest type of dementia. It is a type of dementia that occurs after a stroke. This is because the blood flow to a part of the brain is altered. The onset is generally more sudden than with other types of dementias.

There are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Many dementias are progressive, this means that symptoms start out slowly and gradually get worse.

Diagnosis

There is no single test to determine if someone has dementia. Medical professionals diagnose Alzheimer’s, vascular dementia and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behaviour associated with each type.

Dementia treatment and care

Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression. But there are drug treatments that may temporarily improve symptoms. The same medications used to treat Alzheimer’s are among the drugs sometimes prescribed to help with symptoms of other types of dementias. Non-drug therapies can also alleviate some symptoms of dementia. It is important the difficulties those with dementia have with communication and learning to improve your communication with someone who has dementia.

Who is at risk of developing dementia?

Anyone can develop dementia. There are some predisposing factors that may place you in the higher risk group. The obvious risk factor is ageing but there are several others. Females are more likely to develop dementia than males. Genetics play a vital role and if there is a family history of dementia the risk is increased. Lifestyle factors such as smoking and alcohol consumption also play a role. Lastly if you have other medical conditions such as hypertension you may be at increased risk.

 

How do you prevent dementia?

There is no absolute way to prevent the development of dementia. Some authors suggest that cognitive interventions may prevent dementia but you can reduce the likelihood of developing dementia by addressing the risk factors for dementia. Of course factors such as age and genetics cannot be changed. But there are things you can do to reduce other risk factors:

Lifestyle changes: Stopping smoking and reducing alcohol intake is one sure way of not just reducing your risk of dementia but for several other health conditions as well.

Cardiovascular risk factors: Anything that can disrupt or alter the flow of blood to you brain can cause damage to your brain. Any condition that can damages blood vessels elsewhere in your body can also damage blood vessels in your brain. When the blood vessels are damaged the brain cells are deprived of oxygen and essential nutrients. Blood vessel changes in the brain are linked to vascular dementia. You can help protect your brain with some of the same strategies that protect your heart – don’t smoke; take steps to keep your blood pressure, cholesterol and blood sugar within recommended limits; and maintain a healthy weight.

Physical exercise: Regular physical exercise may help lower the risk of some types of dementia. Evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain.

Diet: What you eat may have its greatest impact on brain health through its effect on heart health. The best current evidence suggests that heart-healthy eating patterns, such as the Mediterranean diet, also may help protect the brain. A Mediterranean diet includes relatively little red meat and emphasises whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats.

Exercising your brain: Some studies indicating that you can benefit from regular mental exercise. The research article Educating the brain to avoid dementia is an informative article on the topic of performing mental exercises.

Clinical Trials

Although there is currently no cure for dementia, early diagnosis and treatment can help with slowing the progression of dementia. Early diagnosis will allow the person to gain the most from the treatments available. The environment and support to someone with dementia can make a huge difference. Early diagnosis also allows time for the person and family to make plans for the future. Finding a cure for dementia is ongoing. There is much research and opportunities to engage in clinical trials and experimental drugs. An option for someone with dementia is to consider volunteering for a clinical trial. Globally there are many centres where you can actively enrol in a clinical study or trial about Alzheimer’s and related dementias.