Dementia

Overview

Dementia is an umbrella term to describe diseases that cause people to lose their cognitive functions. These diseases gradually progress decreasing the ability for someone to function in daily life and take care of themselves. There are some medications used to delay the onset of it and to manage it. People can reduce the chances of developing it by following a healthy diet and lifestyle.

What is Dementia?

Dementia is a progressive illness meaning it gets worse over time. People who have high blood pressure, and high blood sugar, are overweight or obese have a higher risk of developing this disease. Smoking, drinking, physical inactivity, social isolation, and depression also increase the risk. Patients, if they have this condition might start having memory loss and other issues.

Types of Dementia

Different types of dementia occur due to different reasons. Some types of this disease are:

Alzheimer’s Disease

Alzheimer’s disease occurs when two abnormal proteins (tau and amyloid protein) build up in the brain. Some of its diseases include mental confusion, short-term memory loss, and personality and behaviour changes. In later stages, people may start having trouble talking, recalling distant memories and have issues with walking.

Vascular Dementia

Vascular dementia may occur because of a stroke or atherosclerosis. Atherosclerosis is the hardening of the arteries from plaque building up gradually inside of them. It blocks and damages blood vessels in the brain. This disease has symptoms such as memory problems, confusion, concentration problems and difficulty in completing tasks.

Mixed Dementia

Mixed dementia is a combination of two or more types of the disease. Sometimes, Alzheimer’s disease combined with vascular dementia causes mixed dementia. The health condition usually declines faster in people with mixed dementia than those who only have one type.

Huntington’s Disease

A mutation in the huntingtin(HTT) gene causes a breakdown in the brain’s nerve cells and it is responsible for Huntington’s. This disease causes body movement control problems, trouble thinking, decision-making, memory trouble and personality changes.

Traumatic Brain Injury

Someone may develop dementia-like symptoms if they suffer from repeated physical trauma to their head. Symptoms may appear after a long time and may include memory loss, behaviour or mood changes, slurred speech and headaches.

Parkinson’s Disease

People who have Parkinson's disease may develop secondary dementia in the later stages. Some of its symptoms are having trouble with thinking or speaking. Patients may have hallucinations and delusions, or suffer from depression.

Normal Pressure Hydrocephalus(NPH)

When Cerebrospinal Fluid(CSF) builds up in the brain’s ventricles the excess build-up harms the brain and this causes Normal Pressure Hydrocephalus(NPH). A brain infection, brain injury, bleeding in the brain or any previous brain surgery can also cause this condition.

This disease has some symptoms such as poor balance, forgetfulness, and short attention span, loss of bladder control, frequent falls and mood swings.

Infections
Some infections such as HIV infection, syphilis as well as Lyme disease can cause dementia-like symptoms. Urinary Tract Infections or UTIs, and lung infections can cause symptoms that match dementia.

Central Nervous infections and brain infections can cause cognitive symptoms. Also, COVID-19 symptoms include acute delirium or brain fog.

Symptoms of Dementia

Dementia symptoms include cognitive changes in a person, like memory loss, which is usually noticed by someone else. Patients may have trouble with visual and spatial abilities and may have depth perception issues. This can cause them to fall while walking, climbing stairs etc. Some may become unable to recognise faces and locate objects, drive vehicles, and have sleep disturbance.

Other cognitive changes might include difficulty communicating, reasoning or problem-solving, and performing complex tasks. Individuals may have poor coordination and trouble controlling their movement. Some might experience mental confusion and disorientation. They may ask the same question repeatedly, and have problems dealing with money and numbers.

This disease also causes psychological changes such as changes in personality and behaviour. Patients may suffer from depression, anxiety, paranoia, or hallucinations. In some cases, obsessive behaviours may be noticed.

Causes of Dementia

Dementia may be caused due to head injury that leads to brain damage. The blocked blood flow to the brain can cause deprivation of required oxygen and nutrients in the brain, leading to brain tissue death that results in dementia. Medications such as sleeping pills, antidepressants, anti-anxiety drugs, narcotic pain relievers, anti-seizure drugs, and statins can mimic this disease’s condition.

Some risk factors associated with this condition include, high blood pressure, diabetes and obesity. Other factors include, alcohol consumption, vitamin deficiency, age, depression and other neurodegenerative illnesses like Parkinson's disease and Huntington disease

Diagnosis of Dementia

Dementia is a complex brain disorder, and diagnosing it can be difficult as various symptoms of this disease are common to other illnesses. Doctors may ask the patients about their symptoms, and medical history, and review their current medication for diagnosing the condition. They may also enquire about the history of diseases in their family (including this condition) to make a diagnosis. Doctors may order laboratory tests, imaging tests and neurocognitive tests (or, thinking tests).

This disease progresses in three stages. In the early stage, symptoms, such as memory loss will start affecting the person's daily life. In the middle stage, the symptoms may become more noticeable, such as hallucinations. Some may become unable to recognise people and lose their ability to walk and do other daily activities in the later or end stages.

Treatment of Dementia

Almost all forms of dementia are treatable with medications and taking measures to help manage the symptoms but cannot be cured or reversed.
There are some medications approved for Alzheimer’s disease like cholinesterase inhibitors, NMDA receptor antagonist memantine, Anti-amyloid antibody aducanumab etc. Doctors may use these drugs to treat individuals with some of the other forms of the disease too. These medication only help to manage the symptoms but not treat the condition.

Apart from medications, several therapies can help a dementia patient. Occupational therapy can help create a safer home environment and teach coping strategies to prevent accidents like falls. It also prepares individuals for the progression of dementia. Modifying the environment, such as reducing clutter and noise, can enhance focus and functionality.
Additionally, hiding items that pose safety risks, like knives or car keys, and using monitoring systems to track wandering can be helpful. Simplifying tasks by breaking them into smaller steps and maintaining structure and routine can minimise confusion and promote a sense of accomplishment.

Prevention of Dementia

There are so such clear preventive measures for dementia. However, one may reduce the risk factors for certain types of it by maintaining a healthy lifestyle. They should try to keep cholesterol, blood pressure and blood sugar level normal.

In addition, an improvement in lifestyle such as exercising, quitting smoking, and adopting a healthy diet consisting of whole grains, vegetables, fruits, fish, etc. can also help.
Additionally, mental activities like solving puzzles, playing word games and other mentally stimulating activities may also delay the onset of this disease.

Myths and Facts Related to Dementia

Here are some of the myths around dementia with facts to prove them wrong:

Myth 1: This Disease Only Affects Older Adults
Fact: Age is indeed a risk factor for this disease and this may lead to believing that only old people suffer from it. However, this disease can affect younger adults in rare cases, called early-onset dementia.

Myth 2: Having the Diagnosis Means Leading a Meaningful Life is No Longer Possible
Fact: Patients often fear that they may not be able to live life on their own after they get diagnosed with the condition. However, many people lead active, meaningful lives even after they have this disease.

Myth 3: Memory Loss is Always an Indicator of This Condition
Fact: Memory loss is not an absolute indicator of this disease. Some forms of the disease may have symptoms such as changes in mood, language difficulties and obsessive behaviour.