Dementia is a syndrome associated with a persistent decline in brain function. This syndrome affects memory, thinking abilities, and society severely enough to interfere with a person’s daily life. Early therapeutic intervention is needed to control disease progression and limit complications.
What is dementia?
Dementia is a term used to describe a set of symptoms related to disorders affecting the brain. It is not a specific disease but rather a general term for a group of diseases that affect a person’s memory, thinking, thinking ability, personality, mood and behavior.
Alzheimer’s disease is the most common type of dementia. Although dementia affects mainly the elderly, it is by no means part of the normal aging process.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that approximately 5 million American adults age 65 and older have Alzheimer’s disease and related dementias. It is expected that by 2060 this number could fall to about 14 million people, accounting for 3.3% of the US population.
To date, there is no cure for dementia, but early diagnosis is important. Because early intervention will help slow the progression of the disease in many cases. This makes it possible for patients to maintain mental function longer for a better quality of life.
Common types of dementia
According to the analysis of experts, there are 5 most common forms of dementia. Include:
1. Alzheimer’s Disease
Alzheimer’s disease is thought to be the most common form of dementia, accounting for about two-thirds of cases. This disease can cause gradual deterioration of cognitive ability. It often begins with memory loss.
Alzheimer’s disease is characterized by two abnormalities in the brain, including neurofibrillary tangles and amyloid plaques. These two abnormalities block communication between nerve cells and cause them to die.
2. Vascular dementia
Vascular dementia refers to cognitive decline caused by damage to the blood vessels of the brain. This condition can be caused by a single stroke or it can also be related to multiple strokes occurring over time.
Vascular dementia is usually diagnosed when there is strong evidence of vascular disease in the brain and impaired cognitive function that interferes with daily activities. Symptoms can start suddenly after a stroke. Or it can also be started slowly while the disease of the blood vessels in the brain grows more and more severe.
Symptoms of the disease vary depending on the location and extent of the brain damage. This disease can affect only one or a few specific cognitive functions. Mixing vascular dementia with Alzheimer’s disease is relatively common.
3. Lewy body disease
Lewy body disease is characterized by the presence of Lewy bodies within the brain. Lewy bodies are clumps of alpha-synuclein protein that grow abnormally inside nerve cells. These conditions occur in specific regions of the brain and cause changes in movement, thinking, and behavior.
People with Lewy bodies may experience unusual changes in thinking and attention. This change can range from near-normal functioning to severe confusion within a short period of time. Hallucinations can also be a common symptom.
Three overlapping disorders that may be included in Lewy body disease are:
- Lewy body dementia
- Parkinson disease
- Parkinson’s dementia
4. Forehead amnesia
Frontal dementia involves progressive damage to the vestibular and/or temporal lobes of the brain. Symptoms usually begin when the person is between the ages of 50 and 60 and can sometimes be earlier.
There are two main forms of frontotemporal dementia, but they are often mixed. Include:
Vestibular: Associated with behavioral symptoms along with personality changes.
Temporal: Related to language impairment.
The temporal lobes of the brain control judgment and social behavior. As a result, people with frontotemporal dementia often have difficulty maintaining socially appropriate behaviors. They may become rude, lethargic, restless, aggressive, or act impulsively.
5. Mixed dementia
In some cases, more than one type of dementia is present in the brain at the same time. This condition is relatively common in people 80 years of age and older. For example, a person can have vascular dementia and Alzheimer’s disease at the same time.
It is not always possible to clearly identify a person with mixed dementia because symptoms of one form of the disease may be most prominent but may also overlap with symptoms of another. The progression of mixed dementia is likely to be faster than with just one form of the disease.
Causes of dementia
The cause of dementia is determined to be damage or loss of nerve cells and their connections in the brain. Depending on the area of the brain affected, the disease can affect each person and cause symptoms differently.
The disease will usually be grouped by common features. Some conditions can look like dementia, such as those caused by vitamin deficiencies, reactions to medications, or other conditions that may improve with treatment.
The most common causes of dementia include:
- Neurodegenerative disease
- Vascular dementia
- Multiple Sclerosis
- Central nervous system infection
- Ventricular fluid retention
- Traumatic brain injury
Many factors can contribute to an increased risk of dementia. Some of these factors are modifiable and others are not. Common risk factors include:
- Getting older: Your risk of getting the disease increases as you get older, especially after age 65. However, the condition is not a normal part of the aging process and it is still possible in younger people.
- Family history: Having a family history of dementia increases your risk. However, many people with a family history still never develop symptoms, and vice versa. There will be tests to determine if you have certain genetic mutations.
- Down syndrome: By middle age, many people with Down syndrome may develop early-stage Alzheimer’s disease.
- Diet and physical activity: Many studies show that lack of exercise can increase the risk of dementia. And the same goes for people who eat unhealthy.
- Excessive alcohol use: Drinking large amounts of alcohol over a long period of time is a common cause of brain changes. Alcohol use disorders are associated with an increased risk of early-onset dementia.
- Cardiovascular risk factors: These include high blood pressure, fatty deposits in the artery walls, high cholesterol, and obesity.
- Diabetes: People with diabetes are more likely to develop dementia than healthy people, especially in cases where blood sugar is poorly controlled.
- Smoking: Nicotine and the toxins in tobacco can increase your risk of developing blood vessel disease and developing dementia.
- Head Injury: People who have had a severe head injury have a higher risk of developing Alzheimer’s disease. People over the age of 50 with a traumatic brain injury (TBI) are at increased risk of dementia and Alzheimer’s disease.
- Sleep disorders: People with sleep apnea and certain other sleep disorders may be at increased risk for memory problems.
- Air pollution: This is a condition that can accelerate the degeneration of the nervous system. Exposure to air pollution, especially traffic fumes and wood burning, is associated with a higher risk of dementia.
- Vitamin and nutritional deficiencies: Deficiencies in vitamins B6, B12, D and folate may increase the risk of dementia.
- Drugs that can impair memory: Some over-the-counter sleep aids containing diphenhydramine (Advil PM, Aleve PM), tranquilizers, etc. can have potential side effects and make memory worse. Go.
Manifestations of dementia
Dementia usually results in a complete, gradual onset of cognitive impairment. Family members may suddenly notice disturbances as the person’s functioning declines. Usually short-term memory loss will be the first sign.
Early symptoms may be difficult to distinguish from mild cognitive impairment or age-related memory loss. However, over time it will become obvious. Dementia symptoms always exist continuously and manifest differently through 3 main stages. As follows:
1. Expression at an early stage
In the early stages of the disease, short-term memory is impaired. Learning and retaining new information becomes more difficult. Language disorders (especially with word search), progressive personality changes, and fluctuating moods may also be present.
People with the disease may experience increasing difficulty with independent activities of daily living, such as keeping an eye on their books, remembering where they keep their things, or finding their way around. Abstract thinking, reasoning or understanding may also be reduced,
Patients often exhibit irritability, agitation, and hostility in response to loss of independence. Functional performance is often more limited by some of the following:
- Loss of consciousness: Although the function of the senses is still intact, the patient still has a reduced ability to identify objects.
- Impairment: Refers to a state of impairment in the ability to perform previously learned movements despite intact motor function.
- Aphasia: The ability to understand or use language is impaired.
Early-stage dementia may not affect social functioning. However, family members are still likely to notice the odd behavior that accompanies the patient’s feelings of instability.
2. Expression in the intermediate stage
At this stage, the person is unable to learn and recall new information. Memory of distant events is also reduced, but not completely. The person may need help with basic daily activities. For example, bathing, dressing, going to the bathroom or eating.
Personality changes tend to be progressive. The person may become anxious, irritable, rigid, self-centered, or become more passive. It is accompanied by emotional stiffness, indecision, depression or withdrawal from social activities. Habits or personality traits can become more exaggerated.
Behavioral disturbances can also be progressive. The person may wander, suddenly become inappropriately agitated, uncooperative, hostile, or become aggressive.
During this stage, the patient has gradually lost all sense of place and time. They cannot use normal indication signals. Patients often get lost, can not find the bedroom, bathroom. Although they are still able to walk, there is a greater risk of falls or accidents due to confusion.
Sensory or cognitive changes are more likely to build up to psychosis with hallucinations, paranoids, or delusions of harm. At this stage, most people with dementia have sleep disturbances.
3. Expression in late stage
In the late stages, the patient seems to be unable to walk, eat or do other daily activities on his own. Many people do not even have control over their bowel movements. Both near and distant memory are completely lost. Patients may not be able to swallow, and they are at increased risk of malnutrition and pneumonia (usually from aspiration). The final stages of dementia can cause coma and death, often associated with infection.
Is dementia dangerous?
In fact, dementia is not a single disorder but can include many progressive brain diseases. The disease can damage cells that carry out vital functions in the brain, nervous system, and the entire body.
Advanced dementia can increase your risk of developing some dangerous, even life-threatening conditions. Include:
Pneumonia is believed to be the leading cause of death in people with Alzheimer’s disease. Dementia disorders can destroy the ability to swallow completely. Food and liquids are more likely to spill down the trachea than into the esophagus. At this point, an infection can develop in the lungs.
As dementia progresses, people are more likely to get infections. Infections associated with surgery can pose particular dangers to the patient. Because they can’t talk about their symptoms or follow up on a plan of care.
People with Parkinson’s disease-related dementia have a higher risk of falling. Because this disease interferes with balance and movement. Falls can lead to broken bones and sometimes require surgery (potentially many complications). After surgery, you can experience blood clots, infections, and heart problems, and even death.
People with dementia also have a higher risk of stroke. It is usually due to oxidative stress on blood vessels when oxygen-containing free radicals and oxidants in the body are out of balance. This can damage cells.
– Heart-related diseaes:
Research shows that certain types of dementia are associated with atherosclerosis. This condition can lead to heart attack, heart failure, and blood clots.
Dementia can change a person’s eating behavior. When they are not able to maintain healthy eating habits and poor nutrition, it can lead to weight loss, weakness and even inability to move.
Diagnosing dementia and determining its type can be difficult. Your doctor will usually review your medical history along with your symptoms and perform a physical exam. Some necessary questions will also be asked to the patient’s relatives.
There is no single test that can help make a diagnosis of dementia. Therefore, doctors are likely to recommend some tests to help pinpoint the problem. Procedures may include:
- Cognitive test: Doctors will assess the patient’s thinking ability. Several tests that assess thinking skills such as memory, reasoning and judgment, orientation, language skills, and attention will be administered.
- Neurological assessment: Some of the issues that need to be assessed include memory, language, attention, visual perception, senses, balance, problem solving, movement, reflexes, …
- Brain exam: Usually, CT or MRI will be done to check for evidence of stroke, bleeding, tumor or hydrocephalus. In addition, PET scans may also be recommended to observe brain activity patterns. It also shows whether “tau”, amyloid protein and a marker of Alzheimer’s disease have been sent to the brain.
- Lab tests: Simple blood tests can be done to look for physical problems that can affect brain function, such as an underactive thyroid or vitamin B12 deficiency. Sometimes spinal fluid can also be checked for inflammation, infection, or signs of degenerative diseases.
- Psychiatric evaluation: A mental health professional can determine if depression or another mental disorder is contributing to a person’s symptoms.
How to overcome dementia
Currently, most forms of dementia do not have a definitive cure. However, some medications have been found to help alleviate symptoms. Support from your doctor and help from family and friends can make a positive difference to managing this disease.
Here are some methods that can help manage dementia:
1. Using drugs
Doctors often ask people to take medication to help temporarily improve symptoms of dementia. Some medications that may be prescribed include:
This class of drugs works by increasing levels of a chemical messenger involved in memory and judgment. Although used primarily to treat Alzheimer’s disease, these drugs can also be prescribed for other forms of the disease.
Commonly used cholinesterase inhibitors include:
- Donepezil (Aricept)
- Rivastigmine (Exelon)
- Galantamine (Razadyne)
Common side effects may include diarrhea, nausea, and vomiting. In addition, some other side effects can also occur, such as slowed heart rate, sleep disturbance or even fainting.
– Memantine (Namenda):
This drug works by regulating the action of glutamate. This is another chemical messenger that is also involved in brain functions, including learning and memory. In some cases, Memantine is prescribed along with cholinesterase inhibitors. Dizziness is the most common side effect of Memantine use.
– Other drugs:
In some cases, dementia may be accompanied by several other conditions. Such as sleep disturbances, depression, hallucinations, agitation or parkinsonism. The doctor will base on each specific case to prescribe the appropriate drugs.
A non-drug approach may be the initial treatment of choice for some symptoms of dementia and behavioral problems. Some of the methods that offer many benefits include:
- Changing the environment: Reducing noise and clutter can help people concentrate and function more easily. You should hide objects that threaten the safety of the patient, such as knives, scissors, sharp objects, keys, etc. The monitoring system can warn you if the sick person wanders. .
- Simplify tasks: Break tasks down into easier steps and try to focus on success instead of failure. Establishing healthy and structured habits also helps reduce confusion in people with dementia.
- Occupational therapy: The person will work with a therapist to learn how to make the home safer. Also learn behaviors to cope with symptoms of dementia and related problems. The aim is to prevent accidents, manage behavior, and prepare for disease progression.
3. Home Remedies
Dementia symptoms along with behavioral problems tend to progress over time. If you have a loved one who is suffering from dementia, you can support them with the following measures:
- Increase communication: When talking to the sick person, try to maintain eye contact. Speak simple sentences slowly and do not rush to answer. Gestures and signs should be used, which when presenting an idea or instruction should be done at a time.
- Encourage exercise: Physical activity can help people improve strength, balance, and heart health. In addition, exercise also improves symptoms of restlessness, depression, etc. There is increasing evidence that physical activity combined with a healthy diet can protect the brain from prolapse. intellectual impairment.
- Participate in activities: Plan activities that the person enjoys and can do. Joy can come from painting, dancing, singing, cooking, gardening and many other activities. In addition, these activities also help patients connect with their loved ones better.
- Establish good nighttime habits: Behaviors tend to be worse at night. You should advise the sick person to stay away from noise, not to eat late at night, and to turn on night lights in bedrooms, bathrooms and hallways to avoid disorientation. At the same time, limit caffeine and avoid napping to reduce restlessness at night.
- Schedule things to do: This is important to help patients remember upcoming events, routine activities, and medication history. Patients should share the calendar with their loved ones.
Dementia can have a variety of causes, and there are factors that cannot be prevented, such as age. However, certain measures can be helpful to help reduce the risk of the disease. Include:
- Keep your mind active: Mentally stimulating activities such as reading, puzzle solving, and memory training can help delay the onset of dementia and reduce its effects.
- Physical activity and social interaction: These are two important factors that can help reduce the risk of dementia and related problems. Try to aim for 150 minutes of regular exercise each week.
- Quit Smoking: Many studies have shown that smoking in middle age is likely to increase the risk of dementia and vascular diseases. Therefore, it is necessary to quit smoking to reduce the risk and help improve better health.
- Get enough vitamins: Some studies show that people with low blood levels of vitamin D are more likely to develop Alzheimer’s disease and other forms of dementia. You can get more vitamin D through food, supplements, or by exposure to the sun.
- Management of cardiovascular risk factors: It is advisable to proactively treat diabetes, high blood pressure and high cholesterol. If you are overweight, lose weight early by eating a balanced diet and exercising.
- Maintain a healthy diet: Maintain a diet rich in fruits, vegetables, omega-3 fatty acids, and whole grains. This diet may help improve heart health and reduce the risk of dementia.
- Sleep well: Pay attention to good sleep hygiene. Also talk to your doctor if you have problems such as loud snoring, stopping breathing, or gasping for air while you sleep.
Dementia can shorten a person’s life and have a very serious impact on a person’s life. It is very important to visit the doctor to get an early diagnosis. Because it helps patients receive timely medical care and support to control the progression of the disease more effectively.