Here is the A-Z of dementia. Dementia is a collective term used to describe various symptoms of cognitive decline, such as forgetfulness. It is a symptom of several underlying diseases and brain disorders. See what types of dementia there are, the symptoms, the causes, what to expect and treatment. This report was published in Medical News Today.
Dementia is not a single disease in itself, but a general term to describe symptoms of impairment in memory, communication, and thinking.
While the likelihood of having dementia increases with age, it is not a normal part of ageing.
An analysis of the most recent census estimates that 4.7-million people aged 65 years or older in the United States were living with Alzheimer’s disease in 2010. The Alzheimer’s Association estimates that:
This article discusses the potential causes of dementia, the various types, and any available treatments.
Dementia symptoms include memory loss, disorientation, and mood changes.
A person with dementia may show any of the symptoms listed below, mostly due to memory loss.
Some symptoms they may notice themselves, others may only be noticed by caregivers or healthcare workers.
The signs used to compile this list are published by the American Academy of Family Physicians (AAFP) in the journal American Family Physician.
As the patient ages, late-stage dementia symptoms tend to worsen.
Sometimes, dementia is roughly split into four stages:
There are several types of dementia, including:
Early signs of dementia can include:
Dementias can be caused by brain cell death, and neurodegenerative disease – progressive brain cell death that happens over time – is associated with most dementias.
However, it is not known if the dementia causes the brain cell death, or the brain cell death causes the dementia.
But, as well as progressive brain cell death, like that seen in Alzheimer’s disease, dementia can be caused by a head injury, a stroke, or a brain tumour, among other causes.
Vascular dementia (also called multi-infarct dementia) – resulting from brain cell death caused by conditions such as cerebrovascular disease, for example, stroke. This prevents normal blood flow, depriving brain cells of oxygen.
Injury – post-traumatic dementia is directly related to brain cell death caused by injury.
Some types of traumatic brain injury – particularly if repetitive, such as those received by sports players – have been linked to certain dementias appearing later in life. Evidence is weak, however, that a single brain injury raises the likelihood of having a degenerative dementia such as Alzheimer’s disease.
The first step in testing memory performance and cognitive health involves standard questions and tasks.
Research has shown that dementia cannot be reliably diagnosed without using the standard tests below, completing them fully, and recording all the answers; however, diagnosis also takes account of other factors.
Today’s cognitive dementia tests are widely used and have been verified as a reliable way of indicating dementia. They have changed little since being established in the early 1970s. The abbreviated mental test score has 10 questions, which include:
Each correct answer gets one point; scoring six points or fewer suggests cognitive impairment.
The General Practitioner Assessment of Cognition (GPCOG) test includes an added element for recording the observations of relatives and caregivers.
Designed for doctors, this sort of test may be the first formal assessment of a person’s mental ability.
The second part of the test probes someone close to the patient and includes six questions to find out whether the patient has:
If the test does suggest memory loss, standard investigations are then recommended, including routine blood tests and a CT brain scan.
Clinical tests will identify, or rule out, treatable causes of memory loss and help to narrow down potential causes, such as Alzheimer’s disease.
The mini-mental state examination (MMSE) is a cognitive test which measures:
The MMSE is used to help diagnose dementia caused by Alzheimer’s disease and also to rate its severity and whether drug treatment is needed.
Dementia is not a normal part of aging.
Brain cell death cannot be reversed, so there is no known cure for degenerative dementia.
Management of disorders such as Alzheimer’s disease is instead focused on providing care and treating symptoms rather than their underlying cause.
If dementia symptoms are due to a reversible, non-degenerative cause, however, treatment may be possible to prevent or halt further brain tissue damage.
Examples include injury, medication effects, and vitamin deficiency.
Symptoms of Alzheimer’s disease can be reduced by some medications. There are four drugs, called cholinesterase inhibitors, approved for use in the U.S.:
A different kind of drug, memantine (Namenda), an NMDA receptor antagonist, may also be used, alone or in combination with a cholinesterase inhibitor.
Cholinesterase inhibitors can also help with the behavioural elements of Parkinson’s disease.
“Brain training” may help improve cognitive functioning and help deal with forgetfulness in the early stages of Alzheimer’s. This might involve the use of mnemonics and other memory aids such as computerised recall devices.
Certain risk factors are known to be associated with dementia. However, age is the biggest predictor. Other risk factors include:
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