Dementia: Risk Factors and Diagnosis

Dementia is one of the more misunderstood conditions in modern medicine. It is technically a broad term that is used to describe a variety of symptoms which are associated with a decline in memory, thinking or communication skills severe enough to disrupt an individual’s daily activities.

Many confuse dementia with Alzheimer’s disease, and while it accounts for 60 to 80 percent of the cases, Alzheimer’s is merely one of the many types of dementia, albeit the most common. Other types of dementia include vascular dementia, dementia with Lewy bodies, Mixed dementia, Parkinson’s disease and Huntington’s disease.

There are about 47.5 million dementia sufferers worldwide and there is a new case of dementia diagnosed every 4 seconds. Dementia is sometimes incorrectly referred to as senility which was a product of the mainstream belief that mental health decline was a normal part of aging.

Statistics in the UK, for example, show that while only 5.2% of people diagnosed with dementia are under the age of 65, only 7.1% of all people over the age of 65 have dementia. This shows that while dementia mainly affects old people, it is not a normal part of the aging process.

Dementia is loosely categorized into four stages, where the first is not necessarily considered dementia yet:

 

  1. Mild Cognitive Impairment – This usually consists of general forgetfulness and affects many people as they age, however, it does not always progress into dementia.
  2. Mild Dementia – Individuals with mild dementia experience cognitive impairment which occasionally interferes with their daily lives. This can include forgetfulness, losing or misplacing things as well as poor planning and decision making.
  3. Moderate Dementia – They may exhibit symptoms such as increased memory loss, confusion (such as what day it is or where they are), and difficulty planning and carrying out tasks. They may also show significant changes in personality and sleep disturbances.
  4. Severe Dementia – At this point the symptoms have worsened significantly. The patient may require full time care and lose the ability to communicate entirely. Simple tasks such as sitting or holding their own head up become daunting and bladder control may be lost.

 

It should be noted, however, that these stages cannot be used to accurately predict the progression and severity of an individual’s level of dementia as they could appear to be in more than one stage at a time or remain in one stage for a few months or several years.

 

 

TYPES OF DEMENTIA

There are numerous different types of dementia seeing as it is just a term to describe a collection of symptoms. Below are some of the most common types along with how they affect the brain:

 

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Alzheimer’s Disease – This is by far the most common form of dementia. While the exact cause has not yet been determined, patients have an accumulation of an abnormal protein (amyloid plaques) in certain areas of the brain. But it is undetermined whether this is a cause or an effect of Alzheimer’s.

 

Vascular Dementia – This occurs as a result of multiple strokes occurring in the brain. Patients with high blood pressure or heart disease may be at more risk of developing vascular dementia.

 

Lewy Body Dementia – Lewy bodies are clumps of the protein alpha-synuclein which can develop in the cortex of the brain and cause dementia. This same protein also accumulates in the brain of patients with Parkinson’s and so they may experience similar symptoms.

 

Parkinson’s Disease – Alpha-synuclein clumps tend to appear in a deep area of the brain called the substantia nigra. These cause degeneration of the cells that produce dopamine. Click to read more on Parkinson’s Disease 

 

Huntington’s Disease – This is a progressive disorder that is caused by a single defective gene on chromosome 4. The defect results in abnormalities in a brain protein with symptoms worsening over time.

 

 

The Risk Factors For Dementia

Certain risk factors of dementia such as old age and genetics cannot be changed but this hasn’t deterred researchers from exploring other areas that may affect brain health:

  • Cardiovascular risk factors – Damage to the blood vessels can deprive the brain cells of food and oxygen. This is often linked to vascular dementia.
  • Physical Exercise – Regular exercise increases blood and oxygen flow to the brain which helps lower the risk of dementia.
  • Diet – Your diet affects your brain health through its effect on your heart. Studies show heart healthy eating patterns also help the brain.
  • Reversible factors – These include medication interactions, vitamin deficiencies, depression and thyroid abnormalities.

 

 

What Are The Signs and Symptoms of Dementia 

The symptoms of dementia may vary significantly depending on the individual and also the type of dementia. However, generally speaking at least two of the following cognitive abilities must be significantly hampered to be considered dementia:

 

  1. Memory
  2. Communication and Language
  3. Ability to concentrate and pay attention
  4. Reasoning and judgment
  5. Visual perception

 

Many dementias are progressive, meaning that the symptoms start out mildly and get worse over time. Usually what symptoms are present at the early stages help determine what type of dementia it is. Below are some specific types of symptoms they present:

 

  • Difficulty remembering conversations, names or events
  • Apathy and depression
  • Impaired communication
  • Poor judgment
  • Disorientation
  • Confusion
  • Behavioral changes and difficulty swallowing, speaking or walking
  • Sleep disturbances
  • Well formed visual hallucinations
  • Problems with movement (slowness, rigidity, tremors and gait imbalance).

 

 

Diagnosis of Dementia 

There is currently no infallible test to determine if someone has dementia. Doctors use a combination of medical history, lab tests, constant observation of the patient’s behaviors and thinking as well as physical examinations. While this may result in a high level of success, it is considerably more difficult to diagnose which specific type of dementia an individual has. You may need to see a specialist such as a neurologist or a geropsychologist.

 

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Treatment of Dementia 

Unfortunately there is no current drug that slows, stops or cures most of the types of progressive dementias, such as Alzheimer’s. There are however some treatments that help temporarily alleviate some of the symptoms. Non-drug therapies may also provide some temporary relief from some of the symptoms of dementia.

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