Defining Dementia
Dementia is a chronic, persistent disorder of mental processes caused by brain disease or injury marked by memory disorders, personality changes, and impaired reasoning.
Dementia is not a specific disease but a generalised term for the impaired ability to remember, think, rationalise, or make decisions that interfere with everyday activities.
Alzheimer’s disease is the most common form of dementia. Though dementia mostly affects older adults, it is not a part of the normal ageing process.
The World Health Organisation says, “Of those at least 65 years of age, there is an estimated 5.0 million adults with dementia in 2014 and projected to be nearly 14 million by 2060.”
Is Dementia A Normal Part Of Ageing
The short answer is no! Most older adults live their entire lives without developing dementia.
In the Modern Age, dementia as a recognised clinical diagnosis was initially accepted as a medical term in 1797 by Philippe Pinel (1745–1826), a doctor in France.
The normal ageing process includes the weakening of muscles and bones, stiffening of joints, clogging of arteries and blood vessels, and some age-related memory changes that may show as:
- Struggling to find a word but remembering it later
- Forgetting the most recent events
- Forgetting the name of an acquaintance
- Occasionally misplacing car keys or objects
Normal ageing recalls knowledge and experiences built over years, long-term memories, and the ability to speak and write language/s spoken fluently would remain intact.
What Is The Difference Between Dementia And Alzheimer’s Disease
Dementia is currently ranked as the seventh (7th) leading cause of death and has been cited as one of the major causes of disability and dependency in older adults.
Answer From Jonathan Graff-Radford, M.D. Mayo Clinic
“These terms are often used interchangeably, but they actually have different meanings. Dementia is not a specific disease. It’s an umbrella term that describes a wide range of symptoms. These symptoms affect people’s ability to perform everyday activities on their own. Common symptoms of dementia include:
- A decline in memory
- Changes in thinking skills
- Poor judgement and reasoning skills
- Decreased focus and attention
- Changes in language
- Changes in behaviour
Alzheimer’s disease is the most common type of dementia, but it’s not the only one. There are many different types and causes of dementia, including:
- Lewy body dementia
- Frontotemporal dementia
- Vascular dementia
- Limbic-predominant age-related TDP-43 encephalopathy
- Chronic traumatic encephalopathy
- Parkinson’s disease dementia
- Creutzfeldt-Jakob disease
- Huntington’s disease
- Mixed dementia
While dementia is a general term, Alzheimer’s disease is a specific brain disease. It is marked by symptoms of dementia that gradually get worse over time. Alzheimer’s disease first affects the part of the brain associated with learning, so early symptoms often include changes in memory, thinking and reasoning skills. As the disease progresses, symptoms become more severe and include confusion, changes in behaviour and other challenges.”
What Are The 7 Stages Of Dementia
Reference Chart: https://keepingbusy.com/learning-center/early-signs-dementia/
Reference Link: https://qbi.uq.edu.au/dementia/stages-dementia
Stage 1. Appears normal
Normal, no obvious signs, although brain changes may be occurring
Stage 2. Very mild
No noticeable symptoms different to normal ageing. Brain imaging may reveal plaques or degeneration.
Stage 3. Mild
Mild cognitive deficits – increased forgetfulness or disorientation, difficulty finding words. Loved ones begin to notice a decline.
Stage 4. Moderate
The memory of recent events is affected; difficulty with complex tasks and managing personal affairs; may be in denial or withdrawn from the family. The decline is obvious to a doctor. Family and friends notice symptoms.
Stage 5. Moderately severe
Major memory lapses, including significant life events; needs help with daily activities such as dressing or preparing meals; can no longer
manage personal affairs.
Stage 6. Severe
Can no longer care for self; starts to forget names of family members; difficulty finishing tasks; speech affected; incontinence, depression, agitation, and delusions may be evident.
Stage 7. Very severe
Full-time care is needed; loss of speech; requires assistance with all daily activities, including eating, bathing, toileting; may lose the ability to walk.
Dementia Help Line Australia: https://www.dementia.org.au/helpline
Signs And Symptoms Of Dementia
Dementia is a generalised term; its symptoms can vary widely from person to person based on the clinical diagnosis. People with suspected dementia who require diagnosis generally have problems with:
- Memory
- Attention
- Communication
- Reasoning, judgement, and problem solving
- Visual perception beyond typical age-related changes in vision
Signs That May Point To Dementia Include
- Getting lost in a familiar neighbourhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Forgetting old memories
- Not being able to complete tasks independently
What Increases The Risk Of Dementia
- Age
The strongest known risk factor for dementia is increasing age, with most cases affecting those 65 years and older.
- Family History
Those with parents or siblings with dementia are more likely to develop dementia themselves.
- Ethnicity Factors
Older African Americans are twice more likely to have dementia than Caucasians. Hispanics are 1.5 times more likely to have dementia than Caucasians.
- Poor Heart Health
High blood pressure, high cholesterol, alcoholism, drug dependency, and smoking all increase the risk of early onset dementia.
- Traumatic Brain Injury
Head injuries that result in a concussion, or those received from a motor vehicle accident, falling from a horse etc., can all increase the risk of dementia, especially if they are severe and caused damage to a specific region of the brain or repeatedly occurred throughout the individual’s life in the form of minor concussions across multiple regions of the brain, i.e. sports injuries.
How Is Dementia Diagnosed
A neurologist specialist or certified healthcare provider can request, refer, or perform tests on attention, memory, problem-solving, and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI can help determine an underlying cause and rule out all other brain-related conditions and possibilities.
What Are The Most Common Types Of Dementia
Alzheimer’s disease: This is the most common cause of dementia, accounting for 60 to 80 per cent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease.
Other concerns like difficulty walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimer’s disease increases the risk of developing it by 10 to 30 per cent.
Vascular dementia: About 10 per cent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses step-wise, meaning symptoms will suddenly worsen as the individual gets more strokes or mini-strokes.
Lewy body dementia: In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness, including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or experience visual hallucinations (seeing people, objects or shapes that are not observable by other people).
Fronto-temporal dementia: This type of dementia often leads to changes in personality and behaviour because of the part of the brain it affects. People with this condition may embarrass themselves or behave inappropriately. For instance, a previously cautious person may make offensive comments and neglect responsibilities at home or work. There may also be problems with language skills like speaking or understanding.
Mixed dementia: Sometimes, more than one type of dementia is present simultaneously in the brain, especially in people 80 and older. For example, a person may have Alzheimer’s disease and vascular dementia. It is not always obvious that a person has mixed dementia since the symptoms of one type of dementia may be most prominent or overlap with symptoms of another type. Disease progression may be faster than with one kind of dementia.
Reversible causes: People with dementia may have a reversible underlying cause, such as the side effects of medication, increased pressure in the brain, vitamin deficiency, and thyroid hormone imbalance. In women, pre-menopause and menopause symptoms can mimic some classic dementia symptoms during the transition phase. Medical providers should screen for reversible causes and treatments in patients concerned they might be displaying dementia symptoms.
Dementia Treatment
Dementia treatment depends on the underlying cause. Neurodegenerative dementias, like Alzheimer’s disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behaviour changes.
Research to develop more treatment options is ongoing and heavily funded in a bid to prevent future generations from seeing the current number of dementia patients increase exponentially, leading to the overburdening of the medical system and insufficient nursing homes to cater to the demand for specialised, around the clock, daily care.
Leading a healthy lifestyle that includes regular brain stimulation, exercise, healthy eating, and maintaining social contacts decreases the chances of developing chronic diseases and may reduce the number of people who develop dementia.
Brain stimulation in the forms of reading, puzzles, crosswords or sudoku, hobbies, writing, chess, and anything that requires fine motor skills and cognitive processes can stave off the early onset of dementia symptoms in otherwise healthy ageing people.
What To Do If You Suspect The Onset Of Dementia
Discuss your observations and thoughts with your family and friends.
Discuss seeing a medical provider about the observed changes for a confirmed diagnosis.
Please discuss the issue of safely driving a motor vehicle and always carrying ID and next of kin contact details on the person should they be needed.
Medical assessment time. Talk to a family doctor or physician you are comfortable with. Ask them about the Medicare Annual Wellness exam.
Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan/Will etc.
Organ Donation. Discuss with your family if you are willing to be an organ donor and make it clear that is your dying wish to be respected and enacted. Depending on the country, if you are a registered Organ Donor, it is shown on your driver’s licence or via a dedicated Organ Donor Card.
Opt-in Australian Government Registered Organ Donor: https://www.donatelife.gov.au/
