Dementia is a host of neurological and neuropsychiatric symptoms that impair day-to-day cognitive functioning. In broader terms, dementia impairs a person’s thinking and reasoning capability leading to progressive loss of memory, significant mental decline, and a paradigm shift in mood, causing irritability.
Dementia predominantly affects around 5 – 8% of the elderly aged 65 or above with a deteriorating prognosis as years progress. Dementia, however, can also affect people with a traumatic brain injury, underlying medical conditions, or inherent genetic mutations.
Symptoms of Dementia
As dementia can cause hurdles in both personal situations and occupational settings which can progress over time, diagnosing the symptoms in its early stages can aid in rehabilitation. Dementia is often misunderstood as a disease when in fact, it includes a host of symptoms that are usually irreversible and incurable.
- Inability to articulate proper sentences – for instance, fidgeting around with words to communicate properly
- Disorientation to time and place
- Inability to perform daily functions – mainly familiar yet complex tasks – without assistance
- Behavioral changes leading to progressively worsening mood symptoms such as aggression and irritability
- Inability to organize or tend to personal care
- Inability to recall memories of short-term events
- Repeating long-term memories at irrelevant times
- Inability to recognize familiar faces in later stages
- Visual and Auditory hallucinations
- Depression, anxiety, and paranoia lead to psychosis
The symptoms of dementia are categorized into stages which help to devise holistic management strategies as coping mechanisms.
Early stages of dementia – Initially, you might not notice any significant behavioral changes or impairment of cognitive abilities in your loved one. However, tests might report otherwise. As dementia progresses gradually, your loved one might lose track of time, become lost, or experience occasional forgetfulness. The mental decline is hardly noticeable as your loved one will still be independent and capable of performing familiar tasks.
Middle Stage of Dementia – You might notice the significant mental decline, mainly in areas where logical reasoning is required. Your loved one will exhibit diminished thinking ability with a loss of short-term memory concerning recent events.
Other common symptoms include the inability to perform basic familiar tasks such as fixing a meal, handling bills, driving without getting lost, making and remembering plans, and getting dressed properly. Dementia may worsen, leading to severe forgetfulness over the course of time. For instance, your loved one might not remember their home address, phone number, and names of familiar people such as grandchildren.
Late Stage of Dementia – Severe cognitive and psychological impairment leading to extreme forgetfulness and irrational behavior. Inability to remember the names of their partners or spouses. Your loved one might also need assistance to walk around their home as well as help in showering or going to the restroom to relieve oneself. Eventually, patients become bedridden and no longer have the capability to express themselves.
Causes of Dementia
Dementia is caused by a myriad of degenerative neurological diseases or vascular disorders
Over half the population aged 80 years or above suffer from Alzheimer’s Disease which is a myriad of impaired psychological and cognitive symptoms. The underlying root cause of Alzheimer’s is attributed to the accumulation of misfolded beta-amyloid proteins and tau proteins which form plaques and fibrous tangles in the brain cells, respectively.
Similar to Alzheimer’s Disease, Lewy-body dementia is also caused by the accumulation of abnormal proteins (alpha-synuclein) which in this case are called Lewy-bodies. Lewy-body dementia is the hallmark of Alzheimer’s Disease and Parkinsonism, a movement disorder that is characterized by resting tremors and uncoordinated movements.
Lewy Body Dementia is, however, more common and less severe than Alzheimer’s, but is usually associated with visual and auditory hallucinations.
Vascular Dementia, as the term suggests, comprises a host of cognitive and behavioral changes caused by a shortage of blood supply to the brain. Vascular dementia is usually caused by ischemic strokes which prevent the concerned brain tissue from receiving adequate blood supply for nourishment.
Vascular dementia is the most common cause of reversible dementia and is most commonly associated with loss of rational thinking, reasoning, and planning.
The frontal lobe or the ‘front of your brain’ is responsible for processing and carrying out complex and important cognitive (executive) functions such as problem-solving, reasoning, planning, and self-monitoring. The frontal lobe is also involved in communication by allowing you to express language skills.
The temporal lobe, however, mainly partakes in acknowledging auditory impulses, emotional impulses, perception, developing language skills, and memory. Breakdown of nerve cells in the frontotemporal lobes of the brain leads to cognitive impairment affecting one’s personality, judgment, language skills, and memory.
Other Causes of Dementia
- Different causes of dementia can however coexist, hereby leading to mixed dementia. For instance, both Alzheimer’s and Lewy-body dementia can cause symptoms of dementia in the same person.
- Dementia is also caused by genetically inherited diseases such as Huntington’s Disease, nutritional deficiencies, subdural hematomas, brain tumors, endocrine and metabolic abnormalities, or infections.
- Creutzfeldt-Jakob disease is a lesser common yet fatal type of dementia that is caused by prion disease, a disease similar to ‘mad cow disease. Symptoms are due to spongiform encephalopathy which causes severe mental decline, ultimately resulting in death.
Treatment of Dementia
Neurodegenerative causes of dementia are sadly incurable. Since loss or damage to neurons (brain cells) is irreversible, the symptoms of dementia can be managed by medications and lifestyle changes. 20% of cases, however, are due to reversible causes of dementia, the symptoms of which can be treated and managed accordingly.
Acetylcholine is a vital neurotransmitter that partakes in carrying out a majority of cognitive functions involving memory and judgment in the brain. Cholinesterase is a hydrolytic enzyme that is responsible for breaking down acetylcholine, thus allowing the brain tissue to revert to its resting state.
Cholinesterase inhibitors work by inhibiting the enzyme cholinesterase, causing an increased availability of acetylcholine in the brain. Accumulation of acetylcholine can help to diminish, stabilize, improve, or delay the worsening cognitive symptoms of dementia.
FDA-approved Cholinesterase inhibitors including Galantamine, Donezapil, and Rivastigimine are quite often prescribed in patients with Alzheimer’s or Lewy-body Dementia to help cope with behavioral and personality changes.
Lifestyle changes can help stabilize or improve the quality of life of patients with dementia.
- You can take care of your loved one by giving unduly and never-ending support to ensure safety and security.
- Make sure that you take your loved one to their doctor for regular follow-ups
- Ensure that your loved one takes their medications on time
- Improve sleep and food hygiene
- Encourage exercise and meditation for relaxation
The Final Verdict
Dementia is a cruel reality that harshly interferes with your loved one’s quality of life. Therefore, it is important for you to stay mindful of the possible outcomes of dementia so that you can spot any differences in your loved one’s cognitive functioning abilities.
Diagnosing dementia in its early stages can be helpful to delay the degeneration and decay of neurons. Manhattan Medical Arts encourages you to take initiative by reaching out to your primary care physician today. Book an appointment with a neurologist at Manhattan Medical Arts, and help your loved one live a healthy and safe life.
– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.
About The AuthorDr. Syra Hanif M.D.
Board Certified Primary Care Physician
Dr. Syra Hanif is a board-certified Primary Care Physician (PCP) dedicated to providing compassionate, patient-centered healthcare.Read More