Dementia describes various symptoms of cognitive decline, like forgetfulness and difficulty communicating. This is a symptom of several underlying conditions and brain disorders, including Alzheimer’s disease.
Dementia is not a single disease. It’s an overall term to describe a collection of symptoms that one may experience if they are living with a variety of diseases, including Alzheimer’s disease.
Diseases grouped under the general term “dementia” are caused by abnormal brain changes.
Dementia symptoms trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function.
They also affect behaviour, feelings and relationships.
Alzheimer’s disease accounts for 60-80% of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia.
Those who experience the brain changes of multiple types of dementia simultaneously have mixed dementia.
There are many other conditions that can cause symptoms of cognitive impairment but that aren’t dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.
Types and causes of dementia Trusted Source include:
- Alzheimer’s disease
- Vascular dementia
- Lowy body dementia, which may occur with Parkinson’s disease
- Front temporal dementia
- Mixed dementia
Experts may refer to these as Alzheimer’s disease and Alzheimer’s disease-related dementias.
This article discusses the potential causes of dementia, the various types, and any available treatment options.
Dementia symptoms:
Signs of dementia can vary greatly. Examples include problems with:
- Short-term memory.
- Keeping track of a purse or wallet.
- Paying bills.
- Planning and preparing meals.
- Remembering appointments.
- Traveling out of the neighbourhood.
Dementia symptoms are progressive, which means that the signs of cognitive impairment start out slowly and gradually get worse over time, leading to dementia.
If you or someone you know is experiencing memory difficulties or other changes in thinking skills, don’t ignore them.
See a doctor soon to determine the cause. Professional evaluation may detect a treatable condition.
And even if symptoms suggest dementia, early diagnosis allows a person to get the maximum benefit from available treatments and provides an opportunity to volunteer for clinical trials or studies.
It also provides time to plan for the future.
Dementia stages
The World Health Organization (WHO) Trusted Source divides dementia into roughly three stages: early, middle, and late. The sections below will look at each of these in more detail.
- Early stage
At this stage, it may not seem that a person has dementia. They may:
- Become more forgetful
- Lose track of time
- Feel lost in familiar locations
- Middle stage
At this stage, the symptoms become more noticeable and include:
- Forgetting names and recent events
- Feeling lost when at home
- Difficulty communicating
- Behavioural changes
- Repeatedly asking questions
- Needing help with personal care
- Late stage
At this stage, a person needs full-time assistance, as the impact of the symptoms typically becomes more severe. The person may:
- Be unaware of where they are
- Be unaware of time
- Have difficulty recognizing loved ones
- Find it hard to walk
- Experience behavioural changes, which may include aggression
Dementia types
There are several types of dementia. They include but are not limited to the following.
- Alzheimer’s disease
Alzheimer’s disease is the most common cause of dementia, accounting for 70–80%Trusted Source of cases.
In Alzheimer’s disease, “plaques” and “tangles” develop in and between the brain cells. Both are due to changes in proteins.
A person may have short-term memory problems, difficulty finding words and making decisions, and difficulty seeing things in three dimensions.
- Lowy body dementia
Lowy body dementia occurs when Trusted Source unusual structures known as Lowy bodies develop in the brain.
These brain changes involve a protein called alpha-syncline.
In the early stages, there may be fluctuations in alertness, hallucinations, and difficulty judging distance.
The impact on short-term memory may be less severe than it is with Alzheimer’s disease.
People with Parkinson’s disease may also have Lowy bodies.
Although doctors often consider Parkinson’s disease a disorder of movement, symptoms of dementia can also appear.
- Front temporal dementia
This condition involves damage to the front and sides Trusted Source of the brain.
It happens when brain cells die due to clumps of protein developing inside them.
Depending on the part of the brain the condition affects, the person may have difficulty with behaviour, speech and communication, or both.
- Huntington’s disease
Huntington’s disease is an inherited genetic condition. The main symptoms are uncontrolled movements, but dementia can also occur.
Early symptoms may include Trusted Source difficulty focusing, irritability, and impulsivity. Depression may also be present.
The person may have difficulty with organizing, multitasking, and planning. These symptoms may appear before movement changes develop.
- Mixed dementia
When this happens, a person has a diagnosis of two or three types together.
For instance, a person may have both Alzheimer’s disease and vascular dementia at the same time.
Dementia causes
Some types of dementia, such as Alzheimer’s disease, result from the progressive death of brain cells and neurons.
It develops and worsens over time.
However, dementia can also result from head injuries, stroke, brain tumours, and other causes.
A stroke, for example, can stop blood and oxygen from reaching brain cells, resulting in damage and cell death.
Receiving a blow to the head can damage brain cells directly.
Some types of traumatic brain injury — particularly if repetitive, which can happen in some sports — may increase the risk of certain types of dementia later in life.
Some other factors and conditions with similar symptoms Trusted Source include:
- The use of some drugs
- Some infections, such as HIV or neurosyphilis
- Depression
- Vitamin B12 or E deficiency
- Thyroid problems
Dementia tests
Assessment usually involves a number of questions and tasks. The following sections will explore these in more detail.
- Cognitive dementia tests
Experts established the dementia tests that doctors currently use in the 1970s.
A doctor may ask questions such as:
- What is your age?
- What is the time, to the nearest hour?
- What is your address?
- What is the year?
- What is your date of birth?
The doctor may also take into account observations by family members and caregivers.
If the results suggest memory loss, the doctor may carry out blood tests and a CT brain scan to investigate further and rule out other possible causes.
Another test, called the mini-mental state examination which has also been in use since the 1970s measures:
- Orientation to time and place
- Word recall
- Language abilities
- Attention and calculation
- visuospatial skills
It can help diagnose dementia due to Alzheimer’s disease. It can also rate its severity and assess whether or not drug treatment is appropriate.
- Mini-Cog test
The doctor may also carry out a test known as the Mini-Cog test.
This involves the following steps:
The doctor will take three words from a specific set, “banana, sunrise, chair,” and ask the person to repeat them.
The person can have three attempts at this.
If the person cannot do this, the doctor will ask them to draw a clock face, fill in the numbers, and set the hands to a specific time.
The person should do this within 3 minutes.
If the individual cannot complete the clock task in time, the doctor will ask them to recall and repeat the three words from the first task.
There will be a maximum of 10 points. If the person scores fewer than 3–4 points, the doctor will consider dementia as a possible diagnosis.
Dementia treatment
There is currently no cure for most types of dementia, as it is not yet possible to reverse brain cell death. However, treatment may help manage symptoms.
Some medications may help reduce the symptoms of Alzheimer’s disease.
Three drugs Trusted Source, known as cholinesterase inhibitors, have approval for use in the United States. They are:
- Donepezil (Aricept)
- Galantamine (Reminyl)
- Rivastigmine (Exelon)
Cholinesterase inhibitors can also help manage behavioural symptoms of Parkinson’s disease.
A person may also use meantime (Namenda), which is an NMDA receptor antagonist, either alone or with a cholinesterase inhibitor.
If the symptoms result from an injury, medication use, or a vitamin deficiency, it may be possible to prevent further damage.
Other forms of care
Some lifestyle strategies Trusted Source that may help manage dementia include making sure the person:
- Follows a healthy diet
- Gets regular exercise
- Attends all medical appointments
- Takes their medication as prescribed
- Has regular sleep habits
- Has a safe living space
- Has support from family members and caregivers, as needed
Preventing dementia
In most cases, it is not possible to prevent dementia. However, the WHO Trusted Source suggests that the following habits may lower the risk:
- Exercising regularly
- Avoiding smoking
- Limiting alcohol consumption
- Maintaining a moderate weight
- Eating a healthy diet
Seeking treatment for conditions such as high blood pressure, high cholesterol levels, and high blood sugar levels
Wearing protective headgear during contact sports may also lower the risk of sustaining repeated head injuries, which could be a risk factor for dementia.
Frequently asked questions
- How does dementia usually start?
Dementia usually starts due to the progressive death of brain cells and neurons, though it can also happen due to other causes such as a head injury, brain tumour, or stroke. It usually starts with symptoms such as becoming more forgetful, losing track of time, and feeling lost even when in familiar locations.
- At what age does dementia begin?
Dementia typically begins after the age of 65 years Trusted Source. However, symptoms can develop earlier. Dementia that begins before the age of 65 years is known as young onset dementia.
Summary
Dementia is a term that describes symptoms affecting remembering, thinking, and behaviour.
It is a part of Alzheimer’s disease and can occur with some movement disorders, such as Huntington’s disease and Parkinson’s disease.
The symptoms usually worsen over time, and there is currently no cure.
Some drugs may help manage the symptoms, but the person may eventually need full-time help.
