The Complete Guide to Dementia & Dementia Care
There are more than seven million people with dementia and more than three million new cases diagnosed every year. It’s estimated that 5-8% of individuals age 60 and over have dementia at any given time. Beginning at the age of 65, dementia incidence doubles with every five years of age. Up to half of all people over the age of 85 may have some form of dementia. It’s projected that by 2030, more than 75 million people will have dementia and more than 135 million by 2050. With such sobering statistics, it’s important to look more closely at dementia.
What is Dementia?
Not a specific disease, dementia is a wide-ranging term for a group of symptoms that progressively damage and destroy areas of the brain causing a deterioration in mental capabilities severe enough to negatively impact daily life. As dementia progresses, the brain begins to shrink, generally starting in the area that controls memory, reasoning and personality. It’s commonly characterized by impairment of at least two brain functions such as memory loss, reasoning and judgment.
What are the Types of Dementia?
There are more than 100 types of dementia with the most common being:
- Alzheimer’s Disease
- Lewy Body Dementia, also called Dementia with Lewy Bodies
- Vascular Dementia, generally the result of a series of mini-strokes
- Mixed Dementia is when a person has more than one type of dementia
- Mild Cognitive Impairment is the stage between the normal cognitive impairment that occurs with old age and a definitive dementia diagnosis
- Frontotemporal Dementia
- Parkinson’s Disease Dementia
- Wernicke-Korsakoff Syndrome
- Creutzfeldt-Jakob Disease
- Normal Pressure Hydrocephalus
- Huntington’s Disease Dementia
What Causes Dementia?
When damage to the brain interferes with a brain cell’s ability to communicate with other brain cells, the result is dementia. Symptoms are determined by the part of the brain impacted by this damage.
For example, high levels of certain proteins make it difficult for brain cells to maintain health and communicate with each other which results in Alzheimer’s. The damage generally first occurs in the hippocampus, the part of the brain responsible for learning and memory, which is why memory loss is often one of the first symptoms experienced with Alzheimer’s.
Alzheimer’s vs. Dementia
Dementia is an umbrella term for a group of conditions that cause progressive damage to nerve cells in the brain. Alzheimer’s is only one of these conditions, albeit, the most prevalent. Alzheimer’s disease accounts for 60-80% of the cases of dementia. Read more about the differences between Alzheimer's and Dementia here.
What are the Signs and Symptoms of Dementia?
Since each cause of dementia will have its own unique set of symptoms, the symptoms of dementia can vary greatly. Two or more of the following primary mental functions must be substantially impaired for a dementia diagnosis:
- Reasoning and judgment
- Language and communication
- Visual perception
- Ability to focus and pay attention
Other symptoms may include:
- Short-term memory loss
- Difficulties with organizational and planning skills
- Changes in behaviors and personality
What are the Stages of Dementia?
As the nerve cells and their connections are destroyed the brain shrinks. This process happens over time in three stages. Depending on the cause for the dementia, each stage can last months to years.
- Early Stage – An individual can become forgetful or confused. They may also begin to show personality or behavior changes. Typically, they’re able to function without assistance.
- Middle Stage – An individual’s needs for assistance will increase progressively. Many begin to experience difficulties recognizing friends and family. They may start to wander and find themselves lost in familiar surroundings or become restless and experience bouts of anger, frustration and agitation.
- Late Stage – An individual will require assistance in essentially all aspects of life. Since dementia impacts an individual’s ability to cope with infection, death is usually the result of another condition and is often hastened by an acute illness such as pneumonia.
What are the Effects of Dementia?
Living with dementia will have a huge impact on a person’s thoughts and feelings, some caused by the disease processes themselves and some by the person’s reaction to the diagnosis.
An individual who has had a recent diagnosis is likely to feel a wide range of emotions including anger, loss, grief, fear, shock, disbelief and, for some, even relief. They may experience depression and anxiety. They are likely to feel apprehensive about what the future holds, frustrated and upset about the effect dementia will have on family and friends, and frustrated and scared when they experience moments of forgetfulness and confusion.
Friends and family will have their own feelings of anger, loss, grief, fear, shock and disbelief.
Brain changes will cause changes in their emotional responses and in their personality.
How to Prevent Dementia
Although some risk factors, such as genetics and age, cannot be changed, other risk factors affecting brain health and dementia prevention may be controllable.
- Physical Exercise – Evidence suggests regular physical exercise may lower the risk of developing some dementias by increasing blood and oxygen flow to the brain.
- Diet – Brain health is affected by a diet’s effect on heart health. Diets, such as the Mediterranean diet, may help protect the brain as well as the heart.
- Cardiovascular Risk Factors – Anything having the potential to damage blood vessels can deprive the brain of food and oxygen. This can impact an individual’s chance of developing dementia as well as cause increased decline once dementia has been set in motion and can make any impairments more severe. To protect cardiovascular health:
- Maintain a healthy weight
- Don’t smoke
- Keep blood pressure in check
- Maintain healthy cholesterol levels
- Keep blood sugar within recommended limits
Dementia Care and Treatment
When caused by trauma or a degenerative disease such as Parkinson’s, dementia is irreversible; however, some cases can be reversed when the underlying cause, such as alcohol, vitamin or hormone imbalances, drugs or depression, is addressed.
Irreversible dementia is chronic and can last years. For most progressive dementias, such as Alzheimer’s, there is no cure and no treatment that slows the progression; however, there are pharmaceuticals that can produce short-term symptom improvement. Non-drug therapies may be used to ease some symptoms. Although treatments may be similar, each type of dementia has its own individualized treatment approach.
Clinical studies and trials are always looking to enroll individuals with dementia in their quest to find new treatments.