Think You Know What Dementia Is?

Dementia. Alzheimers. Those are two scary words. Many people think they know what dementia is. What Alzheimers is. They use the terms synonymously. Alzheimers is the most common one, but it is not the only dementia.

image of a man where the top of his head is puzzle piece that are floating away

Over the last month we’ve been talking about memory. In my post “What Do You Remember and How” you learned about the study of memory, the stages of memory, and the types of memory. “Do You Have a Terrible Memory?” discussed why you forget, the types of forgetting, and what normal forgetting is. You also learned that there were two umbrella terms that describe abnormal types of forgetting: Amnesia and Dementia. My post, Amnesia: Beyond the Tropes described what the scientific or medical reality of the forgetting called amnesia.

What Dementia Is

Many people think it is only about forgetting past events and people. It is more than that. Some believe that changes to memory, thinking skills, behavior, movement, and emotions are signs of senility or senile dementia. That represents a misbelief that serious mental decline is part of aging.

Dementia is a term for a variety of symptoms caused by damage to brain cells. This damage is not normal aging. Usually, it occurs after age 60. But in rare cases it may develop at earlier ages.

It can affect memory, thinking skills, behavior, movement, and emotions.

There is no cure for dementia. It is permanent and progressive.

While brain damage is permanent, there are conditions that cause the same symptoms but are treatable problems. Things like depression, medication side effects, excess use of alcohol, thyroid problems, vitamin deficiencies can cause thinking and memory problems. They can treat these conditions.  If you or a loved one have any of these symptoms, don’t guess or assume. See a medical professional. Get a diagnosis and appropriate treatment.

What Causes Dementia?

We don’t understand what causes these diseases well enough. More research is needed. Better devices to study the brain are needed. In many cases today, only an autopsy can definitively diagnose the specific disease. 

There are conditions scientists have identified as causing dementia.

  • A genetic mutation passed down from one generation to the next.
  • Alzheimer’s disease patients have plaques and nerve tangles in their brains.
  • Damage to the vessels that supply blood to your brain result in damaged brain cells in Vascular Dementia.
  • Other diseases are due damage from other kinds of proteins or damage from degeneration (breakdown) of nerve cells.

The Diseases of Dementia

Alzheimer’s Disease is the most common cause one. Ronald Reagan and Glen Campbell had Alzheimer’s. 

Vascular Dementia is the second most common cause of dementia. Actor Andrew Sachs had this disease.

Atypical Parkinsonian Dementias are dementias with Parkinsonian movement disorders. This group of dementias include: Progressive Supranuclear Palsy (PSP), Multiple system atrophy (MSA), and Corticobasal Syndrome.

Lewy Body Dementia is a dementia caused by a protein in the brain. Robin Williams had LBD (discovered on autopsy).

Frontotemporal Dementia (a group of diseases) where nerve cells in the frontal lobe (behind the forehead) are damaged. 

Mixed Dementia is when multiple diseases of dementia are present. People with dementia who are over 80 often have more than one.

Huntington’s Disease, Traumatic Brain Injuries,  Creutzfeldt-Jakob Disease, Parkinson’s Disease, and other conditions and diseases may also cause dementia. Huntington’s disease causes certain nerve cells in the brain and spinal cord to whither away. Traumatic Brain Injury (TBJ) refers to injuries of the brain such as concussions and severe injuries to the head and brain. Creutzfeldt-Jakob Disease is a rare, fatal brain disorder. And Parkinson’s Disease is a movement disorder.

Symptoms

There are many distinct areas in the brain. Each area controls certain functions. The area and extent of damage causes compromise or loss of those functions. For example, damage to the hippocampus affects long-term memory and emotional responses.

Each disease has specific symptoms. And each type’s symptoms can overlap other diseases of dementia. For symptoms specific to each disease, see the links above.

According to Mayo Clinic, symptoms can include:

Cognitive changes

  • Memory loss, which is usually noticed by a spouse or someone else
  • Difficulty communicating or finding words
  • Difficulty with visual and spatial abilities, such as getting lost while driving
  • Difficulty reasoning or problem-solving
  • Difficulty handling complex tasks
  • Difficulty with planning and organizing
  • Difficulty with coordination and motor functions
  • Confusion and disorientation

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

Dementia can cause loss of short-term memory, long-term memory, and/or the inability to encode memories. But remember, memory loss isn’t the only symptom.

Usually symptoms develop gradually. Sometimes, especially early in the disease’s course, symptoms can be mild or seem to appear and disappear. Family members who live outside of the home or friends may notice the symptoms first.

Diagnosis

Diagnosis of dementia, particularly the specific disease, is challenging. There is no one test that will clearly diagnose these diseases.

The doctor must review the patient’s medical history and symptoms and do a physical examination. He may order several tests to rule out other medical conditions. He may also refer the patient to a neuropsychologist for cognitive testing. A neurologist’s exam assesses movement, senses, balance, reflexes, etc.

A recent discovery led to biomarkers that makes a more accurate Alzheimer’s Disease diagnosis.

Some of these diseases can only be discovered or confirmed by autopsy.

Treatment

There are a few medications that may temporarily improve the symptoms. Medications may manage symptoms such as sleep disturbances, agitation, hallucinations, Parkinson’s, or depression.

There are non-drug treatments, too. Occupational therapy, changing the patient’s environment, simplifying tasks, and simple directions are helpful. 

You may read about dietary or herbal treatments. Mayo Clinic reports there is no scientific evidence that these treatments are beneficial.

Coping with Dementia

image looking at the back of a woman in a wheelchair facing some buildings that are not sharp in appearance but fuzzy

A diagnosis of dementia is devastating. Many things will and must change. Decisions, dealing with day-to-day care and concerns can be overwhelming.

Use trusted websites such as the Alzheimer’s Association or Mayo Clinic or the National Institute on Aging. Learn as much as you can about the disease.

Do advanced planning as soon as you can. Consult an elder care attorney. Establish a trust. Get a medical power of attorney and a financial power of attorney.

Learn about options for in home care and for long-term care in a facility.

If you are the caregiver, take care of you. Get counseling. Join a support group. Get help. Stay connected to your friends and family.

Caregivers frequently feel caught between guilt and anger and frustration. The dementia patient will act normal then, out of the blue, do or say something that triggers an emotional outburst. Forgive yourself. Be patient and kind with the dementia patient—and yourself.

Did You Learn What Dementia is?

You learned what dementia isn’t. It isn’t normal aging. Forgetting isn’t the only symptom.

It is a broad term for a multifaceted group of symptoms. This post only brushes across the surface of information about dementias. And the condition affects more than the sufferer. Forgetting isn’t the only symptom, but it is often the most painful one to caregiver(s) and family.

Now you know what dementia is. Did you learn anything new? Next week we’ll talk about a phenomena called Recovered Memories.

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