Dementia is a mental disease condition which losses the cognitive functions, thinking, remembering and behavioural abilities. Though it loses patients memory, loss alone of memory is not dementia. There are many reasons for lost memory.
This is most common in elders. But dementia is not a normal part of ageing. Alzheimer’s disease is the most common cause of progressive dementia in older adults. Some diseases and injuries that affect the brain also, cause dementia. According to the causes, it may decide that can reversible or not.
Not only the patient but also relations are suffering due to dementia. Most cases are because of unable to understand the disease or lack of knowledge regarding the disease. There are lots of family problems can be seen in this kind of families. It is not enough only diagnosing dementia, understanding the symptoms and helping them is very important in this situation. These patients need attention and care.
Types of dementia
Alzheimer’s disease, Vascular dementia, Dementia with Lewy bodies, Parkinson’s disease, Frontotemporal dementia, Creutzfeldt-Jakob disease, Wernicke-Korsakoff syndrome, Huntington’s disease, mixed dementia, Normal-pressure hydrocephalus and Huntington’s disease are the different types of dementia.
The most common type of dementia. About 60 to 80% of dementia occurs due to Alzheimer’s disease. This is an irreversible mental illness which progressive. This regularly destroys the memory, ability of thinking, due to the death of brain cells. After that, destroys the ability to do even the easiest tasks. The early symptoms of Alzheimer’s disease are depressed mood and short term memory loss. But depression is not a part of Alzheimer’s disease. Ageing is a risk factor for the disease.
This is the second most common dementia. This occurs due to the lack of blood flow to the brain. This can occur after an atherosclerotic disease or stroke-like vascular problems. confusion and disorientation can be seen in early-stage. those symptoms may occur suddenly or slowly. When coming to the later stage they can’t keep concentration for a long period and can’t complete a work.
Dementia with Lewy bodies
This occurs due to deposits of the proteins in nerve cells. It inhibits the messages in the brain and causes memory loss. Patients with this kind of dementia experience visual hallucination. Sleep pattern problems are common symptoms of these patients. They can’t fall asleep at night and excessively sleep at day time. Faintness, tremors, inability to work, weakness are other symptoms. These symptoms are common to Parkinson and Alzheimer diseases also.
This type of dementia develops in the people who have advanced Parkinson’s disease. Problems with reasoning and judgment are the early signs of this. Hallucinations, understanding problems, memory impairments, difficult to speak due to forgetting words also can see in these patients. Most times these patients got irritable and angry.
Called as Pick’s disease. This is a type that can occur at a young age due to family history or mutations in certain genes. This affect to frontal parts of the brain that controls language and behaviour. Disinhibit behaviour, compulsive behaviour, speech problems and forgetting are the common symptoms.
A rare condition. Only 1 in 1 million people are diagnosed with it every year. Symptoms are the same as other types and agitation can be seen. This affects and works quickly to the patient and lead to death within a year after diagnose. This affects not only the mind but also the body. Twitching and muscle stiffness occur in the body.
Wernicke’s disease is a brain disorder due to vitamin B deficiency. It leads to internal bleeding in lower parts of the brain. In Wernicke’s disease, blurred vision and loss of muscle coordination start. Later, stops the physical symptoms of Wernicke’s disease and Korsakoff syndrome start to appear. processing information, learning new skills, remembering things are can’t do Korsakoff syndrome patients.
Both of these diseases are categorized as one disease. Wernicke’s disease is can be a result of malnutrition or chronic infections. The most common cause of this vitamin deficiency is alcoholism. Korsakoff syndrome is a memory disorder caused by advanced Wernicke’s disease.
When one person has many causes of dementia called mixed dementia. This is a common condition. vascular and Alzheimer’s dementia are the most common combination. It believes, there are 45% of dementia patients have mixed dementia. Symptoms are the same as other types. They experience memory loss and disorientation at first and then the inability to speak and walk.
Normal-pressure hydrocephalus (NPH)
5% of dementia patients have this type of dementia. A condition which produces the extra fluids in the brain’s ventricles. These excessive fluids place extra pressure on the brain. Then damage the brain and occur dementia. Injury, bleeding, infection, brain tumour, previous brain surgeries are the potential causes for NPH. But some times cause is not known. poor balance, forgetfulness, changes in mood, depression, frequent, falls, loss of bowel or bladder control are the symptoms. Further damages of the brain can be prevented by early detections.
Type of dementia occurs due to genetic factors. There are two types called; juvenile and adult-onset. The juvenile dementia is rarer and causes symptoms in childhood or adolescence. The adult form typically first causes symptoms in a person’s 30s or 40s. The cause is a premature breakdown of the brain’s nerve cells. Symptoms are; inability to walking, swallowing, focusing on a task, control problems, speak and learning new things.
Other causes of dementia. diseases like multiple sclerosis, HIV cause dementia.
Signs and Symptoms
The symptoms of dementia vary according to the cause of the disease. It affects each person in a different way. The personality of the person before he becomes ill decide the symptoms. The symptoms can be divided into three stages.
Early-stage; The symptoms just after the onset. Forgetfulness, losing track of the time and becoming lost in familiar places are can be seen in the patients commonly.
Middle stage; The stage that can see the symptoms clearly. Forgetful of recent events and people’s names, difficulty with communication, lost at home, missed personal care and experiencing behaviour changes, including wandering and repeated questioning are the main symptoms in the middle stage. In this stage, starts to problems with others and relations can see the behavioural changes of the patient.
Late-stage; The severity of the symptoms is increased. The patient undergoes dependance or inactivity due to memory loss. The symptoms appear sharply. Absent of awareness regarding time place and person, difficulty recognizing relatives and friends, depend from others, difficult to physical activities and behaviour changes are the main symptoms.
Age; The main risk factor of dementia is ageing. It’s not mean ageing is the cause for dementia. Normally it occurs after 65 years old. Some times it affects to people before 65 years old. It is called young-onset dementia.
Family history; If someone has a family history of dementia, it is also a risk factor to that person. Though it is, some person has a family history with dementia, may be healthy. Someone does not have a family history. but he may undergo the disease.
Down syndrome; When people who have Down syndrome become elder people more prone to early-onset dementia.
Other; Depression, social isolation, low educational level are additional risk factors. Cognitive inactivity also same.
Treatments depend on the cause of dementia. Though there is no treatment currently available to cure dementia or to alter its progressive course, can treat for symptoms. Those treatments may drugs or non-drugs. The goals of the treatments are; early detection of the disease, optimize the patient physical health, improve cognition, physical activities, prevent accompanying physical diseases, treating challenging behavioural and psychological symptoms and educate the relations.
These drugs temporarily improve dementia symptoms.
Cholinesterase inhibitors; boosting memory by improving levels of the chemical messenger. These drugs use treated for Alzheimer’s disease, vascular dementia, Parkinson’s disease dementia and Lewy body dementia. Donepezil, galantamine, rivastigmine are examples.
Memantine; Regulating the activity of glutamate. Glutamate is a chemical messenger that involve in brain functions. It affects brain functions, such as learning and memory. Generally, memantine is prescribed with a cholinesterase inhibitor.
Other medications; Use medications to treat other symptoms, like depression, sleep disturbances, hallucinations, parkinsonism or agitation. The physician will prescribe those drugs according to the symptoms.
These are the non-drug therapies.
Occupational therapy; the occupational therapist teaches the patient how to lives at home. It is not a jock. patients with dementia live at a risk. In occupational therapy, they teach how to make their home safer without accidents and teach coping behaviours.
Environmental changes; helps the patient to keep his concentration by decreasing the noise and clutter. This is important for dementia patients. Wandering behaviour is common in these patients. We can reduce accidents, keeping the environment without harmful objects. Naming the equipment and directions also are helpful to dementia patients.
Early detection of the disease is most important due to some type of dementia causes can cure. Firstly a thyroid function test, normal pressure hydrocephalus, or a vitamin deficiency that may relate to cognitive difficulties is doing to diagnose dementia. Basically following things do by the physician,
Medical history; assesses the family history, how symptoms began, other diseases, and cognitive, behavioural changes of the patients.
Physical examination; assesses the patient’s physical conditions related to dementia.
Neurological test; Assessing balance, sensory response, reflexes, and other cognitive functions.
Dementia is a progressive disease. It is worse with time. The duration which takes worse varies from person to person. The changes occur in a person may disturb to relations and society. That is not wrong of the patient. Dementia patients are actually innocent and helpless. They need your kindful help.