According to the World Health Organization, there are currently 47 million people worldwide who are living with dementia; the number is projected to rise to over 75 million by 2030. Major areas affected by this disease are Asia, America, Europe and Africa.
Greek philosopher, Pythagoras, divided the human age into six phases. The last two phases were named as ‘senium’ which includes the ending of the mental and physical state of the body. Hence, dementia was stated as a common disease in elders aging over 65 years. It was also termed as the decay of a person’s physical and mental state when he/she reaches the closing of mortal existence. Also, there are approximately 10 million new cases of dementia every year. (WHO).
What is Dementia?
It is a long term brain disease that causes damage to our cognitive abilities and remembering things on a daily basis, resulting in severe loss of a person’s healthy brain functioning. Dementia mainly occurs in elderly age and people having unusual environment. Its diagnosis may vary from mental functioning and aging factor of a person.
It is not only a disease that affects the person having it but also the caregivers who help in prevention or cure. The caregiver may often deal with disturbances in their sleep that can result in a weakened immune system. Alzheimer’s disease is the most common type of dementia that affects 50 to 70% of people.
There is no proper cure for dementia yet, but it can be improved or prevented (link it with Best Effective Activities for Preventing Dementia) by using medication (donepezil) and decreasing risk factors like high blood pressure, smoking, diabetes and obesity. Depending on the age factor and body functioning, dementia is divided into the following major four types:
According to the Alzheimer’s Association, 50 to 70% of dementia cases are caused by Alzheimer’s disease. It is accountable for short term memory loss and difficulty in finding words.
Moreover, a person’s ability of reasoning, judgement and insight is also affected. Early symptoms of Alzheimer’s include difficulty in problem-solving, getting lost, repetition, unable to keep track of things and medication. It causes overall damage to the brain, resulting in shrinkage of the temporal and parietal lobe.
Vascular Dementia is accountable for 20-25% of the population globally, making it the second most common cause of dementia. Minor strokes and injury affecting the blood supply to the brain are major causes of vascular dementia. The Levels of vascular dementia depends on the injury of a large or small vessel. Diagnosis and scan of this dementia show different damage scales to various parts of the brain. Risk factors of vascular dementia include tobacco use, high blood pressure, atrial fibrillation, high cholesterol, diabetes and heart attack or angina.
Lewy Body Dementia
It is related to hallucinations, tremor, rigid muscles and face without emotions. A person who has this dementia has vivid hallucinations of animals or people before sleeping or after waking up. Around 15% of the global population is affected by this dementia. Symptoms of Lewy bodies are a disturbance in attention, problem-solving, planning and difficulty with visual-spatial function. Its diagnosis method is not much helpful. One can either opt for a straightforward diagnosis or SCEPT/PET scan.
Sudden personality changes and difficulty in languages is the main cause of Frontotemporal dementia (FTD). It is the fourth major cause of dementia around the globe. Lack of social interaction and inability to communicate properly are the main reasons of this dementia. It is not highly associated with memory loss.
BV-FTD, SV-PPA, NFA-PPA, PSP, CBD and FTD-MND, are the six main types of Frontotemporal dementia. All these dementias have different symptoms depending on human behavior. The main symptoms of these dementias are withdrawal from hygiene, increased appetite, language problems, loss of coordination, asymmetric movements, problems in eye movement, and death of motor neurons.
Apart from the above-mentioned major categories of dementia, there are few more neurological and medical conditions that can cause dementia:
- Alexander disease
- Canavan disease
- Cerebrotendinous xanthomatosis
- Dentatorubral-pallidoluysian atrophy
- Fatal familial insomnia
- Fragile X-associated tremor/ataxia syndrome
- Glutaric aciduria type 1
- Krabbe’s disease
- Maple syrup urine disease
- Niemann-Pick disease type C
- Neuronal ceroid lipofuscinosis
- Organic acidemias
- Pelizaeus–Merzbacher disease
- Sanfilippo syndrome type B
- Spinocerebellar ataxia type 2
Moreover, a person can have more than one dementia at a time.
There is variation in symptoms of dementia in every patient. According to research, around 10% of the affected people have mixed dementia, i.e. they have Alzheimer’s disease and any other type of dementia at the same time, and they show different signs/symptoms. Dementia is slow but progressive and mainly affects memory, visual-spatial, attention, language, and problem-solving.
General and neuropsychiatric symptoms of dementia include:
- Balance problems
- Speech and language difficulty
- Trouble eating or swallowing
- Memory distortions
- Wandering or restlessness
- Perception and visual problem
The behavior and psychological symptoms of dementia include:
- Abnormal motor behavior
- Elated mood
- Changes in sleep and appetite
Levels of Dementia
In the early stage of dementia, people start to show symptoms regarding their behavior, memory and communication skills. It can be diagnosed by comparing the habits and memory of a person with that of his past years (when he didn’t show any symptoms of dementia).
In the middle stage, the dementia of a person is already on the worse phase. They start to face problems in remembering things, and it gets difficult for them to judge stuff. They should be given extra care and be allowed to socialize instead of keeping them alone.
End-stage or Last stage of dementia is the most challenging one to deal with. People in the last stage of dementia need good care and supervision round the clock. As the disease advanced, they become severely limited in terms of eating, sleeping, and remembering familiar things.
Causes of Dementia
Main causes of dementia are hypothyroidism, vitamin B12 deficiency, Lyme disease, and neurosyphilis. Any person showing the symptoms of dementia should be checked for hypothyroidism and B12 deficiency. Along with memory loss and behavior changes, a person can also suffer from hearing loss.
Other causes of dementia are normal pressure hydrocephalus (NPH), Parkinson’s dementia, syphilis, HIV, and Jacob disease.
Diagnosis and Prevention
It is not that simple to diagnose a person with dementia or his condition by just noticing a few symptoms in him. Those symptoms should be present in a person for at least six months to properly diagnose dementia. There are several ways to study dementia that includes a brain scan, cognitive test, neuropsychiatric inventory, and Geriatric Depression Scale.
Following are the most common ways to diagnose dementia:
Mini-mental state examination (MMSE) is the most common way to diagnose and evaluate dementia. This test takes about 10-15 minutes, and it is based on a person’s behavior, daily living, and the ability to perform certain activities. Other cognitive tests are the Abbreviated Mental Test Score (AMTS), 3MS, CASI and MoCA test.
Abnormal laboratory tests show vitamin deficiency, infection, confusion, and inability to coordinate. The lab tests mainly include tests regarding vitamin B12, folic acid, thyroid-stimulating hormones, full blood count, liver enzymes, calcium, and renal function.
CT scan and MRI are the two best ways to diagnose dementia through Imaging. For Alzheimer’s disease, PET scan is used to evaluate the patient, while SPECT scan is used to diagnose vascular dementia.
Prevention and Treatment of Dementia:
The main psychological therapies to cure dementia are improving communication level with an elderly patient (link with Tips for Caregivers to Effectively Communicate with Elderly Patients), providing a healthy environment, good home care, musical therapy, conducting cognitive tests, and anxiety reduction, etc.
Although there is no proper cure for dementia through medication, several symptoms and risk factors can be reduced through it. Acetylcholinesterase inhibitors (donepezil) is one quality medicine for Alzheimer’s disease, vascular dementia, and Parkinson’s dementia.
Several precautionary measures should be taken in early and mild stages to prevent dementia, which are:
- Early education
- Treating high blood pressure
- Resisting obesity
- Treating hearing loss
- Treating depression
- Making your life active
- Quitting smoking
- Reducing social isolation
- Prevention of diabetes
According to statistics by Alzheimer’s Disease International, the number of people that have dementia will double every 20 years. It is a slow but progressive disease. 1.9 million Fatal cases are listed every year, which is not a negligible amount. To prevent dementia in its initial stages, a hygienic environment should be provided to the person showing most of its symptoms. Although dementia is not curable, it can be prevented. Stay healthy!