Dementia: Types, Causes And Treatment

Dementia

Dementia refers to a group of symptoms that affect memory, thinking, behavioral health, and social abilities so much which hinder daily life. It is not a result of any particular disease but numerous health conditions can cause dementia. It typically involves memory loss but is accompanied by various other symptoms. Millions of people in the world suffer from this syndrome and approximately 10 million new cases are introduced every year. Alzheimer’s disease is the commonest type of dementia and nearly 60-70% of cases have been found out. Dementia affects memory, thought process, learning, understanding, decision making, and language. The outcome of dementia can affect a patient’s life in all aspects. Whether it be family, society, and physical, psychological, social, and economic, all parts of a person’s life are affected to a large extent.  

General Symptoms

People suffering from dementia have problems in their daily life such as remembering things and thinking. Some other symptoms include:

• Short term memory loss
• Communication problems
• Become lost 
• Depression and mood swings
• Poor judgment and dilemma 
• Hallucinations and delusions
• Problems with movement
• Asking questions repeatedly
• Completing work in longer durations
• Describing familiar words with peculiar words

Stages Of Dementia

There are 3 stages in which each person is affected by dementia in a distinct way depending upon the personality prior to illness and impact of disease including:

Early-stage: The beginning of dementia is gradual and it may show no impairment or very mild decline in which you can observe either no symptoms or slight changes of the behavior. The common symptoms include:

• Forgetfulness
• Fail to stay away aware of the time
• Getting  lost in a familiar place

Middle stage: The signs and symptoms become transparent and constraining that may show a moderate decline in behavior include:

•  Forgetful of current events and names of people
•  Getting lost at home and familiar places
•  Increasing difficulty with communication 

Late-stage: Dormant and dependence condition in which the memory state is serious. It may show moderately severe to very severe symptoms including-

• Unaware of time and place 
• Walking difficulty 
• Behavioral changes that may include aggression
• Difficulty in recognizing relatives and friends
• Increased dependency

Types of Dementia

Dementia can be of different types-

Alzheimer’s disease: It is also called senile dementia, a progressive disorder in which brain cells degenerate themselves and die and consequently destroy memory and mental functions.

Parkinson’s disease: It is a disorder of the central nervous system in which nerve cell damage may cause a drop in dopamine levels and hence affect movements including tremors.

Frontotemporal dementia (FTD)/frontotemporal lobar degeneration(FTLD): It is commonly known as Pick’s disease. And is kind of similar to Alzheimer’s disease but slightly different. It results in a change in personality and behavior. It can also interfere with judgment and perception.

Vascular dementia: It is also called multi-infarct dementia caused by brain damage caused due to multiple strokes. It affects memory in older adults, specifically those who are at high risk of stroke which is the result of obesity or diabetes.

Creutzfeldt-Jakob disease(CJD): It is also called subacute spongiform encephalopathy in which the brain degenerates. It may arise spontaneously or come in inheritance from family. Or it is possible that the patient gets transmission by coming in contact with infectious tissue such as during transplant or eating contaminated meat. This disorder evokes personality changes, anxiety, depression, and memory loss within a few months. It may lead to dementia and death in the end.

Lewy body dementia(LBD): It is a type of progressive dementia that damages brain cells due to the deposits of abnormal microscopic protein particles called Lewy bodies and interferes with motor functions. It includes changes in vision, hallucinations, inattentiveness, and misidentification of objects.

Primary progressive aphasia(PPA): Changes in the ability to speak, understand, read, write and convey thoughts have been observed in PPA. It is a language disorder that is not the same as the problems with speech and reading and writing abilities.

Disorders Associated With Dementia

There are other disorders also that are concerned with dementia are including:

Huntington’s disease(HD): It is also called Huntington’s chorea, a rare hereditary brain condition that alters the central nervous system which affects movement, moods, and thought processes.

Craniocerebral trauma or Traumatic brain injury(TBI): It happens when an external mechanical force causes brain injury like a car accident. It causes loss of consciousness, memory, muscle weakness, etc.

Argyrophilic grain disease: It is a late-onset degenerative disorder that affects different regions of the brain and causes problems in memory and emotion. It declines cognition and alters memory and behavior. Its diagnosis is only possible by autopsy.

HIV-associated dementia(HAD): It affects the people who are suffering from HIV. It damages the brain’s white matter and then causes problems like memory, social withdrawal, lack of concentration, and movement.

Secondary dementia: It damages the brain tissue. This includes disorders like meningitis, sclerosis, encephalitis, and Wilson’s disease.

Causes & Risk Factors Of Dementia

The causes of dementia include:

• Degenerative neurological disorders like Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and multiple sclerosis.
• Vascular disorders like traumatic brain injuries, infections of the central nervous system, and hydrocephalus. 
• Alcohol or drug use 
• Metabolic deficiencies such as vitamin B12.
• Hypothyroidism and hypoglycemia
• Brain tumors 
• Subdural hematomas 
• Hiv-associated neurocognitive disorders(HAND)

Complications Of Dementia

There are certain factors that lead to the chances of dementia, including:

1. Aging
2. Family history 
3. Diabetes and heart disease
4. Multiple sclerosis and Down syndrome
5. Smoking, alcohol, poor diet, and lack of exercise
6. Depression and sleep apnea
7. Brain injuries and strokes
8. Meningitis, syphilis, and other infections of the brain

Diagnosis Of Dementia

Diagnosis commonly involves a number of questions and tasks including:

Cognitive dementia tests: Doctors may ask questions related to your age, time, address, year, date of birth, etc., and also consider the observations of the family members and carers.

Brain scans and lab tests: If the outcome points to memory loss, the doctors perform some blood tests that check various chemicals, hormones, and vitamin levels and CT (computer tomography)scan, MRI ( magnetic resonance imaging), and PET(positron emission tomography) of the brain to examine further and consider other possible causes.  

Mini-mental state examination: It tests the placement of time and place, word review, language abilities, calculation and attention, and visuospatial skills that can help in diagnosing dementia caused by Alzheimer’s disease. It also checks the level of seriousness and drug treatment plans.

Mini-cog test: The doctor will do some tests including word perception, drawing of a thing, filling the numbers and 3 minutes are given to that person to complete the task. If the patient is unable to complete the task in 3 minutes. Then the patient recalls the task again and the process repeats from the first task. It will carry a maximum of 10 points. And if the scores drop below 3-4 points then dementia is a possible diagnosis.

Preventions Of Dementia

It is not possible to prevent dementia in several cases but we can reduce the possible risks associated with it such as- 

• Interact with family members and friends. Keep your mind, heart, and soul engaged.
• Avoid smoking and alcohol.
• Have a healthy diet. Includes fiber. Emphasize plant foods.
• Do exercises and yoga daily.
• Have regular sleep habits 
• Take medication as prescribed by the doctor on time.
• Aid yourself with all medical appointments
• Have a safe place to live.
• Get treatments for high sugar levels, high blood pressure, high cholesterol levels
• Solve puzzles, play word games, and do mental activities.
• Discuss the ongoing events.
•  Drink plenty of water 

Diets To Reduce The Risk Of Dementia

Several studies have demonstrated benefits of these diets for good heart and brain health as;

• Whole grains 
• Meat, shellfish, and eggs 
• Fermented foods
•  Fortified breakfast cereals
• Spinach and legumes
• Sunflower seeds and flaxseeds
• Oranges and lemons
• bananas
• Pumpkin 
• Corn and walnuts
• Avocados
• Rockmelons
• Strawberries
• Parsnips
• Blueberries
• Tomatoes
• Sugary foods and drinks, fried foods, processed snacks, and red meat but have fish. Avoid salt as much as possible. 
• Drink plenty of water and drink alcohol only in moderation.

Treatment of Dementia

Several medical drugs are in use as medicine for the treatment of dementia. However, these drugs require a doctor’s prescription to be in use. These includes:

Cholinesterase inhibitors like donepezil, rivastigmine, and galantamine block the normal breakdown of acetylcholine which is the main neurotransmitter in both the central nervous system(CNS) and peripheral nervous system(PNS) and is responsible for the contraction of smooth muscles, dilation of blood vessels, increasing secretions from the body and slow the pace of the heart. 

NMDA receptor antagonists like memantine are a class of drugs that may help with memory and reduce neuronal excitation, abnormal pain occurrence, and hyperalgesia.

Who Treats Dementia?

There are doctors who specialize in treating dementia. The person suffering from dementia should consult these medical professionals specialized in the treatment of dementia:

Geriatricians: These physicians are specialized to manage the health conditions of old people. These professionals have good experience in the care of older patients.

Geriatric psychiatrists: These psychiatrists are specialized in the treatment concerned with the mental disorders affecting older adults.

Neuropsychologists: These are psychologists who specialize in the treatment of disorders related to a person’s cognition and behavior concerned with the brain and the nervous system. They assess memory and thinking skills.

Neurologists: These are the physicians specialized in the treatment of disorders of the brain and central nervous system. They assess the nervous system and interpret the results of the brain scans.

Conclusion

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