Dementia

By:    Published: October 31, 2012

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Dementia is the term used to describe a group of symptoms that significantly affect an individual’s intellectual and social abilities. Symptoms can develop as a result of a variety of conditions, with Alzheimer’s disease being the most common. Depending on the underlying cause for dementia, it can sometimes be treated and cured.

What Is It?

Dementia itself does not have specific symptoms, but the term covers a wide group of symptoms that can occur. Symptoms of dementia are severe enough to inhibit an individual’s normal functioning abilities on a day to day basis. Many people know that memory loss is one of the most common symptoms of dementia. However, memory loss alone is not enough to diagnose dementia. For dementia to be diagnosed, deficiencies must be present in at least two brain functions. In addition to memory loss, an individual must also present with another type of brain impairment, such as poor language skills, impaired judgment, confusion or personality changes.

Symptoms

The type of symptoms present in individuals with dementia will depend largely on the underlying cause. For a diagnosis of dementia to be made, at least two of the common dementia symptoms must be present. Common dementia symptoms include:

  • Memory loss
  • Impaired communication skills
  • Difficulty remembering new information
  • Learning difficulties
  • Impaired ability to organize and plan
  • Impaired coordination
  • Motor function impairment
  • Changes in personality
  • Inappropriate behavior
  • Agitation
  • Paranoia
  • Inability to understand reason
  • Hallucinations

Causes

There are numerous possible causes for the development of dementia. Sometimes dementia develops on its own and does not coexist with other conditions, such as in the case of Alzheimer’s disease. Other times, dementia is caused by an underlying condition that leads to brain impairment. In some cases, dementia is caused by a reaction to medication or as a result of an infection. There are different types of dementias, and they are often categorized according to the factors that they share, such as which area of the brain is affected or if they are progressive or reversible with treatment. Progressive dementias are not reversible and they become worse over time. Examples of conditions that cause progressive dementia include:

  • Alzheimer’s disease. This is the most common condition that causes dementia in adults over the age of 65. Symptoms of dementia generally develop after the age of 60, although there are some types of Alzheimer’s disease that can have an early onset, usually due to a defective gene.
  • Lewy body dementia. Approximately 20 percent of individuals with dementia are affected by Lewy body dementia. Lewy bodies are clumps of protein that develop in the brain. This type of dementia is more common as people age.
  • Vascular dementia. After Alzheimer’s disease, vascular dementia is the second most common form of dementia. It occurs as a result of brain damage that is caused by problems in the arteries that lead to the heart and brain. It can also develop as a result of a heart valve infection or hemorrhagic strokes.
  • Frontotemporal dementia. This type of dementia is less common, generally developing at a younger age than Alzheimer’s disease. Symptoms usually develop between the ages of 40 and 70. It refers to a group of diseases that lead to the degeneration of nerve cells in both the temporal and frontal brain lobes. The cause is unknown.
  • Huntington’s disease. This disease is inherited and results in wasting of the nerve cells in the brain and spinal cord. Symptoms generally develop in the 30’s and 40’s, and eventually progress to severe dementia.
  • Dementia pugilistica. Also referred to as chronic traumatic encephalopathy, it is the result of head trauma that occurs repeatedly, such as the type that boxers experience. It is also known as boxer’s dementia. Symptoms may not develop until several years after the trauma occurred.
  • Creutzfeld-Jakob disease. Although this type of brain disorder is rare, however, it is fatal. It generally develops with no warning and there are no risk factors for it. Some cases have been linked to heredity, and others have been linked to exposure to diseased brain.

The other category of dementia is not progressive and can be reversed with appropriate treatment. Causes of reversible dementia include:

  • Disorders of the immune system and infections. Fever and other symptoms that occur as a result of the body fighting an infection can lead to the development of dementia. Examples of infections that can cause dementia include meningitis, encephalitis, Lyme disease, syphilis and leukemia.
  • Metabolic disorders and endocrine abnormalities. Included in this list are hypoglycemia, thyroid issues, abnormal sodium and calcium levels and an improper absorption of vitamin B-12.
  • Nutritional deficiencies: These include deficiencies such as dehydration, low levels of vitamin B-1 (thiamin), and vitamins B-6 and B-12 deficiencies.
  • Drug interactions: Dementia may develop as a result of a reaction to a medication itself or due to a drug interaction between several medications.
  • Subdural hematomas. When bleeding occurs between the surface of the brain and its outer covering, these hematomas can develop.
  • Brain tumors. Although it is not common, dementia can occur as a result of a brain tumor.
  • Insufficient oxygen. Heart attack, asthma that is severe, carbon monoxide poisoning, being at a high altitude, strangulation, anesthetic overdose, chronic lung problems and heart conditions can all deprive the brain of oxygen, which can lead to the development of dementia.

Risk Factors

There are a variety of risk factors associated with the development of dementia. Some factors, such as advancing age and family history, cannot be changed. Other factors, such as alcohol use and high cholesterol levels, can be addressed by good choices and lifestyle changes. Risk factors for dementia include:

  • Advancing age
  • Family history
  • Down syndrome
  • Alcohol use
  • Atherosclerosis
  • Blood pressure
  • Cholesterol
  • Depression
  • Diabetes
  • Elevated estrogen levels
  • Elevated blood homocysteine levels
  • Smoking

Diagnostic Tests

Diagnosis of dementia can be difficult due to the numerous conditions that can lead to dementia symptoms. It may take several visits and diagnostic tests before a diagnosis is confirmed. Common diagnostic tests for dementia include:

  • Medical history
  • Physical exam
  • Cognitive tests
  • Neuropsychological exams
  • Neurological evaluation
  • Brain scans
  • CT scan
  • MRI
  • Electroencephalogram
  • Blood tests
  • Urine screen
  • Spinal tap
  • Psychiatric evaluation

Treatment Options

For reversible dementia, treating the underlying condition can completely reverse the dementia. In progressive dementia, treating the underlying causes can help to slow progression and minimize the development of new symptoms. Medications are used to treat dementia and its symptoms. The most commonly used dementia medications are:

  • Cholinesterase inhibitors that work to boost the amount of chemical messengers of memory and judgment.
  • Memantine, the drug used to treat Alzheimer’s disease. It regulates glutamate activity, the chemical messenger present in all brain functions.
  • Additional medications that can be used to treat specific symptoms.
  • Additional medications aimed at reducing the risk factors for the development of additional brain damage.
  • The use of sedatives and antidepressants to treat specific symptoms and address behavioral issues.

Considerations

When you or a loved one are diagnosed with dementia, you may experience a range of emotions. It is important to be prepared to handle the condition and seek out the support necessary to cope. To help deal with the diagnosis and handle your feelings, consider starting a journal, joining a support group, beginning counseling or therapy, joining an online dementia community, and seeking out assistance from friends and family members.

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