When the challenges of aging include dementia, everything is changed – perceptions of reality, relationships, and priorities shift for all involved. While some memory loss is common as people age, the profound loss of memory associated with dementia is not. Dementia is not a single disorder, but rather a group of symptoms and disorders that involve memory loss, changes in personality, and impairment of intellectual functioning severe enough to impact daily life, independence, and relationships or cause trauma. People who have dementia will struggle with a notable decline in communication, learning, memory, and problem-solving abilities that may occur gradually or very quickly. The outcomes and progression of dementia vary based upon the form of dementia and the affected area of the brain. Alzheimer’s disease is the most common and well-known type of dementia, and while it is the culprit of between 50% and 80% of all diagnosed cases of dementia, it’s now believed that there are over 50 other causes for dementia.
Early recognition, diagnosis, and intervention of dementia is very important as some of the 50 known causes for dementia are treatable; the most favorable outcomes coincide with early treatment. Additionally, earlier diagnosis and intervention can help you and your loved ones decide upon a plan of care that details every one of your wishes as the disease progresses. Ask your healthcare provider what you can come to expect in the future to help you and your loved ones best prepare. Research has made great strides in the treatment of dementia, and while there currently is no cure, there are a variety of therapies and medications that can slow the progression of this disorder or alleviate some of the symptoms.
Worldwide, it’s estimated that about 36 million people are currently living with dementia. That number is expected to double by 2030 and triple by 2050. One in every three older adults will die from some form of dementia; Alzheimer’s disease is currently the sixth leading cause of death in the United States.
Causes and Risk Factors for Dementia
Dementia is caused by widespread or localized damage to cells in the brain and affects each person differently, depending upon the type of dementia and area of the brain affected. The most common causes for dementia include:
Alzheimer’s disease: The most common cause of dementia in individuals over the age of 65, this disease is thought to be the result of damage to the brain caused by plaques and tangles that lead to a progressive pattern of declining cognitive abilities.
Frontotemporal dementia: This form of dementia is often found in younger individuals and is caused by the degeneration of nerve cells in the temporal and frontal areas of the brain.
Lewy body dementia: Affecting 10% to 22% of individuals with dementia, lewy body dementia symptoms are caused by lewy bodies – abnormal clumps of protein in the brain.
Vascular dementia: Vascular dementia is the second most common cause for dementia and is caused by brain damage due to reduced or impeded flow of blood to the brain – such as seen in strokes.
Other Disorders Linked To Dementia:
Creutzfeldt-Jakob disease: This rare disease can be caused by exposure to diseased brain matter or inherited from a family member. Symptoms tend to appear around age 60.
HIV-associated dementia: HIV infection destroys brain matter and can lead to dementia.
Huntington’s disease: This fatal genetic disease causes wasting of the nerve cells in the brain and spinal cord and tends to appear in younger individuals – between ages 30 and 40.
Secondary dementia: Individuals who have movement disorders or other conditions may develop dementia as a part of their disease process.
Traumatic brain injury: Repetitive or single head trauma can lead to injury of the brain. When this injury to the brain occurs in specific areas of the brain, it can lead to dementia.
Anoxia: When the brain does not receive adequate oxygen, hypoxia may develop and memory and concentration may be affected.
Brain tumors: Rarely, dementia may be the result of a brain tumor, depending upon the location and area of the brain affected.
Infections and immune disorders: Dementia may be the result of a fever or side effects of the body’s immune response to infections such as meningitis or encephalitis.
Medication reactions: All individuals react differently to medications. Some may experience dementia symptoms as a result of taking a single medication or a combination of medications.
Metabolic problems and endocrine abnormalities: Individuals who have thyroid abnormalities, hypoglycemia, or improper balance of sodium or calcium in their blood may develop dementia.
Normal-pressure hydrocephalus: Enlarged ventricles in the brain can lead to problems with gait and memory. Surgical placement of a shunt to relieve the excess amount of cerebrospinal fluid can help correct this inherited condition.
Nutritional deficiencies: Dehydration or thiamine deficiency can lead to symptoms of dementia.
Poisoning: Ingesting or exposure to heavy metals like lead or other poisons can cause dementia symptoms in some individuals.
Subdural hematoma: A bleed between the surface of the brain and the Dura mater can lead to symptoms of dementia. When the swelling and bleed have gone down, the symptoms of dementia usually abate.
Risk Factors for Dementia
- Late-life depression
- Down syndrome
- High estrogen levels
- Obesity during middle age
- Family history
- Increasing age
- Alcohol usage
- High cholesterol
Signs and Symptoms of Dementia
The symptoms of dementia will vary based upon the root cause for the dementia; some people may experience all symptoms while others only exhibit a few of the following. It’s absolutely important that if you or someone you love is experiencing any of the following symptoms that a physician is consulted immediately to determine the cause for the dementia, as some cases of dementia are, in fact, treatable.
The most common signs and symptoms of dementia may include:
- Inappropriate behaviors
- Personality changes
- Difficulties making needs known
- Impaired communication
- Asks the same question over and over
- Unable to follow directions
- Doesn’t recognize loved ones and family
- Difficulties with routine tasks
- Impaired coordination
- Increased risks for infections
- Changes in sleep patterns
- Impaired motor function
- Gait and balance problems
- Neglecting personal care
- Increased falls
- Decreased ability to chew and swallow food
- Memory loss
- Trouble finding the right words
- Difficulty performing complex tasks
- Challenges with planning and organization
- Decrease in reasoning ability
- Major mood swings
- Difficulty regulating moods
Effects of Dementia
While some forms of dementia are treatable, most are incurable, and the long-term effects of each particular type of dementia will impact every area of a person’s life. Some of the most common complications of dementia include:
- Loss of ability to chew and swallow, leading to malnutrition and/or aspiration pneumonia
- Decreased appetite, forgetting to eat or drink
- Inability to independently take care of activities of daily living
- Forgetting to take medications or believing he or she has already taken the medications
- Marked, severe personality changes
- Aggression and violence
- Social isolation
- Diminished ability to make needs known
- Full-blown psychosis – hallucinations and delusions
- Major and minor injuries from falls
- Major infections
It is not uncommon for individuals with dementia to struggle with another mental health disorder. Some of the most common co-occurring disorders include:
- Substance abuse or addiction