DEMENTIA
Collected
Compiled,Edited and Presented by :-
Jagannathan
Dementia
is a very big topic and I have tried to be as concise as possible
Dementia is a term used
to describe a group of symptoms affecting memory, thinking and social
abilities. In people who have dementia, the symptoms interfere with their daily
lives. Dementia isn't one specific disease. Several diseases can cause
dementia.
Dementia generally
involves memory loss.
It's often one of the early symptoms of the condition. But having memory loss
alone doesn't mean you have dementia. Memory loss can have different causes.
Alzheimer's disease is
the most common cause of dementia in older adults, but there are other causes
of dementia. Depending on the cause, some dementia symptoms might be
reversible.
SYMPTOMS
Dementia symptoms vary
depending on the cause. Common symptoms include:
Cognitive
changes
- Memory loss, which
is usually noticed by someone else.
- Problems in communicating
or finding words.
- Trouble with
visual and spatial abilities, such as getting lost while driving.
- Problems with
reasoning or problem-solving.
- Trouble performing
complex tasks.
- Trouble with
planning and organizing.
- Poor coordination
and control of movements.
- Confusion and
disorientation.
Psychological
changes
- Personality
changes.
- Depression.
- Anxiety.
- Agitation.
- Inappropriate
behavior.
- Being suspicious,
known as paranoia.
- Hallucinations.
Causes
Dementia is caused by damage to or loss of nerve cells
and their connections in the brain. The symptoms depend on the area of the
brain that's damaged. Dementia can affect people differently.
Dementias are often
grouped by what they have in common. They may be grouped
1.by the protein or
proteins deposited in the brain or
2.by the part of the
brain that's affected.
Also, some diseases have
symptoms like those of dementia. And some medicines can cause a reaction that includes dementia
symptoms. Not getting enough of certain vitamins or minerals also can cause dementia symptoms.
When this occurs, dementia symptoms may improve with treatment.
IRREVERSIBLE
DEMENTIAS
1.Alzheimer's
disease. This is the most common
cause of dementia.
Although not all causes
of Alzheimer's disease are known, a small percentage are related to changes in
three genes. These gene changes can be passed down from parent to child. While
several genes are probably involved in Alzheimer's disease, one important gene
that increases risk is apolipoprotein E4 (APOE).
People with Alzheimer's
disease have plaques and tangles in their brains. Plaques are clumps of a
protein called beta-amyloid. Tangles are fibrous masses made up of tau protein.
It's thought that these clumps damage healthy brain cells and the fibers connecting
them.
2.Vascular
dementia. This type of dementia
is caused by damage to the vessels
that supply blood to the brain. Blood vessel problems can cause stroke or
affect the brain in other ways, such as by damaging the fibers in the white
matter of the brain.
The most common
symptoms of vascular dementia include problems with problem-solving, slowed
thinking, and loss of focus and organization. These tend to be more noticeable
than memory loss.
3.Lewy
body dementia. Lewy bodies are
balloonlike clumps of protein. They have been found in the brains of people
with Lewy body dementia, Alzheimer's disease and Parkinson's disease. Lewy body
dementia is one of the more common types of dementia.
Common symptoms include
acting out dreams in sleep and visual hallucinations. Symptoms also include
problems with focus and attention. Other signs include uncoordinated or slow
movement, tremors, and stiffness, known as parkinsonism.
4.Frontotemporal
dementia. This is a group of
diseases characterized by the breakdown of nerve cells and their connections in
the frontal and temporal lobes of the brain. These areas are associated with personality, behavior and
language. Common symptoms affect behavior, personality, thinking,
judgment, language and movement.
5.Mixed dementia. Autopsy studies of the brains of people age
80 and older who had dementia indicate that many had a combination of several
causes. People with mixed dementia can have Alzheimer's disease, vascular
dementia and Lewy body dementia.
REVERSIBLE
CONDITIONS
Some causes of dementia-like
symptoms can be reversed with treatment. They include:
1.Infections
and immune disorders. Dementia-like symptoms
can result from a fever or other side effects of the body's Immune response.
Multiple sclerosis and other conditions caused by the body's immune system
attacking nerve cells also can cause dementia.
2.Metabolic
or endocrine problems. People with thyroid
problems and Hypoglycemia can develop dementia-like symptoms or other
personality changes. This also is true for people who have too little or too
much sodium or calcium, or problems absorbing vitamin B-12.
3.Low levels of certain nutrients. Not getting enough of certain vitamins or
minerals in the diet can cause dementia symptoms. This includes not getting enough thiamin,which
is common in people with alcohol use disorder. It also includes not getting
enough vitamin B-6, vitamin B-12, copper or vitamin E.
4.Medicine
side effects. Side effects of
medicines, a reaction to a medicine or an interaction of several medicines can
cause dementia-like symptoms.
5.Subdural Hemorrhage. Bleeding can be common in older adults after a fall. Subdural bleeding can cause symptoms
similar to those of dementia.
6.Brain tumors. Rarely, dementia can result from damage
caused by a brain tumor.
7.Normal-pressure
hydrocephalus. This condition is a
buildup of fluid in the ventricles. It can result in walking problems, loss of
bladder control and memory loss.
RISK
FACTORS
Risk
factors that can't be changed
- Age. The risk of dementia rises as you age, especially after age 65.
However, dementia isn't a typical part of aging. Dementia also can occur
in younger people.
- Family
history. Having
a family history of dementia puts one at greater risk of developing the
condition. However, many people with a family history never develop
symptoms, and many people without a family history do.
- Down
syndrome. By
middle age, many people with Down syndrome develop early-onset Alzheimer's
disease.
Risk
factors can be changed
You might be able to
control the following risk factors for dementia.
- Diet
and exercise. Research
has found that people at higher risk of dementia who followed a healthy
lifestyle lowered their risk of cognitive decline. They ate a diet that
included fish, fruits, vegetables and oils. They also exercised, had
cognitive training and participated in social activities.
- Alcohol. Drinking large amounts of alcohol has long been known to cause
brain changes. Several large studies and reviews found that alcohol use
disorders were linked to an increased risk of dementia, particularly
early-onset dementia.
- Cardiovascular risk factors. These
include obesity, high blood pressure, high cholesterol and
atherosclerosis. Having high levels of low-density lipoprotein (LDL), in
particular, is a risk factor for cognitive decline and dementia. Diabetes
and smoking also are cardiovascular risk factors.
- Hearing
loss or vision loss that is not treated. Having hearing
loss is associated with a higher risk of dementia. The worse the hearing
loss, the higher the risk. It is also suggested that vision loss can raise
the risk of dementia, while treating vision loss can lower the risk.
- Depression. Although
not yet well understood, late-life depression might indicate the
development of dementia.
- Air pollution. Studies in animals
have indicated that air pollution particulates can speed degeneration of
the nervous system. And human studies have found that air pollution
exposure — particularly from
traffic exhaust and burning wood — is associated
with greater dementia risk.
- Head
trauma. People
who've had a severe head trauma have a greater risk of Alzheimer's
disease. Several large studies found that in people age 50 years or older
who had a traumatic brain injury (TBI), the risk of dementia and
Alzheimer's disease increased.
- Sleep
symptoms. People
who have sleep apnea and other sleep disturbances might be at higher risk
of developing dementia.
- Deficiency
of of certain vitamins and nutrients. Low levels of
vitamin D, vitamin B-6, vitamin B-12 and folate can increase the risk of
dementia.
- Medicines that can worsen memory. These
include sleep aids that contain diphenhydramine (Benadryl) and medicines
to treat urinary urgency such as oxybutynin
COMPLICATIONS
- Poor
nutrition. Many
people with dementia eventually reduce or stop eating, affecting their
nutrient intake.
- Pneumonia. Trouble swallowing
increases the risk of aspiration. and can block breathing and cause
pneumonia.
- Inability to perform self-care tasks. As dementia
gets worse, people have a hard time bathing, dressing, and brushing their
hair or teeth. They need help using the toilet and taking medicines as
directed.
- Personal
safety challenges. Some day-to-day situations can present safety issues for people
with dementia. These include driving, cooking, and walking and living
alone.
- Death. Coma and death can occur in late-stage dementia.
This often
happens because of an infection.
Prevention
There's no sure way to
prevent dementia, but there are steps you can take that might help. More
research is needed, but it might help to do the following:
- Keeping
the mind active. Mentally stimulating
activities might delay the onset of dementia and decrease its effects.
Spending time reading, solving puzzles and playing word games.
- Being
physically and socially active. Physical activity and social interaction might delay the onset of
dementia and reduce its symptoms.
- Quiting
smoking.
Quitting smoking might reduce the risk and improve health.
- Getting enough vitamins. Some research
suggests that people with low levels of vitamin D in their blood are more
likely to develop Alzheimer's disease and other forms of dementia.
- Manage
cardiovascular risk factors. Treating high blood pressure, high cholesterol and diabetes. Paying
attention to levels of LDL cholesterol
and get treatment if the levels are too high.
- High
blood pressure might lead to a
higher risk of some types of dementia. And treating high blood pressure
may reduce the risk of dementia.
- Good-quality sleep. Practice
good sleep hygiene.
- Treating
hearing loss. People
with hearing loss have a greater chance of developing problems with
thinking, known as cognitive decline. Early treatment of hearing loss,
such as use of hearing aids, might help decrease the risk.
- Getting
regular eye exams and treat vision loss. Research suggests
that not treating vision loss may be associated with a raised risk of
dementia.
TREATMENT
Most types of dementia
can't be cured, but there are ways to manage the symptoms.
Medications
The following are used
to temporarily improve dementia symptoms.
- Cholinesterase inhibitors. These
medicines work by boosting levels of a chemical messenger involved in
memory and judgment. They include donepezil (Aricept, Adlarity),
rivastigmine (Exelon) and galantamine (Razadyne ER).
Although primarily used
to treat Alzheimer's disease, these medicines also might be prescribed for
other dementias. They might be prescribed for people with vascular dementia,
Parkinson's disease dementia and Lewy body dementia.
- Memantine. Memantine
(Namenda) works by regulating the activity of glutamate. Glutamate is
another chemical messenger involved in brain functions such as learning
and memory. Memantine is sometimes prescribed with a cholinesterase
inhibitor.
- Other
medicines. You
might take other medicines to treat symptoms or other conditions. You may
need treatment for depression, sleep problems, hallucinations,
parkinsonism or agitation.
Jagannathan
