Dementia is a general term used to describe difficulties with reasoning, judgment, and memory caused by several different brain disorders. Dementia symptoms are severe enough to interfere with your daily activities and typically include some memory loss and difficulty with at least one other area, such as:
- Speaking or writing coherently (or understanding what is said or written)
- Recognizing familiar surroundings
- Planning and carrying out multi-step tasks
- Alzheimer’s disease causes your healthy brain tissue to degenerate resulting in irreversible mental impairment. Alzheimer’s disease is the most common cause of dementia.
- This form of dementia is more common among people who have had strokes or are at risk for strokes, especially those with a history of high blood pressure and diabetes.
Dementia with Lewy bodies
- Dementia with Lewy bodies is caused by abnormal protein structures called Lewy bodies forming within brain cells and occurs with symptoms of Parkinson disease.
Parkinson disease dementia
- Dementia can also occur later in the course of Parkinson disease and has symptoms that are very similar to dementia with Lewy bodies.
Frontotemporal dementia (formerly called Pick's disease)
- Frontotemporal dementia causes nerve cell loss in the brain and targets the frontal and temporal lobes and arises at an earlier age than Alzheimer’s disease.
Other causes of dementia
- Dementia can also be caused by cumulative damage to the brain, which can occur if you have chronic alcoholism or repeated head injuries (e.g., former football players).
Each form of dementia can cause you to have difficulty with memory, language, reasoning and judgment. Since Alzheimer’s disease is the most common cause of dementia, the symptoms of other forms of dementia often overlap.
- Trouble remember recent events
- Difficulties with language (not being able to find the right words for things)
- Difficulty with concentration and reasoning
- Problems with complex tasks (paying bills or balancing a checkbook)
- Getting lost in a familiar place
As the disease progresses, personality and behavioral symptoms may increase:
- Increased anger or hostility, sometimes aggressive behavior
- Hallucinations and/or delusions
- Needing help with basic tasks (eating, bathing, dressing)
- Incontinence (leaking urine or feces)
Each form of dementia has its own risk factors, but most have several risk factors in common.
- Age. Dementia is uncommon in people younger than 60 years old.
- Family history. People with a parent or sibling with Alzheimer’s disease have a 10 to 30 percent chance of developing the disease.
- Other factors. High blood pressure, smoking, and diabetes may be risk factors for dementia.
- Lifestyle factors. People who remain physically active, socially connected, and mentally engaged seem less likely to fall prey to dementia (or develop dementia later).
The treatment for dementia depends in part on the type of dementia you have, but may include medication and behavioral therapy. It is important to have realistic expectations about medication - none will cure Alzheimer’s disease, but may provide an improved quality of life.
Medication currently available for treating Alzheimer’s disease:
- Donepezil (Aricept®)
- Rivastigmine (Exelon®)
- Galantamine (Razadyne®)
- Memantine (Namenda®)
Treatment of Behavioral Symptoms
Depression is common, especially in the early phases of dementia. It may be managed with behavioral therapy and/or with medications (such as selective serotonin reuptake inhibitors).
A difficult (but uncommon) issue for caregivers and people with Alzheimer’s disease is aggression, which may be caused by:
- Confusion or misunderstanding, disorientation
- Frightening or paranoid delusions or hallucinations
- Sleep disorders, reduced sleep or altered sleep/wake cycles
- Medical conditions such that cause physical pain or discomfort
Delusions are common in patients with dementia, occurring in up to 30 percent of those with advanced disease. Paranoid delusions often include beliefs that someone has invaded the house or that that personal possessions have been stolen.
Sleep disorders can be treated with medicine and/or behavior changes (such as limiting daytime naps, increasing physical activity, avoiding caffeine and alcohol in the evening).
There are no proven ways to prevent dementia. But here are some things that seem to help keep the brain healthy:
- Physical activity
- Social interaction
- Keeping the brain busy, for example by reading or doing puzzles