What is it?
- Dementia isn't a specific disease. Instead, it describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. It's caused by conditions or changes in the brain. Different types of dementia exist, depending on the cause. Alzheimer's disease is the most common type.
- Memory loss generally occurs in dementia, but memory loss alone doesn't mean you have dementia. Dementia indicates problems with at least two brain functions, such as memory loss along with impaired judgment or language. Dementia can make you confused and unable to remember people and names. You may also experience changes in personality and social behaviour. However, some causes of dementia are treatable and even reversible.
Symptoms
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
- Memory loss
- Difficulty communicating
- Inability to learn or remember new information
- Difficulty with planning and organising
- Difficulty with coordination and motor functions
- Personality changes
- Inability to reason
- Inappropriate behaviour
- Paranoia
- Agitation
- Hallucinations
Dementias can be classified in a variety of ways and are often grouped together by what they have in common.
Alzheimer's disease. Alzheimer's disease is caused by the destruction of brain cells.
Lewy body dementia. Lewy bodies are abnormal clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease.
Vascular dementia. This dementia is a result of damage to your brain caused by problems with the arteries serving your brain or heart.
Frontotemporal dementia. This is a group of diseases characterised by the degeneration of nerve cells in the frontal and temporal lobes of the brain. The cause isn't known, although in some cases this dementia is related to certain genetic mutations.
Other disorders linked to dementia
Huntington's disease. This inherited disease causes certain nerve cells in your brain and spinal cord to waste away.
Dementia pugilistica. This condition, also called chronic traumatic encephalopathy or boxer's dementia, is caused by repetitive head trauma, such as experienced by boxers.
HIV-associated dementia. Infection with the human immunodeficiency virus (HIV), which causes AIDS, leads to widespread destruction of brain matter and results in impaired memory, apathy, social withdrawal and difficulty concentrating.
Creutzfeldt-Jakob disease. This rare, fatal brain disorder most often occurs sporadically in people with no known risk factors.
Secondary dementias. Sometimes, people with other disorders that primarily affect movement, for example, Parkinson's disease, may eventually develop symptoms of dementia.
How do you treat it?
- Cholinesterase inhibitors. These drugs — donepezil (Aricept), rivastigmine (Exelon) and galantamine hydrobromide (Reminyl) — are Alzheimer's drugs that work by boosting levels of a chemical messenger involved in memory and judgment. Side effects can include nausea, vomiting and diarrhoea. Although primarily used as Alzheimer's drugs, they're also used to treat vascular, Parkinson's and Lewy body dementias.
- Memantine. This drug for Alzheimer's disease works by regulating the activity of glutamate, another chemical messenger involved in all brain function, including learning and memory. Its most common side effect is dizziness. Some research has shown that combining memantine with a cholinesterase inhibitor may have even better results. Although primarily used to treat Alzheimer's disease, it may help improve symptoms in other dementias.
- Other medications. Although no standard treatment for dementia exists, some symptoms can be treated. Additional treatments aim to reduce the risk factors for further brain damage. Treatment of the underlying causes of dementia can also slow or sometimes stop its progress. To prevent a stroke, for example, your doctor may prescribe medications to control high blood pressure, high cholesterol, heart disease and diabetes. Doctors may also prescribe medication to treat conditions such as blood clots, anxiety and insomnia for people with vascular dementia. In addition, some specific symptoms and behavioural problems can be treated with sedatives, antidepressants and other medications, but some of these drugs may worsen other symptoms. Creutzfeldt-Jakob disease has no known treatments. Care is focused on making sure the person is comfortable.
How do you live with it?
You can take steps to improve quality of life as the disease progresses.
- Carry a reminder calendar: Record not just upcoming events, but things that happen and activities you need to complete on a daily basis.
- Maintain a calm and stable home environment: A calm and stable home environment reduces behaviour problems.
- Establish a nighttime ritual: Try to establish going-to-bed rituals that are calming and away from the noise of television.
- Create a plan: Develop a comprehensive plan that identifies goals for care.
Author: Garvan James Lynch B.Sc.(Gen) N.U.I. B.Sc.(Hons) G.R.S.C. B.Sc.(Hons) Pharm. M.P.S.I. M.R.Pharm.S. M.B.A.(Healthcare) D.I.C.
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