Dementia

Dementia Definition

You've probably heard of dementia but do you know what type of disease it is?

As we age, our cells die – that’s a natural part of the aging process. However, for people with dementia, it can happen earlier than normal and to a greater extent. When the brain cells die, they aren’t ever reborn, leaving gaps in your memory and ability to do things such as motor control. Dementia is a progressive disease, meaning it will continue to get worse; unfortunately, no treatment can stop the course of dementia.

Fig. 1. Do you know someone with dementia?

As brain diseases go, dementia is relatively well-known due to its prevalence. The World Health Organization (WHO) has reported that around 55 million people currently have dementia and the Center for Disease Control (CDC) states that in the United States, a little less than six million people are living with dementia currently.^{1 2} Many people can live with the symptoms of dementia for years after they’re diagnosed, but their quality of life decreases over time. Even though people can live with this disease, the WHO noted it as the seventh leading cause of death across all diseases.

Alzheimer’s Disease

It’s hard to talk about dementia and not talk about Alzheimer's. While you might think of Alzheimer’s disease and dementia as distinct cognitive diseases, Alzheimer’s disease is actually a type of dementia. Although there are other types of dementia, Alzheimer’s accounts for approximately 60-80% of all dementia cases.

Alzheimer’s is a disease many senior citizens develop, with the Alzheimer’s Association reporting that one in every three seniors passes away from Alzheimer’s or another form of dementia. Alzheimer’s is progressive like dementia, meaning that its course cannot be reversed once it happens.

Additionally, since Alzheimer’s disease attacks the brain, people can often go years with their brain changing before their symptoms are noticed. The first noted symptom many people have is memory problems, the most commonly known symptom of Alzheimer’s.

Other types of dementia include:

• Vascular dementia: Dementia caused by brain damage or a stroke

• Lewy body dementia: A form of dementia that has hallucinations, sleep problems, and attention challenges

• Frontotemporal dementia: A type of dementia where the frontal and temporal lobes experience most of the cell loss, causing major changes in personality and judgment

• Mixed dementia: A combination of two types of dementia at once

Dementia Symptoms

As you might have guessed by now, one of the main and most identifying symptoms of dementia is memory loss. It's also usually the first noticeable symptom of dementia.

There are two main types of memory that dementia can affect.

When we think of people with Alzheimer's having memory problems, we often think about them forgetting their episodic memory. While Alzheimer's might impact semantic memory first, episodic memory loss is often more impactful for loved ones.

When someone struggles with their semantic memory, they can be diagnosed with semantic dementia. When someone has semantic depression, they primarily lose the ability to communicate effectively. They are still able to structure sentences like people without semantic dementia, but cannot remember the meaning of words, making their sentences difficult to understand.

Considering dementia is a cognitive disease, can you think of other symptoms that could result from cell loss in the brain?

This is a list of possible symptoms someone could show when they have dementia. However, the symptoms that are present vary depending on the person and what type of dementia the person has.

In the very early stages of dementia, someone might show slight symptoms, but none of them are severe enough to be labeled as dementia. In this case, the person would be diagnosed with mild cognitive impairment (MCI). Not every person who has MCI will go on to develop dementia, but it is far more likely to develop dementia if you have MCI than if you don’t.

Stages of Dementia

Being forgetful is a natural part of aging. As someone without dementia gets older, they will become more forgetful since their brain is aging as well. However, how do you draw the line between being forgetful because of the natural aging process and being forgetful because of dementia? As a family member, how do you know when to be concerned with a loved one’s forgetfulness? Well, there are seven stages of dementia to look out for.

No Impairment

In the first stage of dementia, there are no symptoms to show that the person is actually in the very beginning of developing dementia. If they were to get a brain scan, it would show that they have had brain changes; however, nothing is visible to the naked eye.

Slight/Mild Cognitive Decline

In this stage, there are very slight changes in the person’s behavior. They might be a little more forgetful, but not in such a way that would concern family members.

Mild Cognitive Impairment

This is the stage that was referenced earlier. It’s the earliest stage in dementia where loved ones of the person will truthfully notice symptoms and behavioral changes. In this stage, a person will forget simpler things such as names and where they placed objects and struggle more with being confused at simpler things.

Moderate Cognitive Decline

In this stage of dementia, people will struggle even more with memory loss. This level of forgetfulness might make it difficult for a person to live on their own as they would forget appointments, payments, and what time to go to work.

Moderate to Severe Cognitive Decline

Building upon the symptoms in the previous stages, the fifth stage of dementia hosts more problems for the person. The person cannot function independently and will forget the names of family members.

Severe Cognitive Decline

In this stage, people will no longer remember any family member’s names and will struggle with communication. People will suffer from mood swings and a change in sleep patterns. Additionally, in this stage, while people cannot remember recent events, they can still remember occurrences from years prior.

Very Severe Decline

In the final stage of dementia, the person will lose the ability to communicate and often can no longer form coherent words. People can no longer walk, eat, or control their bladder movements. There is a major disconnect between what the body is capable of and what the brain can do.

Fig. 2. In the final stages of dementia, people need assistance with everything.

Dementia Causes

There is not just one cause of dementia. One of the highest risk factors for dementia is age, with people’s risk increasing drastically after age 65.

It’s always important to look at hereditary risk factors when talking about diseases. However, studies say that dementia is not a truly hereditary disease, meaning that you are not at a higher risk if one of your parents or grandparents has dementia (although there are some cases in which parents and children both have dementia). On the other hand, Alzheimer’s does have a hereditary component.

Other people can develop dementia in different ways, such as a stroke. Someone who has had a traumatic brain injury can develop dementia later in life due to the harm caused to the brain. Others can develop dementia from Parkinson’s, a disease where the damage of nerve cells can lead to the brain degrading. Some can get dementia from Huntington’s disease. Huntington’s disease is a highly genetic disorder that causes nerve cells to stop working, leading to areas of the brain losing their abilities to function.

Additionally, decades of substance abuse can cause someone to be at a higher risk of developing dementia later on in life.

Treatment for Dementia

Unfortunately, there is not yet a cure for dementia. Just like Alzheimer’s, cancer, and other well-known and incurable ailments, hundreds of thousands of dollars are spent researching new treatments that could cure dementia.

Despite there not being cures, some treatments for dementia can help alleviate the symptoms. Medication is one of these treatments. There are now some options of medications to take, depending on what symptoms or underlying diseases the person has. Since one of the most prominent symptoms of dementia is memory loss, these medicines focus on increasing chemical messengers in the brain that help with memory.

Occupational therapy is another option for treatment.

However, when dementia progresses to a certain point, occupational therapy will be useless and only medication will help the symptoms.

Preventing Dementia

While there is not one single cause of dementia, there are still recommendations for middle-aged people to help fight off potential dementia development. It is recommended to stay healthy and active – exercising regularly, maintaining a healthy diet, and not smoking to prevent those cases of dementia caused by a stroke. It’s also recommended to keep using your brain. This can be through social interactions, reading, puzzles, and word games.

While none of these methods can fully prevent someone from developing dementia, they can help fight it off so that the symptoms appear later in life.