Understanding Dimentia

As life expectancy increases, so, too, does the prevalence of dementia. Here, a look at the disorder, from symptoms to treatment.

For many patients—and the families who love them—a diagnosis of dementia can be devastating. A degenerative disease, the condition causes a progressive decline in cognitive function, including memory, attention span, and problem-solving skills. In some cases, dementia patients may suffer from hallucinations or severe disorientation, failing to remember what decade it is, where they are, or even their own names.
Dementia affects approximately 3.4 million Americans, or 13.9 percent of the U.S. population ages 71 and older. In these cases, dementia is generally caused by irreversible brain damage associated with Alzheimer’s disease, vascular dementia, Parkinson’s disease. (In more unusual cases, younger people can be affected by reversible or partially reversible dementia resulting from head injury, brain tumors, hydrocephalus, or infections.)

Dementia can be challenging for both patients and caregivers, but knowing what to expect can help ease the journey. Here, a look at the disease, from symptoms to treatment.

Dementia Symptoms
In later stages of dementia or after a patient has been diagnosed, the signs may seem fairly obvious, but early indicators of the disease can be harder to spot. In fact, families often attribute these initial symptoms to forgetfulness, depression, or simply old age. According to the NIH, early signs of dementia may include:
• asking the same questions repeatedly;
• becoming lost in familiar places;
• being unable to follow directions;
• becoming disoriented regarding time, people, or places; or
• neglecting personal safety, hygiene, or nutrition.

Experts note that those struggling with the disease may have difficulty recalling appointments they’ve made, thinking of the right words to express themselves, or remembering simple steps in everyday activities (such as turning the stove off after cooking).

What’s more, judgment may be impaired (for example, dementia sufferers may bundle up in heavy winter clothes on a hot summer’s day). Other signs to watch out for include sudden mood swings, personality changes, and a loss of initiative.

Diagnosing Dementia
Regardless how much research you do, you must consult with a health-care professional to obtain an accurate diagnosis. This is often a difficult step for patients and families to take, but the sooner dementia is diagnosed, the sooner treatment can begin.

Diagnosing Dementia
Regardless how much research you do, you must consult with a health-care professional to obtain an accurate diagnosis. This is often a difficult step for patients and families to take, but the sooner dementia is diagnosed, the sooner treatment can begin.

Diagnosis of dementia requires a complete medical and neuropsychological evaluation. The full exam allows the doctor to determine whether the patient has dementia and, if so, its severity and causes. From there, the physician can make treatment recommendations and assist the patient and caregivers in planning for the future.

The evaluation may comprise several parts, including a full medical history, a neurological exam, laboratory tests, brain imaging, and mental status testing. Doctors often use a test known as the Mini-Mental State Examination (MMSE) to assess cognitive skills. A variety of other tests may be used to identify specific types of cognitive problems and abilities.

Dementia vs. Alzheimer’s Disease

For about 70 percent of patients, a diagnosis of dementia will be accompanied by a diagnosis of Alzheimer's disease (AD). Although these terms are often used interchangeably, it’s important to note that Alzheimer’s and dementia are not one in the same. Dementia is a loss of brain function that refers to a group of illnesses. Although it may be a symptom of Alzheimer’s, it may have other underlying causes, such as Pick's disease, hypothyroidism, or head trauma.

While Alzheimer’s is the leading cause of dementia, vascular dementia, which is often caused by stroke, accounts for about 17 percent of all dementia cases. With increasing age, however, Alzheimer's disease accounts for a progressively greater percentage of dementia cases (among patients 90 and older, Alzheimer’s is indicated in approximately 80 percent of dementia cases, compared with roughly 50 percent for those in their 70s).

Dementia Treatment
Currently, there is no cure for dementia, so the goals of treatment are to control the disease’s symptoms, manage coexisting disorders, and maintain quality of life for as long as possible.There are several medical treatments that focus on maximizing cognitive and functional abilities. The treatments your doctor recommends will depend on the cause of the dementia.

For patients with Alzheimer’s disease, medications known as cholinesterase inhibitors may slow the rate of decline and improve memory function. Other, newer medications are designed to prevent the buildup of chemicals thought to contribute to memory loss. For vascular dementia, doctors generally focus on controlling risk factors such as hypertension and high cholesterol.

In addition, there are treatments designed to manage symptoms associated with dementia, such as sleep disorders, movement problems, depression, irritability, or agitation. Although these drugs cannot reverse existing brain damage, they may improve an individual’s quality of life and ease the burden on caregivers.