Dementia

Seeing a loved one suffer from dementia is hard. Understanding how dementia works, what causes it, and how it is treated can help people manage its effects and give caretakers clues on how to support them.

What is dementia?

Dementia is a broad term for a range of conditions that negatively affect the brain with symptoms that can affect memory, attention span, overall cognition, and the ability to think and communicate (American Psychological Association, 2013). Dementia is most common in adults as they progress in age. While it is normal for older adults to have some lapses in memory, dementia is different because it can have severe effects on memory and cognition and advance in stages as a person ages.

What causes dementia?

There are some known causes or risk factors which may contribute to a person developing dementia. These include how old the person is. Most dementia is diagnosed in people age 65 and older. Other factors include existing family history of dementia, heart health (including smoking and high blood pressure or cholesterol levels), previous brain or traumatic injuries, and whether the person comes from specific racial or ethnic groups.

Symptoms of dementia

It can be helpful to note symptom frequency, length and intensity, and any other recognizable patterns. Symptoms can include:

  • Difficulty with memory or remembering things
  • Issues with attention or attention span
  • Problems with communicating clearly or forgetting words or phrases
  • Issues with judgment, problem solving, or other types of reason-based thinking and decision-making
  • Visual perception issues, like mistaking one person or object for another or experiencing hallucinations or other visual confusion
  • Challenges or changes in movement, walking, balance, and sleep

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What is dementia?

Dementia is a broad term for a range of conditions that negatively affect the brain with symptoms that can affect memory, attention span, overall cognition, and the ability to think and communicate (American Psychological Association, 2013). Dementia is most common in adults as they progress in age. While it is normal for older adults to have some lapses in memory, dementia is different because it can have severe effects on memory and cognition and advance in stages as a person ages.

What causes dementia?

There are some known causes or risk factors which may contribute to a person developing dementia. These include how old the person is. Most dementia is diagnosed in people age 65 and older. Other factors include existing family history of dementia, heart health (including smoking and high blood pressure or cholesterol levels), previous brain or traumatic injuries, and whether the person comes from specific racial or ethnic groups.

Symptoms of dementia

It can be helpful to note symptom frequency, length and intensity, and any other recognizable patterns. Symptoms can include:

  • Difficulty with memory or remembering things
  • Issues with attention or attention span
  • Problems with communicating clearly or forgetting words or phrases
  • Issues with judgment, problem solving, or other types of reason-based thinking and decision-making
  • Visual perception issues, like mistaking one person or object for another or experiencing hallucinations or other visual confusion
  • Challenges or changes in movement, walking, balance, and sleep

Types of dementia

Dementia can encompass many different conditions and diagnoses. Some of the more common types of dementia include:

Alzheimer’s disease

Alzheimer’s disease is the most common type of dementia. It is caused by changes within certain parts of the brain. Those with Alzheimer’s may have problems remembering recent events or issues with movement, walking, or communicating. They may experience noticeable shifts or changes in their personality. As Alzheimer’s disease progresses, people may have problems remembering events or things from the more distant past (Lane et al, 2017).

Vascular dementia

Vascular dementia is linked to strokes. Small bleeds in the brain and other health issues can negatively impact the flow of blood to a person’s brain. People with vascular dementia may experience challenges with cognition. There will likely be a noticeable link between the time of a stroke or health issue and the onset of vascular dementia symptoms. Since it is a type of stage-by-stage dementia, symptoms may increase or worsen with additional strokes or other health events (Romãin, 2003).

Lewy body dementia

People with Lewy body dementia may experience some of the same memory-related challenges common to other types of dementia. They may have trouble with balance, physical coordination, movement, and cognitive issues, such as confusion, sleep issues (feeling sleepy during the day and alert at night), and visual hallucinations. Studies have shown that certain Parkinson’s disease treatments can be effective for some Lewy body dementia symptoms. Research into treatment is ongoing (Taylor et al, 2020).

Frontotemporal dementia

Frontotemporal dementia will often result in symptoms related to noticeable changes in behavioral, cognitive issues, and motor skills (Tsai et al, 2014). People with frontotemporal dementia may exhibit changes in personality, say inappropriate or potentially offensive things in unexpected situations, and be either overactive (pacing and wandering) or listless (passive or inert in their physical movements). People with a family history for the disease may be more likely to develop this type of dementia (Snowden et al, 2002).

Mixed dementia

Mixed dementia is when a person experiences more than one type of dementia at the same time. In these cases, people are likely to be older (over age 80) with overlapping symptoms.

Dementia and other conditions

Potential contributing factors to dementia include Parkinson’s disease, heart- and blood-related conditions (like congestive heart failure and anemia), osteoporosis, thyroid disease, insomnia, and neuroses (Poblador-Plou et al, 2014). While these factors do not guarantee that a person will develop any type of dementia, they should be disclosed to a clinician.

 

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 
 
Lane, C. A., Hardy, J., & Schott, J. M. (2017). Alzheimer’s disease. European Journal of Neurology, 25(1), 59–70. https://doi.org/10.1111/ene.13439  
 
Romã¡n, G. C. (2003). Vascular dementia: Distinguishing characteristics, treatment, and prevention. Journal of the American Geriatrics Society, 51(5s2). https://doi.org/10.1046/j.1532-5415.5155.x  
 
Taylor, J.-P., McKeith, I. G., Burn, D. J., Boeve, B. F., Weintraub, D., Bamford, C., Allan, L. M., Thomas, A. J., & O’Brien, J. T. (2020). New evidence on the management of lewy body dementia. The Lancet Neurology, 19(2), 157–169. https://doi.org/10.1016/s1474-4422(19)30153-x  
 
Tsai, R.M., Boxer, A.L. Treatment of Frontotemporal Dementia. Curr Treat Options Neurol 16, 319 (2014). https://doi.org/10.1007/s11940-014-0319-0 
Snowden, J., Neary, D., & Mann, D. (2002). Frontotemporal dementia. British Journal of Psychiatry, 180(2), 140-143. doi:10.1192/bjp.180.2.140 
  
Poblador-Plou, B., Calderón-Larrañaga, A., Marta-Moreno, J. et al. Comorbidity of dementia: a cross-sectional study of primary care older patients. BMC Psychiatry 14, 84 (2014). https://doi.org/10.1186/1471-244X-14-84 

Spector, A., Gardner, C., & Orrell, M. (2011). The impact of cognitive stimulation therapy groups on people with dementia: Views from participants, their carers and group facilitators. Aging & Mental Health, 15(8), 945–949. https://doi.org/10.1080/13607863.2011.586622