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Dementia: causes, symptoms and treatments



Overview

Dementia is not a specific disease. Instead, dementia describes a group of symptoms that severely affect memory, thinking, and social skills to interfere with daily functioning.

Although dementia is generally associated with memory loss, memory loss has different causes. Loss of memory alone does not mean that you have dementia.

Alzheimer's disease is the leading cause of progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms can be reversed.

Symptoms

The symptoms of dementia vary according to the cause. The most common signs and symptoms include:

Cognitive changes

  • Memory loss usually noticed by spouse or someone else
  • Difficulty communicating or finding words
  • Difficulty or problem solving
  • Difficulty in complex Tasks
  • Difficulty in planning and organizing
  • Difficulty in coordination and motor functions
  • Confusion and disorientation

Psychological changes

  • Personality changes
  • Depression
  • Anxiety
  • Inappropriate behavior
  • Paranoia
  • Agitation
  • Hallucinations

Doctor if you or a relative has memory problems or other dementia symptoms. Some treatable diseases can cause dementia symptoms, so it is important to determine the underlying cause.

Causes

Dementia involves damage to nerve cells in the brain that can occur in different areas of the brain. Dementia affects people differently, depending on the affected area of ​​the brain.

Dementia groups are often grouped according to what they have in common, for example, to the affected part of the brain or after worsening over time (progressive dementia). Some dementias, z. Due to a reaction to medication or vitamin deficiency, may improve with treatment.

Progressive Dementia

Dementia types that progress and are not reversible include:

  • Alzheimer's disease. Alzheimer's disease is the leading cause of dementia in people over the age of 65 years.

    Although the cause of Alzheimer's disease is unknown, plaques and involvements are often found in the brains of Alzheimer's patients. Plaques are clumps of a protein called beta-amyloid, and tangles are tau-protein fibrous tangles.

    Certain genetic factors could cause people to develop Alzheimer's.

  • Vascular dementia. That Second The most common form of dementia is the result of damage to the vessels that supply your brain with blood. Blood vessel problems can be caused by stroke or other blood vessel conditions.

  • Lewy body dementia. Lewy bodies are abnormal protein clots that have been found in the brain of people with Lewy body dementia, Alzheimer's disease and Parkinson's disease. This is one of the most common types of progressive dementia.

  • Frontotemporal dementia. This is a group of diseases characterized by the degeneration of nerve cells in the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior and language.

    As with other dementias, the cause is unknown.

  • Mixed dementia. Autopsy studies of the brains of people over 80 who suffer from dementia indicate that many had a combination of Alzheimer's disease, vascular dementia and Lewy body dementia. Studies are currently underway to determine how mixed dementia affects symptoms and treatments.

Other diseases related to dementia

  • Huntington's disease. Caused by a genetic mutation, this disease causes certain nerve cells in your brain and spinal cord wasting. Signs and symptoms, including a sharp decline in thinking (cognitive abilities), usually occur at the age of 30 or 40 years.

  • Traumatic brain injury. This disease is caused by repetitive cranial trauma, such as boxers, football players, or soldiers.

    Depending on the injured part of the brain, this condition can cause dementia signs and symptoms such as depression, explosiveness, memory loss, uncoordinated movement and impaired speech, as well as slow movements, tremors and rigidity (Parkinsonism). Symptoms may not occur until years after the trauma.

  • Creutzfeldt-Jakob disease. This rare brain disease usually occurs in people without known risk factors. This condition could be due to an abnormal form of a protein. Creutzfeldt-Jakob disease can be inherited or caused by the action of diseased brain or nervous system tissue.

    Signs and symptoms of this fatal disease usually occur at the age of 60 years.

  • Parkinson's disease. Many people with Parkinson's disease eventually develop dementia symptoms (Parkinson's dementia).

Dementia-like conditions that can be reversed

Some causes of dementia or dementia-like symptoms can be reversed with the treatment. These include:

  • Infections and diseases of the immune system. Dementia-like symptoms can be caused by fever or other side effects of the body's attempt to fight off an infection. Conditions such as multiple sclerosis, which are caused by the body's own defense system of nerve cells, can also lead to dementia.
  • Metabolic problems and endocrine abnormalities. People with thyroid problems, low blood sugar (hypoglycemia), too little or too much sodium or calcium, or a reduced ability to absorb vitamin B-12 may develop dementia-like symptoms or other personality changes.
  • malnutrition. Not enough liquid drunk (dehydration); do not get enough thiamine (vitamin B-1), which is common in people with chronic alcoholism; and getting too little vitamins B-6 and B-12 in your diet can cause dementia-like symptoms.
  • Reactions to drugs. A reaction to a drug or an interaction of several drugs can cause dementia-like symptoms. Subdural hematomas. Bleeding between the surface of the brain and the meninges, which is common in the elderly after a fall, can cause dementia-like symptoms.
  • Poisoning Heavy metals like lead and other poisons like pesticides as well as alcohol abuse or drug use can lead to dementia. Symptoms can improve with the treatment.
  • brain tumors. In rare cases, dementia may be due to damage caused by a brain tumor.
  • anoxia. This disease, also called hypoxia, occurs when organ tissues are absent enough to get oxygen. Anoxia can be due to severe asthma, heart attack, carbon monoxide poisoning or other causes.
  • Hydrocephalus with normal pressure. This condition, which is caused by enlarged ventricles in the brain, can lead to walking problems, urinary problems, and memory loss.

Risk Factors

Many factors can ultimately lead to dementia. Some factors, such as age, can not be changed. Others can be addressed to reduce your risk.

Risk factors that can not be changed

  • Age. The risk increases with age, especially after the age of 65. Dementia, however, is not a normal component. Aging and dementia can occur in younger people.
  • family history. Based on a family history of dementia, there is a greater risk of disease development. However, many people with a family history never develop symptoms and many people without a family history. Tests to determine if you have certain genetic mutations are available.
  • Down syndrome. From middle age, many people with Down syndrome develop early onset Alzheimer's disease.
  • Slight cognitive impairment. This is associated with difficulty with memory but without loss of daily function. This increases the risk of dementia in humans.

Risk Factors That You Can Change

You may be able to control the following risk factors for dementia.

  • Heavy alcohol consumption. If you drink large quantities of alcohol, you may have a higher risk of dementia. However, some studies have shown that moderate amounts of alcohol can have a protective effect.
  • Cardiovascular risk factors. These include high blood pressure (high blood pressure), high cholesterol, buildup of fats in the arterial walls (atherosclerosis). and obesity.
  • depression. Although depression may not be well understood in later life, this may indicate the development of dementia.
  • diabetes. If you have diabetes, you may be at an increased risk of dementia, especially if poorly controlled.
  • smoking. Smoking may increase the risk of suffering from dementia and vascular disease (vascular disease).
  • sleep apnea. People who snore frequently and have episodes of stopping breathing while they sleep may experience a reversible memory loss.

Complications

Dementia can affect many body systems and therefore impair functioning. Dementia can lead to the following diseases:

  • Insufficient nutrition. Many people with dementia reduce or stop the supply of nutrients. Eventually, they may not be able to chew and swallow.
  • pneumonia. Dysphagia increases the risk of choking or sucking food into the lungs, which blocks breathing and can cause pneumonia.
  • Inability to self-sufficiency tasks. With progressive dementia, bathing, dressing, hair or teeth can be cleaned, the toilet can be used independently and medication can be taken precisely.
  • Personal security challenges. Some everyday situations can occur, including safety issues for people with dementia, including driving, cooking and walking alone.
  • Death Late-stage dementia leads to coma and death, often through infection.

Diagnosis

Diagnosis of dementia and finding what type is it a challenge. Dementia diagnosis requires that at least two core mental health functions be so severely impaired that they interfere with everyday life. It involves memory, language skills, concentration and attention, rationalization and problem-solving skills, and visual perception.

Your doctor will examine your medical history and symptoms and perform a physical examination. He or she will probably also ask someone near you about your symptoms.

Not a single test can diagnose dementia, so doctors are likely to conduct a series of tests to pinpoint the problem.

Cognitive and neuropsychological tests

Doctors rate their thinking (cognitive) function. In a series of tests, thinking skills such as memory, orientation, reasoning and judgment, language skills and attention are measured.

Neurological Assessment

Doctors rate your memory, language, visual perception, attention, problem solving, movement and senses, balance, reflexes, and other areas.

Brain scans

  • CT or MRI. These scans may be for signs of stroke or bleeding or tumor or hydrocephalus.
  • PET scans. These scans show patterns of brain activity and when the amyloid protein, a hallmark of Alzheimer's disease, is deposited in the brain.

Laboratory Tests

Simple blood tests can identify physical problems that can affect brain function, such as vitamin B deficiency or hypothyroidism. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative diseases.

Psychiatric Assessment

A psychiatrist can determine if depression or any other mental condition is contributing to your symptoms.

Treatment

19659129] Most types of dementia can not be cured, but there are ways in which you can deal with your symptoms.

Medication

In the following, symptoms of dementia are temporarily improved.

  • Cholinesterase inhibitors. These drugs – including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) – work by increasing the concentration of a chemical messenger involved in memory and judgment.

    Although these drugs are primarily used to treat Alzheimer's disease, they may also be prescribed for other dementias, including vascular dementia, Parkinson's dementia, and Lewy body dementia.

    Side effects may include nausea, vomiting and diarrhea. [19659136] Memantine. Memantine (Namenda) regulates the activity of glutamate, another chemical messenger involved in brain functions such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.

    A common side effect of memantine is dizziness.

  • Other medicines. Your doctor may prescribe medication to treat other symptoms or conditions such as depression or sleep disorders or arousal.

Therapies

Several dementia symptoms and behavioral problems could initially be treated with non-drug approaches, such as:

  • Occupational Therapy. An occupational therapist can show you how to make your home safer, how to handle coping skills. The purpose is to prevent accidents such as falls; Manage behavior; and prepare for the progression of dementia.
  • Changing the environment. Reducing noise and noise can make it easier for someone with dementia to focus and function. You may need to hide collateral objects such as knives and car keys. Surveillance systems can warn you if the person walks with dementia.
  • Modify tasks. Divide tasks into simpler steps and focus on success, not failure. Structure and routine also help to reduce the confusion in patients with dementia.

Alternative medicine

Various dietary supplements, herbal remedies and therapies have been studied for people with dementia. Some may be beneficial.

Be careful if you are considering taking any supplements, vitamins, or herbal remedies, especially if you are taking other medicines. These funds are unregulated, and claims about their benefits are not always based on scientific research.

Some alternative medicines for Alzheimer's and other forms of dementia that have been studied include:

  • Vitamin E. Evidence for the intake of vitamin E to slow Alzheimer's disease is mild. Doctors warn against taking vitamin E because they may be at increased risk of dying, especially in people with heart disease.

  • Omega-3 fatty acids. There is evidence that fish is eaten thrice a week, lowering the risk of dementia.

    However, omega-3 fatty acids have not significantly slowed cognitive decline in mild-to-moderate Alzheimer's disease in clinical trials. Further research is needed.

  • Ginkgo. Although ginkgo is considered safe, the study findings were inconsistent in determining whether ginkgo aids people with dementia .

Other therapies

The following techniques can help reduce agitation and promote relaxation in people with dementia.

  • Music Therapy in which soothing music is heard
  • In home therapy, animals, eg. B. Visits of dogs to improve moods and behaviors in patients with dementia
  • Used aromatherapy that uses fragrant vegetable oils
  • Massage therapy
  • Art therapy in which art is created that focuses on the process and not on the Concentrated Score

Preparation for an Appointment

Most likely, you will first see your primary skin care provider if you have concerns about dementia. Or you will be referred to a doctor who is trained in nervous system disorders (neurologist).

Here is some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if something needs to be done beforehand, such as a fast before certain tests. Make a list of:

  • Symptoms, including those that may not be related to the reason from which you set the appointment
  • Important Personal Information, including any serious stress or recent living conditions and family history
  • All medications, Vitamins or supplements taken, including doses
  • Questions to the doctor

Even in the early stages of dementia, it is good to have a family member or friend with you or as a caregiver so that you can remember the information you have received.

In dementia, you can ask the following basic questions to the doctor:

  • What is probably responsible for my symptoms?
  • Are there other possible causes for my symptoms?
  • Which tests are required?
  • Is the condition temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the proposed primary approach?
  • How can dementia and dementia be? other health problems are solved Gether?
  • Are there brochures or other printed material I can have? Which websites do you recommend?

Do not hesitate to ask other questions.

What you can expect from your doctor

The doctor will probably ask questions such as:

  • When did your symptoms begin?
  • Were the symptoms continuous or uncommon?
  • How serious are the symptoms?
  • What, if anything, seems to improve the symptoms
  • What, if anything, seems to exacerbate the symptoms?
  • How did the symptoms worsen? Symptoms that affected your life?

Lifestyle and home remedies

Dementia symptoms and behavioral problems will progress with time. The caregivers might try the following suggestions:

  • Improving communication. If you talk to your loved one, keep eye contact. Say slowly in simple sentences and do not rush the answer. Present each idea or instruction. Use gestures and hints, eg. B. pointing to objects.

  • Promote exercise. Exercise affects all people, including people with dementia. The main benefits of exercise include improved strength and cardiovascular health. There is increasing evidence that exercise also protects the brain from dementia, especially when combined with a healthy diet and treatment of risk factors for cardiovascular disease.

    Some research also shows that physical activity can slow the progression of thought disorder in people with Alzheimer's disease. And it can reduce the symptoms of depression.

  • Promote activity. Plan activities that a person with dementia enjoys and can do. Dancing, painting, gardening, cooking, singing, and others can be fun, can help you connect with your loved one, and help your loved one focus on what he can do.

  • Schedule a nocturnal ritual. 19659209] Behavior is often worse at night. Try to establish bedtime rituals that are calming and far from the noise of television, cleaning meals and active family members. Turn on the night lights in the bedroom, hallway, and bathroom to prevent disorientation.

    Restricting caffeine, taking a nap, and providing opportunities for exercise throughout the day can make nighttime restlessness easier.

  • Encourage a calendar. Help your loved one remember upcoming events, daily activities, and drug schedules. Consider sharing a calendar with your loved one.

  • Plan for the future. Develop a plan with your loved one while he or she can participate and set goals for future care. Self-help groups, legal counselors, family members, and others may be able to help.

    You must consider financial and legal issues, safety and everyday worries, and opportunities for long-term care.

Coping and Support [19659217] Diagnosing dementia can be devastating. There are many details to consider to ensure that you and the people around you are as well prepared as possible to deal with an unpredictable and progressive condition.

Caring for and Supporting the Person with the Disease

Here are some suggestions you can do. Try to find your way around the disease:

  • Learn as much as you can about memory loss, dementia, and Alzheimer's disease.
  • Write in a journal about your feelings.
  • Join a local support group. [19659223] Get advice from a single or family consultation.
  • Talk to a member of your spiritual community or other person who can help you with your spiritual needs.
  • Stay active and involved, volunteer, exercise and participate in activities for people with memory loss.
  • Spend time with friends and family.
  • Join an online community of people with similar experiences.
  • Find new ways to express yourself B. by painting, singing or writing. [19659229] Delegate help in making decisions to a person you trust.

Help with dementia

You can help a person deal with the disease by listening and assuring the person that they can still enjoy life, be supportive and positive, and do their best to the person to help preserve their dignity and self-esteem.

Support of the caregivers

The care of dementia patients is physically and emotionally exhausting. Feelings of anger and guilt, frustration and discouragement, sorrow, grief and social isolation are commonplace. If you are a dementia caregiver:

  • Learn as much as possible about the disease and take part in caring classes.
  • Find out about supportive services in your community, z can take a break from caregiving at certain times during the week
  • Ask friends or other family members for help
  • Take care of your physical, emotional, and spiritual Health
  • Ask questions from doctors, social workers and other stakeholders in the care of their relatives
  • Join a support group

Prevention

There is no sure way to prevent dementia, but there are steps that You can take that could help. More research is needed, but it may be useful to do the following:

  • Keep your mind active. Mentally stimulating activities such as reading, solving puzzles and playing puns and memory training can delay the onset of dementia and lessen its impact.

  • Be physically and socially active. Physical activity and social interaction can delay the onset of dementia and reduce symptoms. Move more and aim for 150 minutes of exercise a week.

  • smoking cessation. Several studies have shown that smoking in middle age and beyond can increase the risk of dementia and blood vessel (vascular) conditions. If you stop smoking, you may reduce your risk and improve your health.

  • Obtain Enough Vitamin D. Studies have suggested that people with low blood vitamin D levels are more likely to develop Alzheimer's disease and other forms of dementia. You can get vitamin D through certain foods, supplements and sun exposure.

    To prevent dementia, another study is needed before vitamin D intake is increased. However, it is advisable to make sure you get enough vitamin D. [19659251] Lower your blood pressure. High blood pressure can lead to an increased risk of certain types of dementia. To determine if the treatment of high blood pressure can reduce the risk of dementia, further research is needed.

  • Maintain a healthy diet. Eating a healthy diet is important for many reasons, but a diet like the Mediterranean Diet – rich in fruits, vegetables, whole grains, and omega-3 fatty acids, which are common in certain fish and nuts, can promote good health and nutrition Lower dementia risk.

Updated: 2017-08-02

Release date: 2009 -04-17


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