Dementia

Dementia is not a disease itself. The term refers to a group of symptoms caused by changes in brain function. (Read about "The Brain") A person with dementia may ask the same questions repeatedly, get lost in familiar places, become disoriented about time or people. He or she may neglect personal safety, hygiene and nutrition. Dementia makes it hard for a person to carry out normal daily activities.

According to the National Institute on Aging (NIA), as we get older, it takes us longer to remember things or to find the right word to say. This is NOT dementia. The term for dementia used to be senility and it was once thought that becoming senile was just part of getting old. NIA says although dementia is more common in old age, it is not "normal" and should be evaluated. Aging alone should not interfere with our ability to function.

Causes

Dementia is caused by many conditions that affect the brain. Some causes of dementia are reversible and can be cured completely or partially with treatment. Treatable conditions that may cause dementia include:

• a high fever
• dehydration (Read about "Dehydration")
• vitamin deficiency and poor nutrition (Read about "Vitamins & Minerals" "Nutrition and Getting Older")
• drug reactions (Read about "Drug Interaction Precautions")
• emotional problems brought on by such things as forced retirement or the loss of a spouse (Read about "Depression and Seniors" "Coping With Tragedy" "Helping The Bereaved")
• thyroid gland problems(Read about "Thyroid")
• a minor head injury (Read about "Head Injury")
• cerebrovascular disorders (Read about "Stroke" "Vascular Lesions of the Central Nervous System")

Irreversible dementia is caused by an incurable condition, especially in older people. NIA lists several causes including:

• Alzheimer's disease (AD) - In AD, nerve cells in the brain die. Symptoms begin slowly with memory problems and become steadily worse. Over time, the brain damage in AD leads to serious problems in thinking, judgment and the ability to carry out daily activities. (Read about "Alzheimer's Disease")
• Dementia with Lewy bodies - The National Institute of Neurological Disorders and Stroke (NINDS) lists this type of dementia as the second most common cause of dementia in older adults. Lewy bodies are abnormal structures found in certain areas of the brain. It is not yet clear whether dementia with Lewy bodies is a separate illness or perhaps a variant of AD or Parkinson's disease. (Read about "Parkinson's Disease")
• Multi-Infarct Dementia (Vascular Dementia) - In MID, small strokes and blood clots in the brain's blood vessels cause the death of brain tissue. (Read about "Stroke") Symptoms that begin suddenly may be a sign of this kind of dementia. Symptoms may include confusion, memory problems and loss of bladder or bowel control. (Read about "Incontinence" "Fecal Incontinence") NINDS lists probable risk factors as high blood pressure (Read about "Hypertension: High Blood Pressure") and advanced age.
• Binswanger Disease (Subcortical Dementia) - According to the NINDS, this as a rare form of dementia caused by lesions in the deep white matter of the brain. Symptoms may include memory loss, difficulty with speech, clumsiness and slowness of conduct. The disorder may also be marked by strokes (Read about "Stroke") and partial recovery.

Other less common causes of dementia include Huntington's disease, Parkinson's disease, Pick's disease and AIDS. (Read about "Huntington's Disease" and "HIV / AIDS")

Diagnosis

First of all, it is very important not to jump to conclusions. Confusion or forgetfulness does not mean someone has dementia. If you are worried, see your doctor. NIA lists several ways doctors can diagnose dementia. These include a complete medical history as well as physical exams and tests. A medical history involves questions about the use of prescription and over-the-counter medicines, diet, past medical problems and general health. A doctor may also ask a family member for information about the person as well. Tests of blood and urine (Read about "The Urinary System") may also be done to look for problems and there may be tests of mental abilities such as memory, problem solving, counting and language. A brain CT (computerized tomography) scan or a MRI (magnetic resonance imaging) could also be used to help doctors make a diagnosis. (Read about "CT Scan - Computerized Tomography" "MRI - Magnetic Resonance Imaging")

Treatment

Irreversible dementia is caused by permanent brain damage and can't be cured. Still, there is much that can be done to treat the individual and help the family cope. A person with dementia should be under a doctor's care. NIA lists several possible treatments that can relieve symptoms and improve quality of life. These include:

• Drugs that may delay the worsening of some symptoms for people in the early and middle stages of Alzheimer's disease.
• For those with MID, it is important to prevent further strokes by reducing risk factors like high blood pressure, high blood cholesterol, diabetes and smoking. (Read about "Hypertension: High Blood Pressure" "Cholesterol" "Diabetes" and "Quit Smoking")
• Medicines can be used to help control behavioral symptoms of dementia such as sleeplessness, agitation, wandering, anxiety (Read about "Anxiety") and depression.
• Non-drug treatments include a healthy diet, exercise, social activities and a safe environment.

Eventually, dementia may progress to a point where 24-hour care is needed and many sufferers will need to live in a healthcare environment.

Coping

Family members and caregivers can help those with dementia cope with their condition. (Read about "Alzheimer's and the Caregiver") NIA has these suggestions:

• Make sure people with dementia are informed about the details of their lives such as time of day, where they live and what is happening at home and in the world.
• Memory aids such as a calendar, a list of daily plans, safety instructions and written directions on how to use household items can be useful.

Looking after someone with dementia can be emotionally and physically exhausting. Here are some helpful suggestions:

• Talk to someone about how you feel and what you can do. Ask for information, help and advice.
• Share your feelings with other members of the family or friends.
• Keep the doctor informed about any changes.
• Find out what services are available. Try to get as much help as you can.
• Find out about benefits and claim them.
• Talk to other people with dementia or families and caregivers who are facing similar problems.

Try to make life as full and enjoyable as possible. Both people with dementia and caregivers should stay involved in activities that stimulate the mind and body.

Related Information:

    Planning for Long-Term Care