10/Nov/2009
Aging and Memory Loss: Demystifying Dementia
By: John A. Stassi II, CommCare Corporation, President & CEO
As we age, memory loss is a
topic of conversation that comes up at the doctor’s office, dinner table, and with
friends and family.
While memory loss affects
many, there are definite differences between forgetting where the car was
parked or what you ate for dinner last night and forgetting your name, your
child or spouse altogether. Understanding dementia, the various types and
symptoms can help alleviate fear.
According to The Mayo
Clinic, dementia is a loss of brain function that occurs with certain diseases
that affect intellectual and social abilities. Dementia is not a specific
disease. While most individuals associate memory loss with dementia, memory
loss is usually coupled with impaired judgment, language, a feeling of
confusion and an inability to remember people and names, as well as changes in
personality and social behavior.
Alzheimer’s or Dementia?
Many people do not
understand the difference between dementia and Alzheimer’s disease. These are
not two different diseases; instead, Alzheimer’s is a type of dementia – the
most widely discussed type of dementia.
The type of dementia depends
on the part of the brain that is affected. Some dementias can be treated and
reversed including those that are a result of infections and immune disorders;
metabolic problems or endocrine abnormalities; nutritional deficiencies;
reactions to medications; subdural hematomas; poisoning; brain tumors, anoxia;
and heart and lung problems.
Other types of dementia that
get worse over time (known as
progressive dementias) include
Alzheimer’s
disease (that is caused by the destruction of brain cells);
Lewy body dementia
(abnormal clumps of protein in the brain);
vascular dementia (the
result of damage to your brain caused by problems with the arteries serving
your brain or heart); and
frontotemporal dementia (the degeneration of
nerve cells in the frontal and temporal lobes of the brain which are the areas
generally associated with personality, behavior and language).
There are other disorders
that are linked to dementia including:
Huntington’s disease (inherited
disease that causes certain nerve cells in your brain and spinal cord to waste
away);
dementia pugilistica (also known as chronic traumatic
encephalopathy, caused by repetitive head trauma as experienced by boxers);
HIV-associated
dementia;
Creutzfeldt-Jakob disease (rare, fatal brain disorder that
occurs sporadically); and s
econdary dementias (people with other
disorders such as Parkinson’s disease may develop a secondary dementia that
affects movement).
There are several factors
that can lead to dementia which include age, family history, alcohol use,
atherosclerosis (a form of arteriosclerosis characterized by the deposition of
atheromatous plaques containing cholesterol and lipids on the innermost layers
of medium and large arteries), blood pressure, cholesterol, diabetes,
depression, high estrogen levels, elevated homocysteine blood levels, and
smoking.
Symptoms and Treatment
Symptoms
of dementia depend on the individual and the cause of dementia. While many
individuals with dementia experience similar symptoms such as the loss of
short-term memory, others may not experience the same symptoms or be on the
same path. Some experience symptoms of dementia more rapidly and others
experience progressive symptoms.
Early signs
of dementia include difficulty finding the right
word; forgetting names and appointments; misplacing/losing things; difficulty
performing daily tasks such as cooking and driving; noticeable changes in
personality; mood swings; feelings of paranoia and suspiciousness; and
confusion/disorientation in unfamiliar settings.
Intermediate signs
of dementia may include the worsening of the early
signs of dementia; the inability to perform activities such as bathing,
dressing, toileting; disruptive sleep patterns; the inability to learn new
information; disorientation and confusion in familiar and unfamiliar settings;
falls and accidents; increased behavior disorders; hallucinations; poor
concentration; and feelings of anxiety and depression.
Finally,
severe signs
of dementia can be detected with the worsening of symptoms seen in the early
and intermediate stages; complete dependence on others for activities of daily
living; the inability to get from one location to another; impairments of
movements such as swallowing; loss of both short and long-term memory; and
other complications such as dehydration, malnutrition, bladder control;
infections and seizures. Of course at this stage of dementia, the affected
individual will not be aware of these problems.
What’s Next?
If a person experiences
symptoms of dementia, an appointment with the primary care physician should be
scheduled immediately. In some cases, an appointment with a neurologist should
also be sought. The diagnosis requires several tests and visits to the doctor,
including a review of the individual’s medical history; a physical examination;
cognitive and neuropsychological tests; a neurological evaluation; brain scans
(including CT and MRI scans and an Electroencephalogram (EEG)); laboratory
tests; and psychiatric evaluation.
