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What is Dementia?

Dementia is the loss of cognitive function, or the ability to think clearly, such that it is difficult for individuals to work or function independently at home or in their community. The condition occurs when brain cells are damaged or die, leading to problems with memory, thinking, and behavior. Dementia is not just one disease; it includes conditions like Alzheimer’s disease, vascular dementia, Lewy body dementia and frontotemporal dementia. People with dementia have trouble remembering things, using language, focusing, and may have changes in mood.

In the U.S., around 6.7 million adults have dementia, and it’s expected to grow to 13.9 million by 2060. Dementia is more common in older people, affecting 3% to 11% of those over 65 and as much as 25% to 47% of people over 85.
 

What are common types?

Alzheimer’s Disease
Alzheimer’s disease is the most common type of dementia, and is caused by abnormal proteins called amyloid plaques and tau tangles building up in the brain, disrupting cell function and communication. Symptoms include memory loss, confusion, trouble with language, and difficulty performing daily tasks.
Vascular Dementia
Vascular dementia occurs when blood flow to the brain is reduced, often due to strokes or other blood-vessel related issues including chronic blockages in the small vessels of the brain. Symptoms can include problems with planning, judgment, memory, and sometimes sudden changes in thinking and behavior.
Lewy Body Dementia
Lewy Body dementia is characterized by abnormal protein deposits called Lewy bodies in the brain. Symptoms include changes in attention, alertness and reasoning, visual hallucinations, sleep behaviors, and movement problems similar to Parkinson’s disease.
Frontotemporal Dementia
Frontotemporal dementia affects the frontal and temporal lobes of the brain which are responsible for personality, behavior, and language skills. It often occurs at a younger age and can cause symptoms such as a lack of self-control, reduced motivation and interest in activities, loss of language and ability to communicate, or changes in motor function and movement.

Risk Factors

There are some risk factors for dementia that you can’t change and some that you can. The ones you can’t change include getting older and having certain genes, like the APOE ε4 gene. The ones you can change include things like how you live and certain health problems, such as high blood pressure, diabetes, smoking, not being active, eating poorly, and drinking too much alcohol. Other factors that may increase the risk are having little education, being isolated, depression, and losing your hearing.

What symptoms suggest Dementia?

Early symptoms of cognitive decline that may progress to dementia include memory loss, especially for recent events. Individuals may frequently forget conversations, appointments, or where they placed items. Other cognitive symptoms include difficulty finding words, problems with language, and trouble with planning and organizing tasks.

People with dementia may also experience confusion about time and place, such as getting lost in familiar locations or not knowing the date. Behavioral and psychological symptoms can include mood changes, such as increased irritability, depression, or anxiety. Additionally, individuals may show a loss of interest in activities they once enjoyed and may withdraw from social interactions. In more advanced stages, symptoms can include significant difficulties with daily activities, such as dressing, bathing, and eating, as well as more severe memory loss and disorientation.

How is dementia diagnosed?

To diagnose dementia, providers must first take a detailed medical history from the patient and/or a close family member or friend to understand the cognitive decline and its impact on daily activities. Next, they perform a physical examination and use brief cognitive screening tests like the Mini-Cog to identify cognitive impairment. If the initial screening suggests cognitive issues, additional assessments such as the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MMSE) are conducted.

Laboratory tests and brain imaging (like MRI or CT scans) are also performed to rule out other causes of cognitive decline, such as vitamin deficiencies or brain tumors. In some cases, especially if the diagnosis is unclear, neuropsychological evaluation may be used to provide a more detailed evaluation of cognitive functions. This comprehensive approach ensures an accurate diagnosis of dementia.

Who treats Dementia?

Dementia is treated by a team of healthcare providers that may include primary care physicians, neurologists, psychiatrists, psychologists, and geriatricians. Primary care physicians are usually the first to notice symptoms and can manage initial assessments and treatments. Neurologists specialize in brain disorders and can provide more detailed evaluations and advanced treatments. Psychiatrists and psychologists help the individual and their family manage behavioral and psychological symptoms, while geriatricians focus on the overall health and well-being of older adults with dementia. This collaborative approach ensures comprehensive care, addressing both medical and psychosocial aspects of the disease.

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