Dementia

Overview

Dementia is a condition characterized by a collection of symptoms that hinder daily life and activities. It affects various aspects of mental function, including memory, thinking, reasoning, personality, mood, and behavior.

Three categories of dementia include.

• Primary: conditions and illnesses where dementia is the main condition
• Secondary: dementia brought on by another condition or illness
• Reversible: symptoms of dementia that are reversible and brought on by other illnesses or factors.

A person’s memory may also vary as they age since certain brain neurons naturally die when people become older. However, this kind of memory loss does not affect daily living. Even though memory loss is a common symptom of dementia, it might have various underlying causes, and memory loss does not necessarily confirm the diagnosis of dementia.

Dementia can develop when diseases or infections interfere with the areas of the brain responsible for learning, remembering, making decisions, or language. Although there are several additional causes of dementia, Alzheimer’s disease is the most frequent one in the elderly. Some dementia symptoms could be reversible, depending on the underlying reason.

Symptoms

Common signs and symptoms of dementia can vary depending on the specific areas of the brain that are affected. As a result, each individual with dementia may present a distinct combination of symptoms. Certain types of dementia may also include additional or atypical symptoms.

The signs and symptoms of dementia can vary depending on the root cause, but they often include:

• Early signs and symptoms:
  • Forgetting current events or knowledge.
  • Reiterating comments or questions rapidly within a brief period.
  • Putting things that are frequently utilized in unusual places or misplacing them.
  • Not knowing the time of year, month, or season.
  • Having trouble finding the appropriate words.
  • Noticing a shift in behavior, mood, or interests.
• Late signs and symptoms or signs that dementia has worsen
  • Memory and decision-making continues to deteriorate.
  • Difficult to find the correct words to say or speak.
  • Simple daily task like brushing the teeth, brewing coffee, using the TV remote, cooking, and paying payments become more difficult.
  • Capacity for reasonable behavior, thought, and problem-solving keeps declining.
  • Alterations in sleeping habits.
  • Anxiety, frustration, confusion, agitation, suspicion, sadness, and/or depression worsen or increase.
  • Requiring greater assistance with daily tasks like eating, bathing, dressing, and using the restroom.
  • Having hallucinations, or seeing things or persons that are not there.

If an individual experiences memory problems or other symptoms associated with dementia, it is important for them to seek medical attention from a healthcare provider. Identifying the underlying cause is crucial because there are several treatable medical conditions that can manifest as dementia symptoms.

Causes

Dementia is caused by damage to or loss of nerve cells and connections in the brain. The effects of dementia can differ significantly among individuals, resulting in distinct symptoms depending on which specific part of the brain is affected. Another cause of dementia is obstructed blood flow to the brain, which deprives it of oxygen and nutrients. Brain tissue dies without nourishment and oxygen.

Dementias are frequently categorized according to what they have in common, such as the protein or proteins deposited in the brain or the area of the brain affected. Some illnesses that resemble dementia, particularly those brought on by drug interactions, vitamins or minerals deficiencies may get better with treatment.

• Progressive dementias: The following dementias are progressive and irreversible:
  • Alzheimer’s disease: The most common reason for dementia. Despite the fact that not all causes of Alzheimer’s disease are understood, specialists are aware of a small fraction that is connected to mutations in three genes that can be handed down from parent to children. Apolipoprotein E4 (APOE) is a significant gene that raises risk even though many genes are likely involved in Alzheimer’s disease.

Patients with Alzheimer’s disease have tangles and plaques in their brains. Beta-amyloid protein forms aggregates known as plaques, and tau protein forms fibrous masses known as tangles. These aggregates are believed to harm both healthy neurons and the fibers that link them.

• • Vascular dementia: The second most common type of dementia. It is brought on by illnesses including atherosclerosis and strokes, which clog and harm the blood arteries in the brain. Damage to the blood vessels that feed the brain is what causes this particular type of dementia.

Difficulties with problem-solving, sluggish thinking, and lack of focus and organization are some of the most typical symptoms of vascular dementia. These are typically more obvious than memory loss.

Following a stroke, the decline may come on suddenly, or it may happen gradually after several mini strokes. High blood pressure, diabetes, and elevated cholesterol levels are risk factors.

• • Lewy body dementia: People with Lewy body dementia, Alzheimer’s disease, and Parkinson’s disease have abnormal protein clumps called Lewy bodies in their brains.

Common warning signs and symptoms include acting out dreams while sleeping, seeing things that are not there (visual hallucinations), delusions, and difficulty focusing and paying attention. Tremors, stiffness, and sluggish or uncoordinated movement (parkinsonism) are further symptoms.

• • Frontotemporal dementia: The frontal and temporal lobes of the brain’s nerve cells and their connections break down in a variety of disorders. These are the areas that are typically linked to language, behavior, and personality. Common symptoms have an impact on speech and movement as well as behavior, personality, thinking, and judgment.

Early dementia is frequently brought on by FTD, which frequently affects persons between the ages of 45 and 64. FTD accounts for 5% to 6% of all dementias.

• • Mixed dementia: Autopsies conducted on adults aged 80 and older have revealed that causes of dementia can include Alzheimer’s disease, vascular dementia, Lewy body dementia, and other factors. The impact of mixed dementia on symptoms and treatment approaches is an area that continues to be studied and researched.

Because many symptoms of each form of dementia overlap or because some symptoms of one dementia are more visible than others, diagnosing dementia can be challenging. Compared to individuals who only have one type, those with mixed dementia see a faster deterioration.

• Other disorders linked to dementia:
  • Huntington’s disease: This disease, which is brought on by a genetic mutation, causes some nerve cells in the spinal cord and brain to degenerate. The condition affects the capacity to think, make decisions, and remember things. It can also cause personality changes.

The first symptoms typically show between the ages of 30 and 40.

• • Parkinson’s disease: Parkinson’s disease dementia is a common symptom of Parkinson’s disease in most patients. Symptoms include memory and thinking problems, hallucinations, delusions, depression, and difficulty speaking.
  • Creutzfeldt-Jakob disease: The majority of persons who develop this rare brain conditions have no identified risk factors. Prions, which are infectious proteins, may have built up as a result of this disease. disorder. Typically, beyond the age of 60, this deadly illness develops symptoms.

Although there is usually no known cause for Creutzfeldt-Jakob disease, it can be inherited. Additionally, exposure to diseased brain or nervous system tissue, such as that following a cornea transplant, may be the cause.

• • Traumatic brain injury (TBI): Repetitive head trauma is the main cause of this condition. TBI may occur in boxers, football players, or soldiers.

Symptoms such as depression, explosiveness, memory loss, and speech impairment can manifest as symptoms of dementia, depending on the specific area of the brain affected by the injury. It is important to note that symptoms may not appear until years after the initial trauma.

• • Wernicke-Korsakoff syndrome: Serious thiamine (vitamin B1) deficiency is the root cause of this neurological condition. This may cause bleeding in important memory-related brain regions. It is most frequently brought on by alcohol use disorder, although it can also be brought on by chronic infection and starvation. The symptoms include trouble processing information, learning new abilities, and remembering things, as well as double vision and lack of muscle coordination.
• Reversible or conditions that can be reversed: Some causes of dementia or symptoms similar to dementia may be treated. They consist of:
  • Normal-pressure hydrocephalus: When cerebrospinal fluid (CSF) accumulates in the brain’s ventricles, it causes this disorder. The brain is harmed by the excessive buildup. A brain infection, brain injury, brain bleed, or prior brain surgery are all potential causes of NPH. Memory loss, difficulties urinating, and mobility issues can all be symptoms of this disorder, which is brought on by enlarged ventricles in the brain. By surgically implanting a shunt (tube), the healthcare provider can drain extra fluid.
  • Infections and immune disorders: Fever and other side effects of the body trying to fight off an illness can cause symptoms that resemble dementia. Dementia may also result from multiple sclerosis and other disorders where the immune system of the body attacks nerve cells. HIV infection, syphilis, and Lyme disease are among the illnesses that might manifest symptoms resembling dementia.

The symptoms of COVID-19 infection have been described as “brain fog” and acute delirium. Cognitive symptoms can also be brought on by other infections of the central nervous system and the brain brought on by fungus, bacteria, and parasites.

• • Metabolic and endocrine problems: Thyroid issues, hypoglycemia (low blood sugar), imbalances in sodium or calcium levels, and difficulties in absorbing vitamin B-12 can lead to personality changes or symptoms resembling dementia in individuals. Addison’s disease, Cushing’s disease, exposure to heavy metals (such arsenic or mercury), and liver cirrhosis are conditions that might mimic dementia.
  • Nutritional deficiencies: Dementia-like symptoms can result from inadequate water (dehydration), inadequate thiamin intake (vitamin B-1), which is prevalent in chronic alcoholics, and inadequate intake of vitamins B-6 and B-12. Deficits in copper and vitamin E can also contribute to the symptoms of dementia.
  • Medication side effects: Certain medications can mimic the symptoms of dementia in some people. These include sedatives other than benzodiazepines, narcotic painkillers, antidepressants, anti-seizure medications, anti-parkinson medications, anti-anxiety medications, statins, and others. If the patient exhibits any indications of dementia, ask the healthcare provider to check the drugs.
  • Subdural hematomas: As a result of a fall, elderly people frequently experience bleeding between the surface of the brain and the covering over the brain, which might mimic dementia symptoms.
  • Brain tumors: An extremely rare complication of brain tumor damage is dementia.

Risk factors

Dementia can arise from a variety of factors, some of which are beyond our control, such as age. However, we can mitigate the risk by focusing on modifiable factors, such as addressing other contributing influences.

• Age: As a person ages, especially beyond age 65, the risk increases. Dementia can affect younger people and is not always a symptom of aging.
• Family history: Having a family history of dementia increases the likelihood of developing the disease. However, it is important to note that both individuals with and without a family history can experience symptoms of dementia. Genetic tests can be utilized to identify the presence of specific genetic mutations associated with the condition.
• Down syndrome: Many persons with Down syndrome get early-onset Alzheimer’s disease by the middle of their lives.
• Head trauma: Alzheimer’s disease is more likely to affect those who have experienced serious head trauma. The prevalence of dementia and Alzheimer’s disease was shown to be higher in patients with traumatic brain injuries (TBIs) who were 50 years of age or older. People with more severe and numerous TBIs are at higher risk. According to some research, the risk may be greatest in the first six to two years following a TBI.
• Diet and exercise: According to research, dementia risk increases with inactivity. Although there is no definitive diet that can guarantee a reduced risk of developing dementia, studies indicate that individuals following a Mediterranean-style eating pattern, rich in fruits, whole grains, nuts, and seeds, tend to exhibit better cognitive function.
• Excessive alcohol intake: Large alcohol consumption has long been linked to altered brain chemistry. Alcohol use disorders were found to be associated with an elevated risk of dementia, particularly early-onset dementia.
• Smoking: Smoking has been linked to an increased risk of developing blood vessel-related illnesses and dementia.
• Depression: While the relationship is not yet fully understood, late-life depression has been suggested as a potential indicator of dementia development.
• Medications that can worsen memory: Avoid over-the-counter sleep aids containing diphenhydramine, as well as oxybutynin and other drugs used to relieve urinary urgency.

Reduce the consumption of sedatives and sleeping pills, and discuss with the healthcare provider any medications the patient may be taking that could impair their memory.

• Cardiovascular risk factors: These include obesity, high cholesterol, high blood pressure (hypertension) and the deposit of fat in the artery walls (atherosclerosis).
• Diabetes: Dementia risk may be increased by diabetes, particularly if it is poorly managed.
• Air pollution: Air pollution particulates have been shown in studies on animals to accelerate the deterioration of the neurological system. Additionally, investigations on people have revealed a link between air pollution exposure and a higher incidence of dementia, particularly when it comes to exposure to burning wood and traffic emissions.
• Sleep disturbances: Dementia risk may be increased in those with sleep apnea and other sleep disorders.
• Vitamin and nutritional deficiencies: Dementia risk is increased by low levels of vitamin D, vitamin B-6, vitamin B-12, and folate.