Dementia
Dementia is a progressive loss of cognitive function, marked by memory problems, trouble communicating, impaired judgment, and confused thinking. Dementia most often occurs around age 65 and older but is a more severe form of decline than normal aging. People who develop dementia may lose the ability to regulate their emotions, especially anger, and their personalities may change.
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Dementia is an umbrella term that refers to age-related cognitive decline caused by a variety of factors as well as by the aging process, in some people. The term is also used to refer to a range of symptoms, from some minor difficulty functioning to severe impairment. The most common form of dementia is Alzheimer's Disease, a condition that affects more than 5 million Americans. There is currently no cure for most types of dementia, but certain treatments can help alleviate the symptoms temporarily.
When a person experiences memory and thinking problems that prevent them from functioning normally on an ongoing basis, they have dementia. There are three major red flags for dementia: either the individual, their family, or a doctor gets concerned that there has been a significant decline in memory and thinking ability; their performance on thinking or memory tests is impaired; and/or issues related to thinking and memory problems are interfering with everyday activities, from the complex (cleaning, cooking, taking medicine) to the simple (bathing, dressing, eating, and using the bathroom).
Dementia is not a diagnosis—it says nothing about the underlying cause of thinking and memory impairment. Dementia can be caused by a variety of factors, including thyroid disorders, vitamin deficiencies, side effects of prescriptions, depression, anxiety, infections, strokes, Parkinson’s disease, and other medical problems. In some cases, cognitive impairment may be reversible if diagnosed and treated early enough.
Some memory loss is a result of normal aging rather than dementia. Memory problems become concerning when they are disabling and prevent normal, everyday functioning. Some early warning signs of possible dementia include having trouble using words in speaking and writing, having difficulty working with numbers and making plans, struggling to complete routine tasks (like directions to a familiar place), losing track of the normal passage of time, and getting confused easily. A person with dementia may also show signs of poor judgment, exhibit changes in mood or personality, or begin withdrawing from their usual social activities.
Dementia can be mild, moderate, or severe. The progression tends to be slow and can vary depending on the individual patient. Generally, the rate of mental decline is slowest during the earlier and later stages of the disease and may take years to become seriously debilitating.
Alzheimer’s is a progressive brain disease, not a normal part of aging. Early-onset Alzheimer’s (in people under age 65) can be quite common. In the earliest stage, patients may have trouble learning and remembering new information. As it advances, patients may experience a range of symptoms, including disorientation and confusion, memory loss, sudden, unfounded suspicions about loved ones, and even behavioral and personality changes. People with Alzheimer’s may be the last to know they have it, as their brain is being affected, and their condition is often more obvious to those who interact with them on a daily basis, particularly friends and family.
While the terms “Alzheimer’s” and “dementia” are often used interchangeably, Alzheimer’s is actually a subset of dementia, along with Lewy body dementia and vascular dementia. Alzheimer’s is extremely common, accounting for around 60-80 percent of all dementia diagnoses.
Yes, being aware of your own cognitive decline tends to evoke depression and anxiety. Just the worry that you might be losing your mind can cause you to become depressed or anxious. Plus, neurodegenerative diseases like Alzheimer’s often deplete neurotransmitters, such as dopamine, norepinephrine, and serotonin, which impact one’s mood and calmness. As a result, anxiety and depression occur in more than half of those individuals who get dementia. Meditation, exercise, medication, and therapy emphasizing relaxation are often effective in treating the anxiety and depression that frequently accompany dementia.
People with Alzheimer’s tend to recall their greatest hits, emotionally speaking, particularly if they see a visual clue (e.g., a favorite photo). While the broad strokes of the memory remain the same, the details are apt to change with each telling. Alzheimer’s patients often forget they have already told a story and may repeat the same memory across visits. In cases where the memory loss is more disruptive, people with Alzheimer’s may make up fabulous, fictitious stories about their lives that they genuinely believe are true.
Making key lifestyle changes is critical to reducing a person’s risk for developing Alzheimer’s disease, as well as maintaining good cognitive functioning as long as possible. This includes engaging in regular physical activity, which increases blood and oxygen flow in the brain. It’s also important to eat a heart-healthy diet with plenty of water, fruits, vegetables, and whole grains while limiting sugar and saturated fats.
Staying socially engaged later in life can also help protect against Alzheimer’s disease and dementia; this may include developing a strong, supportive network of friends and families and becoming a part of communities that matter to you.
No, there is no cure for dementia. However, healthy lifestyle choices can help reduce the risk of serious cognitive impairment, and in some cases, treating the underlying cause can reverse the negative effects.
Cognitive decline may be unavoidable, but it can be delayed through healthy lifestyle choices. Eat a nutritious diet; nutrients like lutein (a carotenoid pigment found in egg yolks and leafy green and cruciferous vegetables) can save the gray matter in your brain. Prioritize good sleep, don’t smoke, limit your alcohol consumption, stay physically active, and look for ways to keep your brain active (e.g., crossword puzzles). Staying social active may also offset the risk of cognitive decline, especially starting around age 60.
It’s natural to be irritated when a question is asked for the zillionth time, but people with dementia will pick up and absorb your mood. When communicating with people with dementia, try to be calm and reassuring. You can also distract them with an activity they enjoy. When someone you love has dementia, losses and changes are inevitable, but you don’t have to shoulder the responsibility alone; enlist the help of friends and family. Try to live in the present as much as possible and seek out joy.
In the case of atypical dementia, memory problems are not the first noticeable symptoms. Atypical dementias tend to have an earlier age of onset than do other forms and may present as a sudden mental illness. Dementia can occur as a result of malfunctioning proteins not found in other neurodegenerative disorders, such as Lewy body dementia, or due to injuries that prevent blood flow to the brain and cause long-term damage.
Lewy body dementia develops when abnormal protein deposits (called Lewy bodies) cause brain cells to malfunction or die. This process usually begins around brain areas associated with memory and movement, but later progresses to areas involved with learning, language, emotion, and later breathing and alertness. Common symptoms of Lewy body dementia are similar to those found in Alzheimer’s patients. More than one million Americans suffer from this form of dementia, and there is currently no cure.
Vascular dementia arises as a result of brain injuries that reduce blood flow and oxygen to the brain, such as a stroke, or other conditions that increase a person’s risk for a stroke, such as high blood pressure, irregular heartbeat, or diabetes. This trauma causes progressive memory loss, which is one component of vascular dementia. Symptoms include slowed attention and thinking and trouble with organization and problem-solving.
Treatment for vascular dementia specifically revolves around the prevention of stroke, which includes modulating blood pressure. There are also medications that may reduce the risk of additional brain damage that accompanies strokes.