Family Education

Dementia Overview

Dementia is a general term that describes a group of symptoms such as loss of memory, judgment, language and other intellectual function. It is caused by the permanent damage of the brain’s nerve cells.

Causes of dementia include disease (Alzheimer’s is the most common), vascular destruction, trauma and alcohol.

Clinical symptoms and progression of dementia vary depending on the type of disease and the location and number of damaged brain cells. Some types progress slowly over years while others may result in sudden loss of intellectual function.

Experienced clinicians can accurately diagnose dementia 90% of the time. Accurate diagnosis is critical.

When forgetfulness could be dementia

Dementia is a loss of memory that worsens over time, but is also associated with personality changes and an inability to care for oneself. Normal forgetfulness has no effect on day-to-day activities or personality. In the early stages of dementia, memory changes can mimic normal forgetfulness, so dementia becomes apparent over time. Some memory loss – age-related memory impairment – can be normal as we get older, although this is by no means a universal experience. Unlike dementia, it can be helped by keeping the brain active. In dementia, the most recent memory tends to be the first to go, so sufferers remember childhood events but forget where they put their purse or why they went into a store.

Dementia can cause disorientation, as well as personality changes. There can be mood swings and irritability plus an inability to concentrate or grasp new ideas. Self-care and personal hygiene can also be forgotten. A tendency to fall and unexplained weight loss may also be early signs of dementia.

Memory problems are not always caused by dementia, so the earlier you see a GP, the more quickly these can be diagnosed. Depression can mimic dementia but resolves once treated.Other conditions such as hormone imbalance, vitamin deficiency and infections can also cause dementia-like symptoms.

Certain medications slow the progression of dementia symptoms. Controversially, the medicines were previously not recommended until the disease was moderately advanced. This guidance from the National Institute for Clinical Excellence has now been reviewed and they say the drugs should be offered to those in the early stages of Alzheimer’s.

Occupational therapy, physiotherapy, social services and voluntary support groups all have a role to play. Strategies to aid memory as well as exercise, reality orientation and cognitive stimulation have been proven to help.

Warning signs of Alzheimer’s

It’s hard to know to what extent memory loss is a normal part of aging. The Alzheimer’s Association says that memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer's Disease, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills. Every individual may experience one or more of these signs in different degrees. If you notice any of them, please see a doctor.

• Memory loss that disrupts daily life
  One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What's a typical age-related change? Sometimes forgetting names or appointments, but remembering them later
• Challenges in planning or solving problems
  Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. What's a typical age-related change? Making occasional errors when balancing a checkbook.
• Difficulty completing familiar tasks
  People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.
• Confusion with time or place
  People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What's a typical age-related change? Getting confused about the day of the week but figuring it out later.
• Trouble understanding visual images or special relationships
  For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror. What's a typical age-related change? Vision changes related to cataracts.
• New problems with speaking or writing words
  People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock"). What's a typical age-related change? Sometimes having trouble finding the right word.
• Misplacing things and losing the ability to retrace steps
  A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What's a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.
• Decreased or poor judgement
  People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What's a typical age-related change? Making a bad decision once in a while.
• Withdrawal from work or social activities
  A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. What's a typical age-related change? Sometimes feeling weary of work, family and social obligations.
• Changes in mood and personality
  The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What's a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Summary

Again, if you think you notice any of these signs in your loved one, take him/her to a doctor. An accurate diagnosis is essential. Once you know what you are dealing with you can begin to get educated about it.

Carolyn McIntyre’s article A Careful Look at the 3 Stages of Caregiving offers some interesting insights via her family’s experience.