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Alzheimer's & Dementia Awareness Month - Part 1: Dementia

Imagine you are headed out the door to run some errands and you can't seem to remember where you left your keys. You know you had them with you not too long ago, but now you can't find them. After a few minutes spent searching, you find your keys in the most unlikely places - the refrigerator. You're bewildered as to why they are there, but assume you must have accidentally placed them there when you were grabbing a glass of water. You carry on and chalk your moment of forgetfulness to stress, or fatigue, and hop in your car. Where were you going? You had a whole list of places you mentally noted. The grocery store? No. The gym? No. Maybe, the mall? No.

After running through a checklist of your frequently visited locations, you remember where your headed. Oh, of course, the bank! You chuckle to yourself for forgetting something that you're used to doing every Tuesday afternoon. You drive a little ways down the road and suddenly stop. You can't remember how to get there. Which highway do you take? What exit is it off of? You call your spouse and share your concerns. You've always had a great sense of direction. You used to be able to find your way anywhere, never even needing a map or a GPS.

Between those three scenarios, you're starting to become worried. It's not like you to lose your focus like that, even if you are more than a little tired. You decide to set up an appointment with your doctor to discuss your memory. After doing some tests, he tells you that you have the start of Dementia. 

June is National Alzheimer's and Dementia awareness month, and this week on our blog we will be taking a more in depth look at how these two tragic medical conditions are related. Let's start by exploring more about Dementia.

What is Dementia?

Dementia is a general term for a decline in mental ability that is severe enough to interfere with daily life. Dementia is not a specific disease, but rather it is an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills that are severe enough to reduce a person's ability to perform every day, routine activities.

There are 10 different types of Dementia, with Alzheimer's being the most common type. In fact, Alzheimer's disease accounts for 60 - 80% of cases, followed by Vascular Dementia (which occurs after a stroke) as the second most common type of Dementia.

Many Dementias are progressive, which means that they start out slow, but gradually worsen as time goes on. People with Dementia may begin to have problems with short term memory, keeping track of every day items, paying bills, cooking, remembering appointments, or traveling outside of their neighborhood. 

 Symptoms of Dementia

The symptoms of Dementia can vary greatly, but at least two of the below core mental functions must be significantly impaired to be considered Dementia:

  • Memory Loss
  • Communication and Language Difficulty
  • Lack of Ability to Focus and Pay Attention
  • Lack of Reasoning and Judgement
  • Changes in Visual Perception

Note: It is important to consult with your doctor if you are experiencing any of the above symptoms. There are many other conditions that mimic the symptoms of dementia, including some that are reversible, such as thyroid problems or vitamin deficiencies. Through testing, your doctor should be able to determine your diagnosis.

 What are the Causes of Dementia?

Dementia is caused by damage to brain cells. Different types of Dementia are associated with particular types of brain cell damage in a particular region of the brain. Damage interferes with the ability of brain cells to effectively communicate with each other, and, when brain cells can't communicate normally, thinking, behavior, and feelings are affected. Therefore, when cells in a specific area or region of the brain are damaged, that region cannot carry out its normal functions. 

The Types of Dementia

Alzheimer's Disease: the most common type, accounts for 60 to 80% of cases. Symptoms include: memory loss, apathy and depression, impaired communication, poor judgment, disorientation, confusion, behavior changes, and difficulty speaking, swallowing and walking.

Vascular Dementia: Second most common form of Dementia, accounts for 10% of cases. Typically known as "post-stroke" Dementia. Symptoms include: impaired judgment, inability to make decisions, plan, or organize. This occurs from blood vessel blockage, bleeding in the brain, or damage that leads to strokes. The location of these, plus the number and size of the brain injuries determine whether Dementia will result, and how the person's thinking and physical functions will be affected.

Dementia with Lewy Bodies (DLB): Lewy Bodies are abnormal clumps of the protein alpha-synuclein which can develop in the cortex part of the brain. When that happens, Dementia can result. Symptoms include memory loss, thinking problems, sleep disturbances, visual hallucinations, slowness, imbalance, and Parkinson movements.

Mixed Dementia: When abnormalities linked to more than one cause of dementia occur simultaneously in the brain. Studies have shown that Mixed Dementia is becoming more common that in previous years, and show that the likelihood of having Mixed Dementia increases with age. Mixed Dementia is seen highest in people 85 and older.

Parkinson's Disease: Occurs when the protein clumps begin in the substantia nigra, located deep in the brain. These clumps cause degeneration of the nerve cells that produce dopamine. Symptoms include: problems with movement, slowness, rigidity, and tremors.

Frontotemporal Dementia: Includes Dementias such as FTLD, Primary Progressive Aphasia, Pick's Disease, Corticobasal Degeneration, & Progressive Supranuclear Palsy. Symptoms include: changes in personality, behavioral changes, and difficulty speaking. This occurs when nerve cells in the front and side regions of the brain are damaged.

Creutzfeldt-Jakob Disease (CJD): CJD is the most common human form of the rare, fatal brain disorders that affect people and certain other mammals. It is believed to be caused by consumption of products from cattle who have been affected by mad cow disease. It's a rapidly fatal disorder that impairs memory and coordination, and causes behavior changes.

Normal Pressure Hydrocephalus: Caused by a buildup of fluid in the brain. Symptoms include: difficulty walking, memory loss, and incontinence. This disorder can sometimes be corrected with surgical installation of a shunt in the brain that can drain any access fluid.

Huntington's Disease: Huntington's Disease is a progressive brain disorder caused by a single defective gene on chromosome 4. This gene defect causes abnormalities in that specific brain protein. Symptoms include: abnormal involuntary movements, a severe decline in thinking and reasoning skills, irritability, depression, and other mood changes.

Wernicke-Korsakoff Syndrome: a chronic memory disorder that is caused by severe deficiency of Thiamine - or Vitamin B-1. Thiamine helps brain cells produce energy from sugar. When the levels fall too low, brain cells cannot generate enough energy to function properly. Symptoms include: severe memory problems. 

    Diagnosis & Treatment of Dementia

    It's important to know that there is no one test to determine if an individual has Dementia. Doctors diagnose Dementia, and its different types based on careful medical history, a physical exam, lab tests, and monitor any characteristic changes in thinking, every day function, and the behaviors associated with each type. While many Doctors can diagnose Dementia with a high degree of certainty, often times they cannot pinpoint the exact type of Dementia because many of the symptoms from each type overlap each other. At this point, Doctors may recommend seeing a specialist, such as a neurologist, or gero-psychologist. 

    The treatment of Dementia is dependent on its cause. In most progressive Dementias, including Alzheimer's Disease - there is no cure or treatment that stops or slows its progression. However; there are drug treatments that may temporarily improve the symptoms of each Dementia. Non-drug therapies can also help to alleviate some symptoms of Dementia. 

    Ultimately, Doctors and researchers are continuing to seek the path to new, and effective treatments for the various types of Dementia. It is through funding and clinical trials that they can develop better ways to live with, and hopefully be cured from Dementia. 

    Remember: consulting with a medical expert, such as your physician will benefit you or your loved one in how to cope with Dementia. Various types of help and support are available to you and your loved one, so no one has to walk this journey alone. 


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