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Weekend Doctor: Dementia

By Chris Steffan, RN, ADON Birchaven Village

Dementia is a general term used to describe various symptoms of cognitive decline including impairment in memory, communication and thinking, which is caused by damage to cells in the brain. The symptoms do not appear suddenly but build over time and become more noticeable. Damage can occur for many reasons including increased proteins inside and outside of brain cells, lack of oxygen to the brain, stroke, genetics, medication side effects, depression, alcohol use, and thyroid and vitamin deficiencies.

Symptoms of dementia could include the following: reasoning and judgment–for example, using toothpaste as lotion instead of putting it on your toothbrush, problems communicating–forgetting simple words for everyday items, disorientation–getting lost when traveling to a familiar destination, personality changes–becoming fearful or suspicious, misplacing things–forgetting the location of everyday items such as keys, difficulty completing familiar tasks–making a meal or a familiar recipe. 

It is important to have a healthcare professional, especially a neurologist, evaluate your loved one, since dementia can appear similar to many other illnesses, including a brain tumor or delirium. In the early stages of dementia, distinct types present differently, so it is important to have a professional evaluate the subtle differences.

It is often the person’s caregiver who will notice symptoms that build over time. Since there is not one specific test to diagnose dementia, a physician will review the medical history, complete a physical exam and blood work, and evaluate the behavioral changes and decreases in daily function with judgment and reasoning.

There are many types of dementia, including:

Alzheimer’s disease. This is characterized by plaques and tangles between dying cells in the brain. The brain tissue in a person with Alzheimer’s has progressively fewer nerve cells and the overall size of the brain shrinks.

Dementia with Lewy bodies. This is one of the most common causes of dementia in the elderly population. Lewy body disease happens when abnormal structures, called Lewy bodies, build up in areas of the brain. The disease may cause a wide range of symptoms including changes in alertness and attention, hallucinations, problems with movement and posture, muscle stiffness, and confusion.

Mixed dementia. This occurs when two or three types of dementia exhibit together.

Parkinson’s disease. This shows a presence of Lewy bodies but is considered a movement disorder and can lead to dementia.

Huntington disease. This presents with uncontrolled movements but includes dementia as well.

Early signs of dementia can include changes in short-term memory or mood, difficulty finding the correct words, trouble completing everyday tasks, and repeating thoughts or stories.

A healthy lifestyle may help in preventing dementia. Eating a balanced diet, not smoking, exercising daily, having good sleeping habits, maintaining a healthy weight, avoiding excessive alcohol intake, taking medications as scheduled and keeping your mind active may be beneficial in preventing dementia. Memory games may help improve cognitive function and help deal with mild forgetfulness in the early stages of dementia.

Seeing your physician at the earliest signs of any issue will help with an early diagnosis and allow you to benefit from treatment options and possibly receive an improved outcome.