What Is Dementia?

If you have experienced difficulties with thinking, remembering, or making decisions, and you are 65 years of age or older, you should visit your doctor and discuss the possibility of dementia. Dementia is not a single disease but a class of illnesses that includes Alzheimer’s disease and is marked by a decline in cognitive function particularly after age 65.

In 2014, almost 5 million Americans had been diagnosed with dementia, but this number is expected to grow to 14 million by 2060. Although there is no cure for dementia, there are therapies that may slow the progression of this condition. If you suspect that you or someone you love has dementia, speak to a physician as soon as possible.

Various Forms of Dementia

There are several forms of dementia, each with its own origin and treatment options.

  • Alzheimer’s disease—this is the most common kind of dementia, afflicting from 60 to 80 percent of all dementia patients. Alzheimer’s disease is marked by an inability to remember recent events with loss of older memories as well when the disease has progressed far enough. There is a strong genetic component to this disease with those who have a close relative with Alzheimer’s with a 10 to 30 percent higher chance of developing the condition.
  • Lewy body dementia—this form of dementia has symptoms like memory loss as well as more unusual symptoms like movement and balance issues. Some patients with Lewy body dementia may also experience daytime drowsiness or visual hallucinations.
  • Vascular dementia—almost 1 in 10 cases of dementia is related to a stroke or loss of blood flow to the brain. The severity of the condition is normally related to the area and amount of brain affected. Diabetes, high blood pressure and high cholesterol are risk factors for this condition.
  • Fronto-temporal dementia—this kind of dementia is marked by changes to personality that may include embarrassing or inappropriate behavior. There may also be issues with talking or comprehension.

It is possible to have more than one form of dementia concurrently. Overlapping forms of dementia is more common among those 80 years or older.

Some kinds of dementia may have reversible causes like medications, pressure in the brain, a vitamin deficiency, or a thyroid hormone imbalance.

How Is Dementia Diagnosed?

In order to accurately diagnose dementia, your doctor may order a battery of tests. This process begins with a physical examination and a review of your medical history. If necessary, your doctor may also interview people close to the patient to obtain information about their behavior.

The clinician may then proceed to other tests including

  • Biomarker assay—new biomarker tests for Alzheimer’s are becoming available and can help confirm a positive diagnosis for Alzheimer’s disease.
  • Neurological exam—these will evaluate memory, attention, movement, language, problem-solving, balance and other neurological traits.
  • Imaging scans—a MRI, CT or PET scan may be used to detect the presence of bleeding, tumor, or pressure in the brain. A PET scan may also be used to determine if there are amyloid or tau proteins present, denoting Alzheimer’s disease.
  • Psychiatric evaluation—this may pinpoint mental health conditions like depression which may be symptomatic of a dementia condition or is a comorbidity that could be interfering with treatment.
  • Blood tests—your physician may run blood work to rule out health conditions like a vitamin B-12 deficiency or a thyroid gland issue.

Therapies for Dementia

There are a wide range of therapeutic options that include lifestyle changes, medications, or occupational therapy.

  • drugs like donepezil, rivastigmine or galantamine increase levels of the neurochemical essential for memory and decision-making.           Cholinesterase inhibitors are primarily used with Alzheimer’s disease but may also be therapies for vascular dementia, Lewy body dementia or Parkinson’s disease dementia.
  • Memantine—this medication regulates the activity of glutamate, a key neurochemical in learning and memory. Memantine is most commonly prescribed to Alzheimer’s disease patients.
  • Occupational therapy—working with an occupational therapist can help optimize your home for safety and disease progression.
  • Improving the home setting—it is possible to make your home much more amenable to a person with dementia. By reducing the noise and clutter can better enable concentration and function. You may also want to hide dangerous things like sharp objects and car keys. You may also want to install monitoring equipment.
  • Optimize routine—people with dementia often function best with structure and routine. Enable them to break down tasks into simplest actions that are easily accomplished.
  • Exercise—improving balance, strength and stamina can greatly enhance quality of life. More physical activity can also slow the progression of dementia by improving brain function.
  • Hobbies—find an enjoyable activity like painting, cooking, or singing that helps empower them. This can also help them connect with loved ones.
  • Bedtime ritual—dementia is often worse during the night, so it is important to have a soothing bedtime routine. Avoid caffeine and TV before bed as well as daytime napping.
  • Alternative therapies—you may want to consider unconventional treatment options like music, pets, aromatherapy, art, or massage which may provide some personal improvement.

Dementia Prevention

Although not every case of dementia is preventable, there are ways to lower the risk that you will develop this condition.

  • Exercise regularly—there is strong evidence that regular exercise can lower the risk of dementia.
  • Stay social—there are many physical and emotional benefits to being socially active including a lower likelihood of dementia.
  • Stay mentally active—activities like ongoing education or learning a language can help stave off a mental decline.
  • Stop unhealthy habits—drinking, smoking and drug use can markedly damage your brain and raise the risk of developing dementia.
  • Eat well—research suggests that a healthy diet like one that includes fish, nuts, whole grains, fruits, and leafy greens may protect against dementia.
  • Treat mental illness—it is important to manage mental health conditions like depression or anxiety disorders that can accelerate cognitive decline.
  • Manage health conditions—illnesses like diabetes, high blood pressure and high cholesterol raise the risk of dementia, so it is important to keep them in check.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA, and you should not post any of your private health information.