Dementia
Dementia is a condition that affects the brain and causes problems with memory, thinking, and behaviour. It's a common condition that affects many people, especially as they get older.
When someone has dementia, their brain cells are damaged, which can make it hard for them to remember things, learn new information, and communicate with others. It can also affect their mood and behaviour, causing them to become confused, anxious, or depressed.
Dementia can make it hard for people to do everyday things, like cooking, cleaning, and taking care of themselves. It can also affect their ability to recognize familiar people and places, which can be scary and confusing for them.
While dementia can be a challenging condition, there are many ways to help people who have it. Families and caregivers can provide support and care, and there are also many resources available, such as memory clinics, support groups, and therapy.
It's important to remember that dementia is not a normal part of aging, and not everyone who gets older will develop dementia. However, it is a common condition, and it's important to be aware of the signs and symptoms so that you can seek help if you or a loved one is affected.
Dementia is a brain-based disease that is characterized by a set of symptoms that point to progressive cognitive decline. The symptoms are generally (but not limited to):
Loss of Memory
Lack of Attention
Declining ability to Communicate
Trouble with Reasoning, judgment, and problem solving
Diminished visual perception beyond typical age-related changes in vision
There are different types of Dementia and each type can be caused by a different factor that acts as a catalyst. Ie. Physical injury or trauma to the head due to sports, accidents or abuse. The most common type of Dementia is Alzheimer’s. (CDC, 2024)
Alzheimer’s disease
Alzheimer's is a type of dementia that affects the brain. It's a progressive disease, which means that it gets worse over time. It's caused by a buildup of two types of proteins in the brain: beta-amyloid and tau. These proteins form sticky clumps called plaques and tangles that damage brain cells and make it hard for them to communicate with each other.
As Alzheimer's progresses, it can affect different parts of the brain, including the hippocampus, which is important for memory, and the cerebral cortex, which is involved in thinking, planning, and decision-making.
The symptoms of Alzheimer's can vary from person to person, but they often include:
Memory loss, such as difficulty remembering recent events or learning new information
Confusion and disorientation
Difficulty with communication, including trouble finding the right words or understanding what others are saying
Trouble with problem-solving, decision-making, and judgment
Mood changes, such as depression, anxiety, or agitation
Personality changes, such as becoming more passive or suspicious
Difficulty with coordination and movement, including trouble with walking or balance
There is no cure for Alzheimer's, but there are several medications and therapies that can help manage its symptoms and slow down its progression. These include medications that help improve memory and cognitive function, as well as therapies that focus on behavioural and cognitive changes.
Researchers are still working to understand the causes of Alzheimer's and to develop new treatments. In the meantime, there are several things that people can do to reduce their risk of developing Alzheimer's, including:
Exercising regularly
Eating a healthy diet that includes plenty of fruits, vegetables, and omega-3 fatty acids
Staying mentally active and engaged in activities that challenge the brain
Managing chronic health conditions, such as diabetes and high blood pressure
Avoiding head injuries and taking steps to prevent falls and other injuries
Alzheimer’s is the most common type of dementia and accounts for the predominant number of cases. Many older adults live full lives without developing dementia, it is not commonly believed to be a normal part of the aging process. The trademark symptom of Alzheimer’s is trouble remembering recent events, such as a conversation that occurred very recently, remembering the names of one’s grandchildren or children, or having trouble recalling the name of the city that one is residing in. Other concerns like difficulty with basic functions like speaking, walking, eating etc. eventually happen as the disease progresses. Family history is the most “telltale” risk factor. Having direct or nuclear family members who have Alzheimer’s disease increases the risk of developing it by a significant degree. (CDC, 2024)
Vascular dementia
Vascular dementia is a type of dementia that is caused by problems with the blood vessels in the brain. It's the second most common type of dementia after Alzheimer's disease.
The brain needs a steady supply of blood to work properly, and when the blood vessels in the brain become damaged or blocked, it can lead to a lack of oxygen and nutrients to certain areas of the brain. This can cause the brain cells to die, leading to problems with memory, thinking, and behaviour.
There are several different ways that vascular dementia can develop, including:
Strokes: A stroke occurs when the blood supply to the brain is suddenly interrupted, either due to a blockage or a bleed. This can cause damage to the brain cells in the affected area, leading to vascular dementia.
Small vessel disease: This is a condition where the small blood vessels in the brain become damaged or narrowed, which can reduce the amount of blood flow to the brain.
Mini-strokes: These are small, temporary interruptions to the blood supply in the brain, which can cause brief episodes of confusion, memory loss, or other symptoms.
The symptoms of vascular dementia can vary depending on the location and severity of the damage to the brain. They may include:
Memory loss, such as difficulty remembering recent events or learning new information
Confusion and disorientation
Difficulty with communication, including trouble finding the right words or understanding what others are saying
Trouble with problem-solving, decision-making, and judgment
Mood changes, such as depression, anxiety, or agitation
Personality changes, such as becoming more passive or suspicious
Difficulty with coordination and movement, including trouble with walking or balance
There is no cure for vascular dementia, but there are several treatments and therapies that can help manage its symptoms and slow down its progression. These include medications to improve memory and cognitive function, as well as therapies to help with communication and behavioural changes.
In some cases, vascular dementia can be prevented or delayed by taking steps to reduce the risk of stroke and other cardiovascular problems. This includes:
Exercising regularly
Eating a healthy diet that is low in saturated fat and cholesterol
Managing high blood pressure, diabetes, and other chronic health conditions
Quitting smoking and limiting alcohol consumption
Taking medications as prescribed by a doctor to lower cholesterol or blood pressure
About 1 in 10 cases of dementia cases are attributed to strokes, aneurysms, epilepsy/seizures (JAMA, 2024), cardiovascular diseases or other issues concerning adequate blood flow to the brain. Diabetes -which is a disease that Indigenous populations also find themselves increasingly vulnerable to, is also among the risk factors. Depending on the area, length of time, and size of the brain impacted the severity of the dementia symptoms can vary. The disease is a progressive one which gets progressively more severe as the individual experiences more hindrances to blood flow to the brain. ie multiple strokes. (CDC, 2024)
Lewy body dementia
Lewy body dementia is a type of dementia that is caused by abnormal protein clumps called Lewy bodies. These clumps form inside the brain cells, which can lead to problems with memory, thinking, and movement.
Lewy body dementia can cause a range of symptoms, including:
Memory loss, such as difficulty remembering recent events or learning new information
Confusion and disorientation
Difficulty with communication, including trouble finding the right words or understanding what others are saying
Trouble with problem-solving, decision-making, and judgment
Mood changes, such as depression, anxiety, or agitation
Personality changes, such as becoming more passive or suspicious
Difficulty with coordination and movement, including trouble with walking or balance
Visual hallucinations, which are seeing things that are not there
Sleep disturbances, such as insomnia or excessive sleepiness
Lewy body dementia can be difficult to diagnose, as it can resemble other types of dementia, such as Alzheimer's disease. However, there are certain characteristics that can help doctors distinguish Lewy body dementia from other types of dementia. For example, people with Lewy body dementia are more likely to have a sudden decline in cognitive function, and they may experience a "freezing" or "stiffness" in their movement.
There is no cure for Lewy body dementia, but there are several treatments and therapies that can help manage its symptoms. These include medications to improve memory and cognitive function, as well as therapies to help with communication and behavioural changes.
In some cases, Lewy body dementia can be treated with a procedure called deep brain stimulation, which involves implanting a device in the brain that sends electrical impulses to specific areas. This can help improve movement and cognitive function.
It's important to note that Lewy body dementia is a progressive condition, which means that it will get worse over time. However, with the right treatment and support, people with Lewy body dementia can continue to live fulfilling lives and maintain their independence for as long as possible.
In specific, in addition to memory loss, people with Lewy Body Dementia, have experienced progressively worsening trouble with movement or balance, ie. walking, standing, stiffness, and tremors. Changes in alertness are also commonplace and include daytime sleepiness, confusion or staring spells. Insomnia at night and visual hallucinations can also be something that an individual with Lewy Body Dementia can experience. (CDC, 2024)
Fronto-temporal dementia
Frontotemporal dementia (FTD) is a type of dementia that affects the front and temporal lobes of the brain. These lobes are responsible for personality, behaviour, and language, among other things.
FTD can cause a range of symptoms, including:
Changes in personality and behaviour, such as becoming more passive, suspicious, or apathetic
Difficulty with language, including trouble finding the right words or understanding what others are saying
Trouble with social interactions, such as difficulty recognizing familiar faces or understanding social cues
Difficulty with decision-making and judgment
Memory loss, particularly for recent events
Difficulty with coordination and movement, including trouble with walking or balance
Difficulty with eating and swallowing
FTD can be difficult to diagnose, as it can resemble other types of dementia or neurological conditions. However, there are certain characteristics that can help doctors distinguish FTD from other conditions. For example, FTD often affects younger people, typically in their 50s or 60s, and the symptoms can progress quickly.
There is no cure for FTD, but there are several treatments and therapies that can help manage its symptoms. These include medications to improve language and cognitive function, as well as therapies to help with behavioural changes and social interactions.
In some cases, FTD can be treated with a procedure called deep brain stimulation, which involves implanting a device in the brain that sends electrical impulses to specific areas. This can help improve cognitive function and behaviour.
It's important to note that FTD is a progressive condition, which means that it will get worse over time. However, with the right treatment and support, people with FTD can continue to live fulfilling lives and maintain their independence for as long as possible.
This type of dementia is characterized by a progressive change in the default personality and behaviour because the damage to the part of the brain that dictates personality and behaviours is affected. Individuals who are affected by this type of dementia can embarrass themselves or behave inappropriately or aggressively in a way that is atypical for their character. (CDC, 2024) Ie. a typically reasonable or calm person may behave robustly and impulsively.
Mixed dementia
Mixed dementia is a type of dementia that is caused by a combination of two or more underlying diseases or conditions. It's called "mixed" because it involves a mix of different types of dementia, such as Alzheimer's disease, vascular dementia, and Lewy body dementia.
Mixed dementia can cause a wide range of symptoms, depending on the specific combination of conditions that are present. Some common symptoms include:
Memory loss, such as difficulty remembering recent events or learning new information
Confusion and disorientation
Difficulty with communication, including trouble finding the right words or understanding what others are saying
Trouble with problem-solving, decision-making, and judgment
Mood changes, such as depression, anxiety, or agitation
Personality changes, such as becoming more passive or suspicious
Difficulty with coordination and movement, including trouble with walking or balance
Difficulty with eating and swallowing
Visual hallucinations, which are seeing things that are not there
Sleep disturbances, such as insomnia or excessive sleepiness
Mixed dementia can be difficult to diagnose, as it can resemble other types of dementia or neurological conditions. However, doctors may use a combination of medical history, physical examination, laboratory tests, and brain imaging studies to help identify the underlying causes of this dementia.
There is no cure for mixed dementia, but there are several treatments and therapies that can help manage its symptoms. These may include medications to improve memory and cognitive function, as well as therapies to help with communication, behavioural changes, and social interactions.
In some cases, mixed dementia may be treated with a combination of medications and therapies that target the specific underlying conditions that are contributing to the dementia. For example, a person with mixed dementia may receive medication to help manage their Alzheimer's disease, as well as therapy to help with their vascular dementia.
It's important to note that mixed dementia like most dementia types is a progressive condition, which means that it will get worse over time. However, with the right treatment and support, people with mixed dementia can continue to live fulfilling lives and maintain their independence for as long as possible.
This type of Dementia can progress quicker than most types because it is the presentation of an individual with more than one type of dementia as opposed to one type. (CDC, 2024) ie. having Fronto-temporal dementia due to playing American football professionally and being subjected to frequent head injuries/concussions but also having a parent or grandparent with Alzheimer’s.
In this example, we see that there are external and environmental factors that have accelerated the onset and acquisition of dementia (football and head injuries) as well as having a genetic/familial history of Alzheimer’s which can often lead to a predisposition to developing dementia.
Reversible causes
Reversible causes of dementia are conditions that can cause symptoms of dementia but can be treated or reversed with appropriate medical care. These causes are not necessarily degenerative, meaning that they do not necessarily get worse over time.
Some common reversible causes of dementia include:
Medication side effects: Certain medications, such as sedatives, anti-anxiety drugs, and antidepressants, can cause confusion, memory loss, and other dementia-like symptoms.
Alcohol-related brain damage: Long-term heavy drinking can damage the brain and cause dementia-like symptoms, but this damage can be reversed if the person stops drinking.
Vitamin B12 deficiency: A lack of vitamin B12 can cause memory loss, confusion, and other dementia-like symptoms, but can be reversed with vitamin B12 supplements.
Chronic alcoholism: Chronic alcoholism can cause a form of dementia called Wernicke-Korsakoff syndrome, which can be reversed if the person stops drinking and receives appropriate medical care.
Traumatic brain injury: A severe head injury can cause dementia-like symptoms, but these symptoms can be reversed with appropriate medical care and rehabilitation.
Infections: Certain infections, such as meningitis, encephalitis, and Lyme disease, can cause dementia-like symptoms, but these symptoms can be reversed with antibiotic treatment.
Poor nutrition: Poor nutrition, especially a lack of certain nutrients such as vitamin B12, can cause dementia-like symptoms, but these symptoms can be reversed with proper nutrition.
Sleep disorders: Sleep disorders, such as sleep apnea, can cause dementia-like symptoms, but these symptoms can be reversed with appropriate treatment.
Chronic fatigue syndrome: Chronic fatigue syndrome can cause dementia-like symptoms, but these symptoms can be reversed with appropriate treatment.
It's important to note that while these causes of dementia can be reversed, they can still have a significant impact on a person's quality of life. It's important to seek medical attention if symptoms persist or worsen over time. People who develop this type of dementia often have a reversible underlying cause such as the use of a long-term medication/drug, pressure in the brain, vitamin, dietary, or nutrient deficiency, or hormonal imbalance, but unless the underlying cause is diagnosed and treated effectively the effects of this type of dementia will remain constant. (CDC, 2024)