What is Dementia & Alzheimer's

Dementia is not a disease but a state of progressive decline in mental function that’s severe enough caused by brain damage or disease characterised by memory loss, thinking problems, reasoning, problem-solving, difficulties with language and communication that affects personality and behaviour that interfere with their daily and social life and activities of a person due to a variety of factors.

Dementia is a progressive neurodegenerative condition where the symptoms typically worsen over time and the severity can vary greatly from person to person. 

It can significantly impact a person's ability to perform daily tasks, maintain independence, and participate in social activities. In some elders mental function decline is so severe that it interferes with daily living and normal activities of the person.

It affects the thinking process, memory function, reasoning, personality, mood and behavior of a person. It defines a decline in mental function from a previously higher level that’s severe enough caused by brain damage or disease characterised by memory loss, thinking problems and behavioural changes to interfere with normal daily life and activities of a person. 

Remember that age is the most common risk factor for dementia and is more common in older people but is not a normal part of aging.  Dementia or memory loss develops when the parts of the brain involved with learning, memory function, decision making, coordination or language are affected. 

A person with dementia has two or more of these specific difficulties, including a decline in:
•    Memory
•    Reasoning
•    Language
•    Coordination
•    Mood
•    Behavior

Early Signs & Symptoms of Dementia

•    Memory Lapse - Selective lapses like forgetting wallets or switch off water tapes, not being able to place people and their names
•    Confusion and despair - Trouble with organizing, sense of direction, finding the right words, retaining information
•    Personality and behavioral changes - due to forgetfulness, making mistakes or not identifying known people
•    Mood swings and irritability - due to forgetfulness and coordination problem and making mistakes they get irritated with increased angerness 
•    Depression - since it affects daily lives, social life, livelihood with decreasing performance gradually fear sets in that leads to depression

Causes of Dementia
Alzheimer's disease is the most common cause of dementia while other known causes are - 
•    Vascular dementia
•    Lewy body dementia
•    Frontotemporal dementia
•    Parkinsonian dementia
•    Mixed type
•    Reversible causes due to vitamin deficiency, thyroid disorder or side effects of medicine
•    In some cases there is a genetic cause

Dementias can be of 3 types:
•    Primary (diseases and conditions that directly causes dementia).
•    Secondary (dementia due to another disease or condition).
•    Reversible dementia-like symptoms caused by other illnesses or causes.

Primary dementia
•    Alzheimer’s disease - This is the most common type of dementia. Two abnormal proteins build up in the brain, tau and amyloid proteins which disrupt neural communication between nerve cells and causes the nerve cells to die, starting in one area and spreading to other areas. 

Symptoms include short-term memory loss, confusion, personality and behavioural changes. Difficulty in communication or talking, remembering distant memories and walking disorders happen at a later stage of the disease.

Alzheimer’s disease mainly affects adults who are older — up to 10% of those over age 65 and about 50% of people older than 85 have the disease. Family history is an important risk factor. Approximately 60% to 80% of people with dementia have this type. It is of gradual onset.

•    Vascular dementia: This is the second most common type of dementia caused by strokes or atherosclerosis, which block and damage blood vessels of the brain. 

Symptoms include memory problems, confusion and trouble concentrating and completing tasks. The decline may appear suddenly following a major stroke or in steps due to a series of mini strokes. Risk factors include high blood pressure, diabetes and high cholesterol levels. About 15% to 25% of people with dementia have vascular dementia.

•    Lewy body dementia - This condition involves the buildup of clumps of proteins — called Lewy bodies — in the brain. Lewy bodies damage nerve cells. Symptoms include movement and balance problems, changes in sleep patterns, memory loss, planning and problem-solving difficulties, and visual hallucinations and delusions. About 5% to 10% of dementias are Lewy Body dementia.

•    Frontotemporal dementia (FTD) - This dementia results from damage to the frontal and temporal lobes of your brain. The damage is caused by the buildup of abnormal proteins in these areas. 

It causes changes in social behavior, personality, and/or loss of language skills (speaking, understanding or forgetting the meaning of common words) or motor coordination. FTD is a common cause of early dementia, often occurring in people between the ages of 45 and 64. Between 5% and 6% of all dementias are FTD.

•    Mixed dementia: This is a combination of two or more types of dementia. The most common combination is Alzheimer’s disease with vascular dementia. It’s most common in people 80 years of age and over. It’s often hard to diagnose because symptoms of one dementia may be more obvious and/or many symptoms of each type overlap. The decline is faster in people who have mixed dementia compared with those who only have one type.

There are some available medications that may help to slow the mental decline but cannot cure it or stop it from further decline.