What is dementia?

What is Dementia in the Elderly? Causes, Symptoms, and Treatments

Dementia is common enough that people tend to generalize it without knowing all the facts. Memory loss is one of the most common symptoms of dementia, but that doesn’t mean that when the elderly occasionally forget things that dementia is creeping up on them.

If forgetting things isn’t a sign of the onset of a disease, what is dementia in the elderly? Dementia [i] isn’t classified as a disease. It’s a term that encompasses a group of symptoms that affect memory and other cognitive processes.

It’s also common for people to confuse dementia with Alzheimer’s disease [ii] and use the terms interchangeably. Alzheimer’s disease is a type of dementia that gets worse with time. What’s common between them is that people of any age can get dementia or Alzheimer’s disease and that neither is a part of normal aging.

We will discuss in this article

Here are some things that we know about dementia:

  • It’s not a specific disease, disorder or syndrome.
  • It’s not the same as Alzheimer’s disease.
  • Alzheimer’s disease is the most common type of dementia.
  • Dementia results in a severe decline of mental ability and interferes daily life.
  • Neither senility nor senile dementia are proper terms for dementia.
  • Dementia often encompasses more than memory loss.
  • Dementia is sometimes progressive, but not always.
  • Dementia is sometimes treatable, depending on the cause.

While Alzheimer’s disease is the most well-known form of dementia, other types of diseases can also cause symptoms of dementia such as:

  • Alzheimer’s disease
  • Huntington’s disease
  • Parkinson’s disease
  • Creutzfeldt-Jakob disease
  • Wernicke-Korsakoff syndrome

Other medical issues [iii] within the body can also cause symptoms of dementia such as:

  • Mixed dementia
  • Vascular dementia
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Normal pressure hydrocephalus

What is Dementia Caused By?

Knowing a little bit about the brain and how it works helps us understand what dementia is caused by. Our brains have distinct regions. Each region is responsible for different activities like memory, judgement, movement, or other functions.

Here are some other important considerations about the brain as it relates to what is dementia in the elderly:

  • When cells in a particular region become damaged, they can’t carry that function normally.
  • The type of dementia relates to the region of brain that’s damaged.
  • Damaged brain cells can’t communicate with each other.
  • The hippocampus is the center of learning and memory and is often first to be damaged.
  • Memory loss is one of the earliest symptoms of Alzheimer’s disease.

Most causes of dementia are changes in the brain which create dementia symptoms which are usually permanent and worsen over time. Some cognitive and memory loss problems may improve with treatment.

Some possible causes related to dementia symptoms include:

  • Depression
  • Medication side effects
  • Alcoholism
  • Thyroid problems
  • Vitamin deficiencies
  • Stroke

Some people believe that dementia and Alzheimer’s disease are a normal part of aging, but that is a myth. Dementia is more common as people age, but people of any age can be affected by it.

What is Dementia Care Mapping?

Dementia Care Mapping (DCM) [iv] is an observational tool that grew out of the work of Professor Tom Kitwood of the Bradford Dementia Group. The late Professor Kitwood was a pioneer in person-centered care. DCM attempts to use a combination of empathy and observational skill to understand the viewpoint of the person with dementia.

How Does Dementia Care Mapping Work?

DCM takes place in the communal area of a care facility. An observer sits in an area of a care facility where people with dementia come in and go out at will. The observer selects five people and tracks them over a period of six hours in the same day.

The observer then codes their activities in 5-minute increments. The observer evaluates the scores and rates them as well-being or low potential. DCM stresses the importance of relationships and customized care for people living with dementia.

What is dementia care mapping? DCM is recognized by the National Institute for Health and Clinical Excellence. Only care practitioners trained in DCM may perform the assessment. DCM has been used for over 20 years to improve the quality of life for people living with dementia.

DCM also provides insight for caregivers of people living with dementia so that they can see the perspective of the person with dementia and engage in evidence-based care.

How Does Someone Get a Diagnosis of Dementia?

It’s possible for a general practitioner or specialist nurse to diagnose dementia, depending on their training and expertise. More commonly, a general practitioner will refer someone to one of the following types of specialists:

  1. A psychiatrist-a doctor who specializes in diagnosing and treating mental illness.
  2. A geriatrician-a doctor who specializes in the physical health of older people.
  3. A neurologist-a doctor who is an expert on nervous diseases of the nervous system.

To date, there is no single test for what is dementia in the elderly that provides an accurate diagnosis. A diagnosis of dementia usually includes a medical professional taking a careful medical history and giving a physical examination.

The doctor may also perform laboratory tests and learn more about characteristic changes in the person’s thought processes and daily function and behavior.

A doctor who diagnoses someone with dementia will be looking for significant impairment in at least two of the following areas:

  • Memory
  • Communication and language
  • Focus and attention
  • Reasoning and judgment
  • Visual perception
  • Problem-solving
  • Self-management

What Dementia Symptoms Should I Be Looking For?

So many of our daily activities require thinking, reasoning, planning, remembering and problem-solving. Dementia affects some or all of these processes, which is why symptoms of dementia significantly disrupts daily life.

Symptoms of dementia [v] are characterized by:

  1. Memory loss that disrupts daily activities
  2. Difficulty in planning or problem-solving
  3. Inability to complete familiar tasks at home and in other settings
  4. Confusion with time and dates
  5. Difficulty with reading, interpreting images, and spatial relationships
  6. Difficulty finding the right written or oral words
  7. Misplacing things and retracing their steps
  8. Lack of judgment
  9. Withdrawal from activities they formerly enjoyed
  10. Mood and personality changes

Dementia symptoms can be mild, especially in the beginning. As symptoms progress, dementia can become severe enough that a person living with it must depend on other 100% of the time to manage their basic activities of daily living.

What Options are Available for Dementia Treatment?

Dementia and Alzheimer’s disease aren’t curable, but the symptoms of both afflictions can sometimes be treated. The approaches to dementia treatment depend upon the cause.

There is no dementia treatment that slows or stops progressive dementia and Alzheimer’s disease, but there are a few medications that ma improve symptoms temporarily. Other drugs may control mood, psychosis, and improve sleep habits.

Doctors consider several things before making a decision about prescribing drugs because each individual has different needs. These are some of the things that doctors may consider:

  • A medication’s side-effects
  • Cost
  • Ease of use
  • Medical history

Research on medications for dementia is on-going. Currently, doctors believe that certain medications may work better when taken during the earlier or later stages of dementia. Researchers also agree that while medications have some differences, none of them stand out as being better than the others.

Physicians commonly prescribe:

  1. Cholinesterase Inhibitors-most effective in the early to middle stages of dementia. They only slow the progress of dementia and Alzheimer’s disease, but don’t stop or reverse it. They do their best work in the early months and years and may not be effective at all during later stages of the disease.
  2. Memantine-improves communication between brain cells and prevents cells from dying or being damaged. This medication works better in the later stages of dementia and has a few side effects like dizziness, headaches, and constipation.
  3. Anti-anxiety medications-relieves severe symptoms of panic attacks and emotional outbursts.
  4. Antidepressants-improves mood, loss of appetite, fatigue, and lack of interest in daily activities.
  5. Antipsychotics-reduces hallucinations, agitation, and aggression.
  6. Sleep medications-some medications for dementia tire individuals out during the day and medications can help them sleep better at night.

Some people find that alternative treatments [vii] and therapies work well to relieve their symptoms of dementia. There are some concerns about the effectiveness and safety of over-the-counter vitamins, herbal remedies, and dietary supplements. Some concerns include:

  • They aren’t approved by the FDA.
  • Manufacturer’s develop their own guidelines for safety and purity.
  • Alternative therapies may have side effects.
  • Alternative therapies may interact or interfere with prescribed medications.

How In-Home Caregivers Provide Support for People Living with Dementia

People living with dementia usually appreciate being able to age in place rather than move to an assisted living facility or dementia care center. Those who can arrange for an in-home caregiver to help out usually have a better quality of life.

Family members are often willing to help out, but it may be more than they can handle, especially as symptoms of dementia or Alzheimer’s disease worsen.
Getting regular visits from a trusted in-home care provider often gives people with dementia the social and emotional support they need to continue taking their medications, eating healthy, getting exercise, and continue socializing with people.

Some Final Thoughts on Dementia in the Elderly

Unfortunately, there’s no way to predict who will become affected by dementia. Hopefully, new research will yield new treatments and at best, a new cure for dementia. In the meantime, with the help of physicians, medications, therapies, in-home caregivers, and support, many people living with dementia can experience a good quality of life.

sources

[i] https://www.alz.org/what-is-dementia.asp

[ii] https://www.healthline.com/health/alzheimers-disease/difference-dementia-alzheimers
[iii] https://www.nia.nih.gov/health/what-dementia

[iv] https://academic.oup.com/gerontologist/article/45/suppl_1/11/553773
[v] https://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp

[vi] https://www.dementiacarecentral.com/aboutdementia/treating/othermeds/
[vii] https://www.alz.org/alzheimers_disease_alternative_treatments.asp