Dementia: Symptoms, Causes, Prevention, Treatments, Stages and Types
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Dementia: Symptoms, Causes, Prevention, Treatments and Types


Dementia

Dementia is a collective word that is used to describe a group of symptoms affecting memory, social abilities, thinking, orientation, learning capacity, and communication. It is not a disease in itself, but several specific conditions may cause dementia. Though dementia involves memory loss, it may be due to different causes. Just having a memory loss does not indicate a person has dementia.

Dementia is one of the common causes of dysfunction and dependency in older people. Alzheimer’s disease is the most common cause of progressive dementia in people.


Symptoms of Dementia

Dementia affects each person differently, depending on the impact of disorder and a person’s ability to catch the disease. Signs and symptoms of dementia are associated with three stages:

Early Stage:

This stage of dementia is usually overlooked because of gradual onset. Common symptoms include

  • forgetfulness
  • losing time of track
  •  behaving lost in familiar places

Middle Stage:

Signs and symptoms become more precise and more restricting as the disease progresses to the middle stage. The symptoms include:

  • becoming forgetful of current events 
  • forgetting a person’s name
  • difficulty with communication
  • needing support in personal care
  • behavioral changes

Late Stage:

The late stage of dementia is the stage of total inactivity and dependency. Memory disruptions are severe, and physical symptoms become more crystal clear. The common signs and symptoms are:

  • Unaware of the time and place
  • Having difficulty in walking
  • An increasing need for assisted self-care
  • Difficulty in recognizing friends and families
  • Behavior change that may lead to aggression


Stages of Dementia

There are two types of insomnia:

Stages of dementia are categorized into four parts:

  1. Mild cognitive impairment
    Recognized by general forgetfulness. This stage affects many people with aging, but it only progresses to dementia in a few.

  2. Mild dementia 
    People with mild dementia experience cognitive impairment that affects their daily life. Symptoms include memory loss, confusion, personality changes, difficulty in carrying out any task, etc.

  3. Moderate dementia
    An individual at this stage needs more help, and daily life becomes more challenging. Symptoms are similar to mild dementia but increased. Individuals may also show significant changes in their personality. A person can become suspicious or agitated for no reason.

  4. Severe dementia
    Symptoms become more worst at a severe stage. An individual can experience loss of communication ability; also, they might need full-time self-care. Control on the bladder may be lost.


Types of Dementia

There are various types of dementia.

  1. Alzheimer’s disease: It is the most common type of dementia, which is characterized by plaques between drying brain cells and tangled within the cells (due to protein abnormalities). The brain tissue in a person who has alzheimer’s progressively reduces nerve cells and connections and total brain size constricts.

  2. Vascular dementia: it is the second most common type of dementia that is caused by damage to the blood vessels which supply blood in the brain. Blood vessel problems can cause stroke or damage in many other forms, like damaging fibers in the white matter of the brain.

  3. Dementia with Lewy bodies: It is a neurodegenerative condition that leads to abnormal structures in the brain. Irregular balloonlike clumps (Lewy bodies) of protein formation takes place in this condition. The protein involves in brain change is alpha-synuclein.

  4. Frontotemporal dementia: Group of disorders which is characterized by degeneration or breakdown of nerve cells in the frontal and temporal lobes of the brain. These areas are generally associated with personality, language, and behavior.

  5. Mixed dementia: It refers to the diagnosis of more than one type of dementia occurring together. An individual may show signs and symptoms of Alzheimer’s disease, vascular, or Lewy body dementia at the same time.

  6. Huntington’s disease: Caused by a genetic change. This disease causes nerve cells in the brain and spinal cord to waste away. A specific type of uncontrolled movement characterizes it.

  7. Parkinson’s disease: it is often considered a movement of movement and may lead to dementia.


Causes of Dementia

Neurogenerative disease and brain cell death are the two major causes of dementia. Progressive brain cell death that occurs over time is associated with most dementias.
Dementia can also be caused by a brain tumor, any head injury, or even a stroke.

Multi-infract dementia/ vascular dementia- is a result of brain cell death due to cerebrovascular disease. In this condition, there is oxygen depletion in the brain cells as normal blood flow disturbs.
Injury- post-traumatic dementia is directly linked with brain cell death caused by any damage.

Dementia can also be caused by :

  • HIV infection
  • Prion diseases
  • Reversible factors


Risk Factors

Many risk factors contribute to dementia. Some of them can be changed while some of them cannot be. 
Risk factors that can’t be changed are:

  • Age – The risk of dementia rises with aging. Though dementia is not a normal part of aging and it can occur in younger people too.

  • Family history – Having a family history of dementia can put a person at a higher risk of developing this problem. However, many people with a family history of dementia never develop symptoms, while some people without any family history do.

  • Down syndrome – some people with down syndrome develop early onset of Alzheimer’s disease.

Risk factors that can be change

  • Cardiovascular risk factors – include high blood pressure, high cholesterol, atherosclerosis (fat deposition in arterial walls), and obesity.

  • Heavy alcohol use – if anyone consumes a massive amount of alcohol daily, they might be at a high risk of developing dementia.

  • Diabetes – having diabetes may increase the risk of dementia, especially if it is poorly treated.

  • Sleep apnea – people who snore and have episodes of frequently breathing while asleep may have reversible memory loss.

  • Vitamin and nutrition deficiency – low level of vitamin D, vitamin B-6 and vitamin B-12, and folate may increase the risk of dementia.


Dementia Complications

Dementia may affect various body parts and their ability to function. It may lead to:

  • Poor nutrition – People with dementia reduce or stop eating, which trouble nutrition intake in the body. People will find difficulty in swallowing and chewing.

  • Pneumonia – Difficulty in swallowing increases the risk of aspiration of food in the lungs or chocking, which can influence breathing and cause choking.

  • Inability to perform self-care tasks – Dementia can interfere with daily tasks such as bathing, brushing, dressing, etc. as it progresses. The person needs a caretaker. 

  • Personal safety challenges – Few day-to-day situations can make safety issues for the people suffering from dementia, including cooking, walking, driving, etc. 

  • Death – The most severe stage of dementia can lead to coma or death.


Dementia Prevention

There is no specific or positive way to prevent dementia, but there are few preventive measures that an individual can take, which might be helpful.

  • Keep the mind active – Memory stimulating activities like reading, solving puzzles, word games, memory training might delay the arrival of dementia.

  • Quit smoking – Many studies recommend that smoking in middle age and beyond can increase the chances of developing dementia and vascular (blood vessels) conditions. Quitting smoking is the best way to which can reduce the risk and improve health.

  • Physically and socially active – Being physically active and socially interacted may be helpful in reducing the risk of dementia and developing its symptoms.

  • Manage cardiovascular factors – Treat high cholesterol, high blood pressure, BMI (body mass index), and diabetes. These problems can increase the risk of the onset of dementia.

  • Healthy diet – Eating a nutritive diet is essential for many reasons. Still, foods that are rich in fruits, vegetables, whole grains, omega-3 promote good health and decrease the risk of developing dementia. Such diets are also beneficial in balancing cardiovascular problems.

  • Proper sleep – Try to maintain good sleep hygiene and an adequate amount of sleep. If an individual is having a problem of snoring or have periods related to breathing or gasps should take the help of doctors. 


Diagnosis of Dementia


Brain Imaging

Brain imaging is also known as brain scans, can measure the size of the brain, identify and detect specific regions of the brain, detect biochemical changes, and vascular damage. Doctors can use brain scans to find any brain disorders like a tumor or stroke. Brain imaging is used to monitor biochemical and structural changes in the brain in Alzheimer’s disease. There are several types of brain scans:


Computerized Tomography (CT) scan

CT scan is a kind of X-ray that uses radiation to create images of the brain. A CT scan can show the size of the brain and also detect any tumor, stroke, or head injury or any other potential symptom of dementia. CT scan gives a more significant image than normal X- rays, but less detailed image than MRI.

During a CT scan, an individual lies down in a scanner for 10 to 20 minutes. A donut-shaped device moves around the head to produce an image of that region. A CT scan can show shrinkage of the brain’s region that may occur in dementia. 


Magnetic Resonance Imaging (MRI)

MRI uses magnetic fields and radio waves to produce more detailed pictures of body structures, including the size and shape of the brain. MRI scan can identify some causes of dementia symptoms such as a tumor, stroke, or head injury. The imaging may also show whether the areas of the brain have shrunk or atrophied. 

During the procedure, a person lies down in a tunnel-shaped scanner for 20-30 minutes. MRI is a safe, painless procedure that does not involve any radioactivity. Because MRI uses a high magnetic field to produce images, people with few metal types in their body such as pacemakers, surgical clips, etc. cannot undergo this process.

MRI Scan provides pictures of the brain and brain-related abnormal changes such as shrinkage. Indication of shrinkage may support the detection of Alzheimer’s disease or any other neurodegenerative disorder, but it cannot indicate any specific diagnosis.
Doctors often use MRI scans to identify or figure out the cause of memory loss and vascular brain injury, tumors, etc. 


Positron Emission Tomography (PET)

PET scan uses a small amount of radioactive substance, called a tracer, to estimate specific activity– such as energy (glucose) used in different parts of the brain. Different PET uses different tracers. It is commonly used in dementia research. The person having a PET scan is injected with a radioactive tracer into the veins of the arm and then lied on the cushioned table which is moved into a donut-shaped scanner. The PET scanner takes images of the brain, revealing regions of normal and abnormal chemical activity. It is much quieter than an MRI. The entire procedure may take approximately one hour. 

Several PET tracers can be used to detect different aspects of dementia, such as disease status, progression, and metabolic changes in different parts of the brain.


• Fluorodeoxyglucose (FDG) PET scan

This test measures glucose use in the brain. Glucose is used as a primary source of energy for cells. People with dementia usually have an abnormal pattern of decreased glucose used in a particular area of the brain. FDG PET scan shows the pattern that may support a diagnosis of a specific cause of dementia. FDG PET imaging may be useful if a doctor strongly suspects frontotemporal dementia in opposition to Alzheimer’s dementia based on the individual’s symptoms.

• Amyloid PET scan

This type of PET scan measures the abnormal deposition of a protein― beta-amyloid. A high level of beta-amyloid indicates the presence of amyloid plaques, an authentication mark for Alzheimer’s disease. Several tracers can be used for amyloid PET scans such as florbetapir, florbetaben, flutemetamol, etc. Sometimes amyloid PET scan is used by the specialists to diagnose when Alzheimer’s disease is suspected but undetermined. This imaging may also help with diagnosis when people with dementia usually show very mild symptoms.

• F-DOPA PET scan

F-DOPA PET-CT Scan is a molecular imaging test generally used to study Parkinson’s Disease (a form of dementia). An F18-DOPA labeled radioisotope is administered and studied under Positron Emission Technology (PET). 18 F-DOPA is a precursor of dopamine, a neurotransmitter, or a cell-signaling molecule that is usually reduced in Parkinson’s disease due to the death of nerve cells that secrete dopamine. 18 F-DOPA can cross the blood-brain-barrier, and it can be converted into dopamine. Once the is fully absorbed, the test is performed. The patient lay flat on a table, which is moved around a large tunnel-shaped scanner. The computer creates 3D images of the brain that can be visualized on a monitor. The pictures produced shows the uptake and distribution of 18 F-DOPA in different regions of the brain. The pattern reveals the physiological activity is happening inside the brain.


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Dementia: Symptoms, Causes, Prevention, Treatments, Stages and Types
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Dementia: Symptoms, Causes, Prevention, Treatments, Stages and Types
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Read dementia symptoms, prevention, treatment, stages, causes and types. Dementia is a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform everyday activities.
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