Common Questions about a Dementia Diagnosis
Once you or a loved one has received a diagnosis of dementia, you are bound to have a lot of questions about what to expect. Here are a few of the most common ones to help get you started on the road to understanding dementia.
What Is Dementia?
Dementia is a blanket term for various types of medical conditions which impair memory and the ability to think and reason.
Is All Memory Loss Dementia?
No. There are many other reasons why a person might find their memory altered, including stress, lack of sleep, and certain medications.
Is All Dementia Alzheimer’s?
No. Alzheimer’s is one particular form of dementia, the most severe. There are several other types, each with their own signs and symptoms. Knowing which type of dementia you have can help you get the right treatment.
Can an Alzheimer's Diagnosis Be Confirmed 100% While a Person Is Alive?
No. A number of diagnostic tests can point to whether or not a person has Alzheimer’s, but otherwise, doctors can only get a definitive diagnosis through an autopsy and examination of the brain tissue.
What Are the Next Steps after Diagnosis?
There are several next steps. The first is to learn all you can about your particular type of dementia. The second step is to tell those in your life who need to know and will support you in this new phase of your life.
Your third step is to find out what treatments your doctor recommends, and to follow through regularly. Next, ask them what support is available for you and your family, especially if you have Alzheimer’s. You might find local support groups, an adult day care center, and more.
The next step is to start planning for the future now, so your wishes will be followed. There are a number of issues to consider:
1. Your care, and in particular, who will make healthcare decisions if you are not able to. A living will and a lasting power of attorney can help.
2. Finances - who will administer your finances if you are not able to? Your will can also help you state who you would like to leave certain bequests to when you pass away.
3. Dependents - if you have anyone dependent upon you, such as a child or grandchild, or pets, provision would need to be made for them. In addition, you might decide to appoint a guardian for yourself to ensure continuity of care.
To learn more about the important paperwork to have in place, visit:
https://www.alz.org/care/alzheimers-dementia-legal-documents.asp
What Treatments Are Available for Dementia?
This depends on the type of dementia you have been diagnosed with. In most cases, it will involve medication to treat the troublesome symptoms, and perhaps lifestyle changes such as adding exercise to your daily routine, which has been shown to slow cognitive decline even in people with Alzheimer’s.
Each medication will have varying degrees of effectiveness as well as certain side effects, so it is important to discuss all of your options with your doctor/s as you work out a treatment plan.
What Strategies Can Help Me Cope with Memory Loss?
There are several strategies that can help:
* Labeling cupboard doors with written labels, sticky notes, or pictures can help in the kitchen. Use a similar system for your clothing drawers.
* Use a paper diary so you can write down all of your appointments.
* Get a special pill carrier for all your medications. One type allows you to lay out your medicine for a week at a time, with four compartments in each daily pill box. The small pill box can be removed from the larger unit and taken with you anywhere. If you are not sure you have taken your medicine, just look at the box compartments.
* Have routines for taking off clothes and putting them in the laundry, lists for shopping at the supermarket, and so on.
Understanding more about a dementia diagnosis can make it easier to deal with, whether it's for you or a loved one.
Common Symptoms of Dementia
There are a number of different forms of dementia. Not all dementia is Alzheimer’s. However, the various types often have some signs and symptoms in common.
Common Symptoms of Dementia
There are two types of symptoms, cognitive (related to thinking) and psychological changes.
Cognitive changes
* Memory loss, which is usually noticed by a spouse, relative, or someone other than the person suffering from cognitive impairment
* Difficulty handling complex tasks
* Trouble with everyday tasks the person would normally do easily, such as at work
* Trouble with planning and organizing
* Difficulty communicating or finding words
* Difficulty reasoning or problem solving
* Difficulty with coordination and motor functions
* Confusion and disorientation
Psychological changes
* Personality changes, such as a normally quiet person becoming loud and aggressive, or vice versa
* Sadness, depression
* Anxiety, worrying about things for no specific reason
* Inappropriate behavior, such as being rude or lacking in good manners
* Paranoia, being convinced that people are spying on them or out to get them
* Agitation, nervousness, even in familiar situations
* Hallucinations, seeing things and people that aren’t there (around 50% of Parkinson’s patients have this)
Causes of Memory Loss
It is important to note that not all of these symptoms demonstrate a clear diagnosis of dementia. For example, some medications can cause memory loss and/or behavioral changes. So can stress, and a lack of sleep/sleep deprivation.
Discussing the issue with your doctor could mean a switch to a similar medication but without the same side effect. Stress management techniques and focusing on a person’s sleep routine could lead to improvement.
Progression of the Condition
If you notice your own memory failing, or see a loved one exhibiting more and more symptoms, it is likely to be dementia - in which case, you would need to see a doctor for a definitive diagnosis.
Warning Signs of Alzheimer’s
As the population in the West ages, many people are concerned about developing Alzheimer’s. They can often become disturbed by changes in their memory and fear the worst. But not all dementia is Alzheimer’s. Here are some warning signs to watch out for in yourself or a loved one.
1. The memory loss is so severe, it disrupts daily activities
In this case, the person is unable to remember simple things or do their regular daily activities easily. They start to become more dependent and unable to handle things on their own.
2. The person has trouble with planning and simple tasks
Many older people find themselves having trouble managing their finances and paying bills, following recipes, and taking much longer than usual to complete simple tasks.
3. Becoming challenged by technology
The person finds it hard to use tools they usually have no problems with, such as a computer or microwave.
4. Confusion with the time or where they are
They lose track of hours and days and are often confused about where they are and how they got there.
5. Vision problems
There are a number of tests a doctor can administer which will reveal typical vision distortion and other issues suffered by those with Alzheimer’s.
6. Trouble speaking or writing
A person with Alzheimer’s will start to lose their words and will also have trouble following conversations.
7. Social isolation
As a result of psychological changes and trouble communicating, those with Alzheimer’s often withdraw from family and friends, which can actually worsen their condition.
8. Losing things
The person will often lose things like keys and money.
9. Decreased or poor judgment
People with Alzheimer's may also experience changes in judgment or decision making. For example, they may use poor judgment when dealing with money, such as giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
10. Changes in mood
The most common change is depression, but it might also be anxiety or aggression.
These signs and symptoms can help identify Alzheimer's and other dementia so that the best possible help can be sought.
Dementia Risk Factors and How to Reduce Your Risk
With populations living longer than ever before, there is a greater concern amongst those aging as to whether they will develop dementia, such as Alzheimer’s.
The latest research is yielding valuable information on dementia risk factors, with a view to people reducing their risk if they can. Here are some of the risk factors we know so far.
Age
The older you get, the more likely you are to develop dementia. But it is important to note that not all dementia is Alzheimer’s. One in nine people over 65 and one in three people over 85 have Alzheimer’s.
Family History
Anyone with a parent, brother or sister with Alzheimer’s is more likely to develop the disease. Scientists are not sure if this is due to genetics, environment, or both. Genetic tests are available for both APOE e4 and the rare genes that directly cause Alzheimer’s. Those with the APOE e4 gene tend to develop dementia at a younger age. Doctors are now seeing dementia and Alzheimer’s in patients in their late 40s and early 50s.
Race
Latinos are 1.5 times more likely and blacks two times more likely to develop dementia as compared with whites. This is believed to be because they often have poorer cardiovascular health and unhealthy eating habits (consuming lots of carbohydrates and fried foods).
Diet
Sugar has been called "white death" in relation to what it does to the body and brain. A diet low in carbohydrates seems to be protective.
Aluminum Is NOT a Cause
Aluminum was once blamed for Alzheimer’s, through antacids, soda cans and so on supposedly leeching aluminum into our foods. Fast forward to the present day, and no study has ever confirmed this.
Diabetes
Diabetes is commonly linked with Alzheimer’s. In fact, Alzheimer’s is being called Type 4 diabetes by some. Diabetes poses a significant health challenge in terms of heart health and brain health. Tight glucose control can decrease one’s risk of developing diabetic complications or worsening heart health and dementia.
Concussion/Head Injury
There is a growing body of evidence that there may be a strong link between serious head injury and future risk of Alzheimer’s, especially when trauma occurs repeatedly or involves a loss of consciousness.
It’s easy to stay safe. Don’t engage in contact sports. Always wear a seatbelt in the car. Check your home to make sure there are no danger spots for slips, trips and falls. Learn more about concussion and traumatic brain injury (TBI) and how to avoid them.
The Heart and Brain Connection
Cardiovascular health is strongly linked to brain health. As we age, we often develop high blood pressure, which has been linked to heart attack and stroke. Narrowing of blood vessels can diminish essential oxygen supplies to certain parts of the brain, causing them to function at less than their best. Eat a heart-healthy diet and exercise regularly.
Exercise
Exercise has been shown to be protective against dementia. In fact, in people with Alzheimer’s, it has even been shown to reduce symptoms.
Don’t Smoke
It is bad for heart, brain, and the entire body. If you smoke, it’s time to quit.
Avoid Alcohol
Alcohol is known to damage brain cells. It also has a great deal of sugar in it, which is harmful to the brain.
You can't always avoid getting dementia, but being aware of these factors can help reduce the risk.
Factors Other Than Dementia That Can Affect Your Memory
Most people suffer some degree of memory loss as they age, but just because a person is forgetful or even confused does not mean they have Alzheimer’s. There are a number of "memory stealers" worth considering before rushing to a diagnosis of dementia. Here are some to consider.
Depression
People with depression often have a hard time paying attention to things and often don’t feel alert enough mentally to remember everything they need to. Spending time with others and getting treatment for depression, such as cognitive behavioral therapy (talk therapy), can help a person get back to their old self.
Urinary Tract Infections (UTI)
Many older people, especially women, have UTIs and don’t even know it. Left untreated, a UTI can spread to your bladder or kidneys, resulting in confusion, sleepiness, a change in behavior, trouble paying attention, and even hallucinations. A simple test at the doctor and a course of antibiotics is usually enough to take care of most UTIs. Staying hydrated and drinking cranberry juice or taking cranberry supplements can also help.
Thyroid Disease
The thyroid is a small butterfly-shaped gland in the front of your neck that makes hormones which help your organs work and controls how well your body uses food for fuel. A slow thyroid can lead to weight gain and mental sluggishness. A fast thyroid might result in you having trouble focusing or feeling anxious, depressed or stressed. A simple blood test can determine your thyroid levels and determine the best treatment.
Diabetes
Diabetics have trouble producing insulin, which can result in an imbalance of glucose in the blood stream. If your level drops too low, your brain literally does not have enough energy to function, leading to confusion and even fainting. A small amount of food, and good glucose monitoring, should help keep things in balance.
Lyme Disease
Lyme disease is transmitted by an infected tick. If a person does not get antibiotic treatment in a timely manner, they can start having neurological issues such as memory loss, brain fog, trouble communicating with others, and difficulty with daily tasks. A test called a Lyme disease titer should reveal if you have been exposed and what treatments can help.
Vitamin B12 Deficiency
B vitamins are essential for many bodily functions. Unfortunately, they are water soluble, which means we can’t store them in the body and they get eliminated in our urine. Therefore, we need to regularly eat sources of B vitamins such as whole grains, and certain meat and vegetables, in order to stay healthy.
Those who are low in B12 will often suffer confusion and muscle spasms. If you are a vegetarian, or have inflammatory bowel disease, ask your doctor to check your levels. If they are low, you can get a B12 shot and take supplements.
Certain Medications
Many drugs such as antihistamines, anti-nausea medicine, steroids, and bladder relaxants, can cause symptoms that look like dementia. The older you get, the more medicines most people take, and the greater the risk of side effects. And as we age, the body finds it more difficult to eliminate toxins from the body.
Memory loss, confusion and mental fog that develop suddenly after a change in medications should be investigated. Discuss the issue with your doctor; chances are they will be able to suggest alternatives with fewer side effects.
How to Make the Most of Your Doctor's Visit
If your memory loss (or that of a loved one) has started to worry you, your first step should be to go to the doctor. Early detection of any medical condition can often be the best way to get a good outcome.
But before you go, there are a number of steps you can take to help you make the most of what can often be a short space of time for your doctor’s visit. Here are some things to prepare before you go.
1. Keep a Journal
In this journal, you can write down all the things you have noticed about yourself, or about your loved one, in terms of:
* Physical symptoms
* Mental symptoms/obvious memory loss that affected your ability to work or do chores as you/they normally would
* Changes in behavior - note the behavior, what happened, and how long the episode lasted
Try to keep track of "milestones", such as:
* When the symptoms first appeared
* Are you worse at certain times of the day than others?
* Can you spot any triggers, such as stress, lack of sleep, or a new medication?
Note down:
* Have the symptoms changed over time? In what ways?
* What has been tried in order to improve memory? Examples might include establishing new routines, doing "brain exercises" on sites like Luminosity.com, and so on.
2. Make a List of Current Medications
Include both prescription and over-the-counter drugs, including:
* Vitamins
* Supplements
* Herbal remedies
* Patches (such as for pain or stopping smoking)
* Eyedrops
* Antacids
* And so on
List:
* The name of the drug
* The dosage, such as 25 milligrams
* The frequency the pill is taken, such as twice a day
* The doctor who prescribed it
* Why it was prescribed
* How long it has been taken
* Any suspected side effects
You should be able to find all of the factual data on the bottle about the prescription drugs you take. For non-prescription drugs, consider bringing the bottles with you in a clear, plastic zippered storage bag or two.
It is important to know who prescribed the medicine and why because as we get older, we tend to see more than one doctor or specialist, and each will make their own recommendations. However, this can lead to medications that interact with each other.
The other issue is what the medicine is designed to deal with. Do you have a short-term (acute) or long-term (chronic) condition? If it is acute, you should probably not be taking, for example, opioid pain relievers for months or years.
Many medicines and over-the-counter remedies like antacids are known "memory stealers", so you can discuss with the doctor if there are any alternatives that can be switched to. The average 50-year-old takes eight prescription medications per day, plus vitamins and herbs, so any of these items could be the culprit.
The trend in medicine these days is "de-prescribing" - that is, taking people off many of the medicines they have been taking for years. When discussing your options with your doctor, be sure to give them a list of any drug allergies you might have, such as to penicillin, and mention any major underlying health issue, such as heart problems. In this way, they should be able to make recommendations that will improve memory and keep you safe.
3. Bring a Pen and Paper or a Notebook
It’s always a good idea to take notes at an appointment about what was discussed and done, such as blood work and cognitive tests. You should also write down any follow-up steps.
4. Take Another Person with You
Another person can lend moral support and pick up on things you might miss. They can also act as a "scribe", using the pen and paper to make notes so you can concentrate on interacting with the doctor. Then you can review the notes together after.
How to Tell Family and Friends That You Have Dementia
Being told you have any medical condition can be a very upsetting situation, but you don’t have to face it alone. However, it is up to you who you wish to tell or not tell, and how you wish to tell them.
Educate Yourself
Before you tell everyone, it is often best to educate yourself as much as possible about your condition. For example, there are several different kinds of dementia, each with its own prognosis (suggested outcome). Every patient is of course different. Some are genetically predisposed towards dementia and Alzheimer’s. Others are more proactive about their health, which can help counteract genetics to some extent.
Some forms of dementia have standard treatments that are successful and can help you maintain a high quality of life and independence for many years to come. In the case of Alzheimer’s, however, cognitive decline will reach the point where a person can no longer be independent. Most Alzheimer’s patients rarely live beyond 10 years after diagnosis.
Giving people brochures or website links that convey the message you want to share can help.
Age
Age can be a factor in one’s outlook. If you are in your 80s, for example, dementia is probably not such a huge surprise or upheaval in your life compared to some patients who are developing dementia as early as in their 40s and 50s.
Marital Status
If you are married or in a relationship, a diagnosis of dementia can put a real strain on a relationship. It can be depressing for the person diagnosed. They often hate the idea of "being a burden" on anyone. For both partners, it can be frightening, because there are no definite answers as to what happens next. There are treatments for dementia and Alzheimer’s, and new ones are emerging all the time, but each person will respond differently to their type of dementia.
Deciding Who to Tell
Your decision should be based on how close you are to the person and how important it is they know. It can also be based on what you think the person will be able to hear without being devastated by the news. A third consideration is how much that person is likely to remain in your life and give you emotional and perhaps practical support as time goes on.
Sharing your diagnosis with others is an important step toward integrating Alzheimer's disease into your life. You may be hesitant to share your diagnosis with some people, given the impact such a disclosure may have for you. Keep this mantra in mind: Alzheimer's disease is not your fault.
Determine your comfort level as to how many people you would like to know. You can always tell more people later as needed. The important thing is to feel supported as you cope with your news.
Picking Your Moment
Some people with dementia like to get their important people one on one to break the news. Others might organize a gathering of family and friends to tell people all at the same time and deal with some of the most common questions most people have when they first hear the word dementia.
The group should be relaxed and not hyper when you tell them. You might also consider writing down what you wish to say so you can give them the important fact without getting sidetracked.
Talk about planning for the future together, and your loved ones should soon start to accept the diagnosis and help you with your "new normal" as you live with dementia.
Signs That You Need to See Your Doctor
If you suspect you or a loved one might be showing signs of dementia, your first step should be to see your doctor. It is only through various tests that an actual diagnosis can be made.
Common Signs of Dementia
These are all common signs of dementia that indicate that it is time to visit your doctor.
* Subtle short-term memory changes, such as not remembering the name of a person you know well, or a common object
* Difficulty following conversations
* Changes in mood or personality, such as being very quiet, or suddenly aggressive and loud
* Listlessness; a lack of interest in things they normally do
* Trouble completing tasks you would usually do, such as at work or around the house
* Confusion, lack of awareness of what day or time it is, where you are and how you got there
* Difficulty following movies or TV shows
* Getting lost more often, even in familiar areas
Not All Memory Loss Is Dementia
The good news is that not all memory loss is dementia, and not all dementia is Alzheimer’s. In many cases, there can be simple lifestyle reasons as to why your memory isn’t as sharp as it used to be. Three main causes are stress, lack of quality sleep, and certain medications.
Your doctor can help you with all of these. There are many effective stress management techniques. Your doctor can review your sleep habits to make sure your nightly routine is a good stepping stone to a full night of high-quality sleep. Certain medications have known side effect of impairing memory. Your doctor can usually offer alternatives that won’t harm your memory, and monitor you to see if your symptoms improve or even disappear.
Early Detection Is Key
As with most medical conditions, early detection can often be the key to a better outcome, rather than having waited to see a doctor until things have progressed too far.
Your primary care doctor will be your first stop. They will run blood tests and urinalysis to detect any underlying health issue that might be triggering memory issues. For example, high blood pressure, diabetes and thyroid issues can all lead to memory problems. If they discover any medical condition, it can be treated and you can monitor whether or not memory returns.
Being Referred to Specialists
Depending on what the first set of tests uncovers, a person suffering from memory loss will usually either be treated, or referred to one or more specialists. Each of these specialists can help decide if it is dementia, or some other brain health issue.
Neurologist
A neurologist will help determine whether the structure of the brain is normal, and the degree of cognitive function.
Psychiatrist
A psychiatrist can help determine whether or not the behavioral changes which might have manifested are a sign of dementia, or of a mood disorder.
Geriatrician
A geriatrician specializes in the medical conditions suffered by older people. They can help formulate a treatment plan depending on whether or not the person is suffering from cognitive impairment, dementia or Alzheimer’s.
Diagnostic Tests
Each doctor will administer verbal tests and tests on paper to the patient; these are an established method to help diagnose dementia. And if dementia is present, the tests will also determine the rate of decline, such as in Alzheimer’s.
They might also order CT scans, MRIs and other imaging tests to determine if the structure of the brain has changed in any way, such as due to a tumor or a stroke. Again, depending on what is found, the doctor will determine a course of treatment or other plan of action to deal with the memory loss.
Tests You Can Do Yourself to See If You Have Dementia
There is no single test that proves a person has dementia, including Alzheimer's. Rather, the diagnosis is made through a complete assessment that considers all possible causes. A doctor will look at a person’s:
* Medical history
* Physical condition
* Neurological status
* Mental abilities
* Physical condition of the brain
But with the growing concern amongst older people as to whether or not they might have dementia, many are looking for tests they can take to help them determine if they are suffering from something as serious as Alzheimer’s.
Medical Tests
Your first port of call should really be the doctor, who would do a full blood and urine work-up and make their determination based on any medical conditions that might be discovered. For example, memory problems can be caused by anemia, infection, diabetes, kidney disease, liver disease, vitamin deficiencies, thyroid issues, high blood pressure, and cardiovascular problems.
If you have diabetes, test your blood glucose levels regularly and try to maintain tight glucose control. Consider buying a high blood pressure monitor so you can check it regularly. Get a cholesterol testing kit and strips.
Genetic Testing
Researchers have identified certain genes that increase the risk of developing Alzheimer's, and other genes that directly cause Alzheimer's. Most doctors do not recommend genetic testing for these genes, but if you are concerned with determining whether or not you are genetically prone so you can combat it with lifestyle measures, it might be worth it for your peace of mind.
Home Screening Tests
A number of dementia screening tests are being been marketed directly to consumers, but they should never be used as a substitute for a full screening by one or more medical professionals.
These tests look at different aspects of cognitive function:
* Mental status tests - These test your memory, ability to solve simple problems and other cognitive skills like remembering words and doing simple math calculations.
* Date, day of the week, time, location - The person should be able to correctly identify all of these.
* Mini-mental state exam (MMSE) - MMSEs are used by health professionals in order to test a range of everyday mental skills. Some have made their way online. The varying scores identify dementia and Alzheimer’s. In the case of Alzheimer’s, the scores would go down by a few points each year, demonstrating cognitive decline.
* Mini-cog - A mini-cog, or mini-cognitive test, requires a person to complete two tasks:
1. Remember and a few minutes later repeat the names of three common objects.
2. Draw a face of a clock showing all 12 numbers in the right places and a time specified by the examiner.
Failure to do both is often an indicator for a doctor to follow up further regarding Alzheimer’s. Take it here: https://www.alz.org/documents_custom/minicog.pdf
* The SAGE test - The self-administered gerocognitive exam (SAGE) is designed to detect early signs of cognitive, memory or thinking problems. You can take it online or administer it to a loved one.
https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage#english
* Computerized tests approved by the FDA - There are a number of companies currently creating, marketing, and gaining clients for cognitive testing. One of the biggest is Automated Neuropsychological Assessment Metrics (ANAM) devices, currently developing more than 200 tests with the help of the military. Some will be used by doctors, but others should be available online or via mobile in the near future.
* Neurotrack - As the name suggests, this test helps track cognitive function over time to detect the degree of decline, if any. Visit https://neurotrack.com/ to take the test; it might be covered by your health insurance, or you can take the test for $99.
* Memtrax - Memtrax can also be taken at home online. The first test is free. https://memtrax.com/test/
These tests can be very helpful indicators of whether a person has dementia but again, they should never be used as a substitute for a doctor's diagnosis.
The Different Types of Dementia
When people hear the word dementia, they almost instantly think of Alzheimer’s. However, there are several different types of dementia. Knowing the difference means knowing what to expect, and getting the right treatment when available. Here are the most common types of dementia apart from Alzheimer’s.
Vascular Dementia
Vascular dementia accounts for about 10 percent of dementia cases and is the result of problems with the blood vessels which supply the brain. It often develops after the person has had a stroke. A person with vascular dementia will not have the degree of memory loss of a person with Alzheimer’s, but they will have trouble thinking, planning and organizing.
The course of the illness is unpredictable, because the location, number and size of the brain injuries from one or more strokes will determine whether dementia will result, and how the individual’s thinking and physical function will be affected.
Mixed Dementia
A person can have brain changes resulting from more than one cause, such as vascular dementia and Parkinson’s. In this case, they are said to have mixed dementia. This is most likely in people over 85.
Dementia with Lewy bodies (DLB)
Lewy bodies are clumps of a particular protein that can clog the cerebral cortex and affect memory and thinking problems. People with this condition often have trouble sleeping and visual hallucinations. They sometimes exhibit similar symptoms to those with Parkinson’s disease. The symptoms/course of the disease will vary depending on the movement of the Lewy bodies. This can result in many normal moments and then sudden declines into dementia.
Parkinson's Disease
As Parkinson's disease progresses, it often results in dementia similar to dementia with Lewy bodies, or Alzheimer's. The main symptoms are problems with movement, such as slowness, rigidity, tremor and changes in gait and tremor (the shakes). With Parkinson’s, Lewy bodies form in an area deep in the brain called the substantia nigra. They cause degeneration of the nerve cells that produce dopamine, an essential neurotransmitter or chemical which controls movement.
The boxer Muhammad Ali developed Parkinson’s after his sports career and lived with it for many years. The actor Michael J. Fox was diagnosed with it at a very young age, but lifestyle strategies and medication help him keep working.
Frontotemporal Lobal Degeneration (FTLD)
This dementia affects the frontotemporal area of the brain and results in changes in personality and behavior, as well as difficulty with language. Nerve cells in the front and side regions of the brain are especially affected. It tends to affect people at a younger age: 60% of people with FTLD are aged 45 to 60. It accounts for about 10 percent of all dementia cases.
Creutzfeldt-Jakob Disease
CJD is the most common human form of a group of rare, fatal brain disorders affecting people and certain other mammals. It is often referred to as "mad cow disease" and is thought to result from eating animal products from infected cows. It is a fatal disease that impairs memory and coordination and causes behavior changes as the proteins in the brain all start to malfunction.
Huntington's Disease
Huntington's disease is a progressive brain disorder caused by a single defective gene on chromosome 4. Symptoms include tremor and jerking, a severe decline in thinking and reasoning skills, and irritability, depression, and other mood changes. The symptoms will get worse over time as more of the proteins in the brain are affected.
Wernicke-Korsakoff Syndrome
This syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B1), usually the result of chronic alcoholism. Symptoms include a very bad memory, though otherwise the person’s thinking will seem normal. Getting more B1 and cutting back on alcohol should restore the natural balance in the brain.
As you can see, there are many different types of dementia and a medical professional will be able to diagnose which type a person suffers from.
What Medical Help Will I Get If I Am Diagnosed with Dementia?
A diagnosis of dementia may seem devastating for you or in reference to a loved one, but there are a number of treatments for dementia, depending on what type it is and how far it has progressed.
There are several different kinds of dementia; not all dementia is Alzheimer’s. Four of the most common are:
* Vascular dementia
* Dementia with Lewy bodies (DLB)
* Parkinson’s
* Alzheimer’s
Let's look at each type in more detail.
1. Vascular Dementia
Vascular dementia is caused by problems with the blood vessels which supply the brain. It often develops after the person has had a stroke. Stroke can trigger a range of symptoms, from mild impairment to paralysis down one side of the body. Treatment includes medications to:
* Lower blood pressure
* Reduce cholesterol
* Prevent blood from clotting, to keep arteries clear
* Tight blood sugar in the case of diabetes
* Exercise
* A healthy diet
* A healthy weight
* Checking to see that the carotid arteries which supply blood to the brain are clear
2. Dementia with Lewy Bodies (DLB)
Lewy bodies are clumps of a particular protein that can clog the cerebral cortex and affect memory and thinking problems. Sufferers often have trouble sleeping and visual hallucinations.
A number of treatments can help.
* Alzheimer’s medications - Medications for Alzheimer’s (known as cholinesterase inhibitors) such as rivastigmine (Exelon), work by increasing the levels of neurotransmitters in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems.
* Parkinson's disease medications - Medications such as carbidopa-levodopa (Sinemet) may help reduce Parkinsonian symptoms, including as rigid muscles and slow movement.
* Medications to treat other symptoms - Sleeping pills are often prescribed. People with DLB should not be given anti-psychotic medications, as these can worsen behavior and hallucinations.
3. Parkinson's Disease
With Parkinson’s the cells that produce dopamine, an essential neurotransmitter, are damaged. As Parkinson's disease progresses, it often results in dementia similar to dementia with Lewy bodies, or Alzheimer's. The main symptoms are problems with movement, such as slowness, rigidity, and changes in gait and tremor (the shakes).
There are many medications which may be used to treat the various symptoms of the condition:
* Carbidopa-levodopa - This is the most effective Parkinson's disease medication. It is a natural chemical that passes into your brain and is converted to dopamine. However, the effects can vary over time and the patient may eventually develop resistance to it. It can also make them have more tremors.
* Dopamine agonists - These mimic dopamine effects in your brain. They include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (given as a patch, Neupro).
* A short-acting, injectable apomorphine (Apokyn), can be used for quick relief of troublesome symptoms.
* MAO-B inhibitors - These help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO-B). This enzyme metabolizes brain dopamine. Medications include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect).
* Catechol-O-methyltransferase (COMT) inhibitors - Entacapone (Comtan) mildly prolongs the effect of levodopa therapy by blocking an enzyme that breaks down dopamine.
* Anticholinergics - These are used to control tremor, include benztropine (Cogentin) and trihexyphenidyl.
* Amantadine - This is used in cases of mild, early-stage Parkinson's disease and can be used to control tremor.
4. Alzheimer’s
Alzheimer’s is the most severe form of dementia, but new treatments are emerging all the time as a result of patients enrolling in clinical trials and new drugs and strategies being used. For example, a growing body of research has shown that exercise can actually slow the progression of Alzheimer’s and help even those with severe disease so their symptoms don’t worsen.
There are also a number of strategies for dealing with "sundowning", a typical symptom of Alzheimer’s that happens towards the end of each day, usually around dinner time or when the person with Alzheimer’s is supposed to be going to bed. Experts believe it is the result of overtiredness similar to a child having a temper tantrum, and have a number of effective ways to deal with it.
Medications include cholinesterase inhibitors and memantine (Namenda). It can slow the progression of symptoms with moderate to severe Alzheimer's disease.
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