Studies Showing A Significant Decline In Cognition Over Time
In a re-evaluation of the IOWA 500 study of a cohort of people with hebephrenic or catatonic schizophrenia followed up for 40 years, Reference Winokur, Pfohl, Tsuang, Miller and CohenWinokur et al found that the subgroup of older participants was significantly more likely to have worsened orientation and memory.
Can Dementia Be Prevented
Although dementia cannot be prevented, living a health-focused life might influence risk factors for certain types of dementia. Keeping blood vessels clear of cholesterol buildup, maintaining normal blood pressure, controlling blood sugar, staying at a healthy weight basically, staying as healthy as one can can keep the brain fueled with the oxygen and nutrients it needs to function at its highest possible level. Specific healthful steps you can take include:
- Follow a Mediterranean diet, which is one filled with whole grains, vegetables, fruits, fish and shellfish, nuts, beans, olive oil and only limited amounts of red meats.
- Exercise. Get at least 30 minutes of exercise most days of the week.
- Keep your brain engaged. Solve puzzles, play word games, and try other mentally stimulating activities. These activities may delay the start of dementia.
- Stay socially active. Interact with people discuss current events keep your mind, heart, and soul engaged.
What Are The Symptoms Of Dementia
Early symptoms of dementia include :
- Forgetting recent events or information
- Repeating comments or questions over a very short period of time
- Misplacing commonly used items or placing them in usual spots
- Not knowing the date or time
- Having difficulty coming up with the right words
- Experiencing a change in mood, behavior or interests
Signs that dementia is getting worse include:
- Ability to remember and make decisions further declines
- Talking and finding the right words becomes more difficult
- Daily complex tasks, such as brushing teeth, making a cup of coffee, working a tv remote, cooking, and paying bills become more challenging
- Rational thinking and behavior and ability to problem solve lessen
- Sleeping pattern change
- Anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression increase
- More help with activities of daily living grooming, toileting, bathing, eating is needed
- Hallucinations may develop
The symptoms mentioned above are general symptoms of dementia. Each person diagnosed with dementia has different symptoms, depending on what area of the brain is damaged. Additional symptoms and/or unique symptoms occur with specific types of dementia.
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Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
How Is Parkinson Disease Diagnosed
Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinson’s disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.
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Studies Showing A Lesser Decline In Cognition
An early study of older in-patients with schizophrenia demonstrated that cognitive changes were very slow over time, despite low MMSE scores at initial assessment. The authors concluded that cognitive functioning in older people with schizophrenia is different from that seen in Alzheimers disease.
Reference Heaton, Paulsen and McAdamsHeaton et al compared three groups of people with schizophrenia with ambulatory patients with Alzheimers disease and normal controls. They concluded that cognitive impairment in schizophrenia is unrelated to current age, age at onset or duration of illness. They also suggested that there is an encephalopathy associated with schizophrenia that is non-progressive and that has a different pattern of deficits from that seen in Alzheimers disease.
What Are Potentially Treatable Causes Of Dementia
The dementia in treatable conditions may be reversible or partially reversible, even if the underlying disease or damage is not. However, readers should note that if underlying brain damage is extensive or severe, these causes may be classified as irreversible by the individual’s physician.
There is no specific test for dementia. However, dementia may be diagnosed if at least two of the following core mental functions are significantly impaired, according to some researchers:
- Attentiveness/focus on a problem or subject
- Visual perception
In some people, the signs and symptoms of dementia are easily recognized in others, they can be very subtle. A careful and thorough evaluation is needed to identify their true cause.
An assessment of dementia symptoms should include a mental status evaluation. This evaluation uses various “pencil and paper,””talking,” and physical tests to identify brain dysfunction. A more thorough type of testing, performed by a psychologist, is called neuropsychologic testing.
Lab tests may be used to identify or rule out possible causes of dementia.
In some cases, imaging studies of the brain may be necessary to detect conditions such as normal pressure hydrocephalus, brain tumor, or infarction or bleeding in the brain.
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Can Dementia Be Diagnosed During A Single Visit
So can dementia be diagnosed during a single visit? As you can see from above, it depends on how much information is easily available at that visit. It also depends on the symptoms and circumstances of the older adult being evaluated.
Memory clinics are more likely to provide a diagnosis during the visit, or shortly afterwards. Thats because they usually request a lot of relevant medical information ahead of time, send the patient for tests if needed, and interview the patient and informers extensively during the visit.
But in the primary care setting, and in my own geriatric consultations, I find that clinicians need more than one visit to diagnose dementia or probable dementia. Thats because we usually need to order tests, request past medical records for review, and gather more information from the people who know the senior being evaluated. Its a bit like a detectives investigation!
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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Managing Alzheimer’s Disease Behavior
Common behavioral symptoms of Alzheimers include sleeplessness, wandering, agitation, anxiety, and aggression. Scientists are learning why these symptoms occur and are studying new treatments drug and nondrug to manage them. Research has shown that treating behavioral symptoms can make people with Alzheimers more comfortable and makes things easier for caregivers.
Having A Hard Time Managing Money
One of the classic early signs of Alzheimers disease is an increasing difficulty with money management. This might start off as having trouble balancing a checkbook or keeping up with expenses or bills, but as the disease progresses, poor financial decisions are often made across the board. Though many people brush this symptom off as just a normal part of aging, they shouldnt. We tend to associate aging with losing your mind. Thats not healthy aging its a disease, emphasizes Rankin.
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What Are The 7 Stages Of Dementia
Dementia does not affect every person in the same way. It presents itself differently in each individual and progresses at different rates. Some people will stay in a state of mild decline for an extended period, while others may develop multiple symptoms quickly. Understanding the seven stages of dementia can make these transitions a little easier for your loved one and you as their caregiver.
Signs And Symptoms Of Dementia
As we age, many of us experience lapses in memory. It can be worrying and confusing to realize that something you once took for granted isnt working as well as it used to. But not all memory changes indicate dementiaand dementia impacts more than just memory. Symptoms can also affect visual and spatial skills, executive functioning, language, and mood or personality. To meet the diagnostic criteria for dementia, youd need to experience difficulties in at least one of those areas in addition to memory loss.
Common signs and symptoms include:
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What Increases The Risk For Dementia
- AgeThe strongest known risk factor for dementia is increasing age, with most cases affecting those of 65 years and older
- Family historyThose who have parents or siblings with dementia are more likely to develop dementia themselves.
- Race/ethnicityOlder African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.
- Poor heart healthHigh blood pressure, high cholesterol, and smoking increase the risk of dementia if not treated properly.
- Traumatic brain injuryHead injuries can increase the risk of dementia, especially if they are severe or occur repeatedly.
How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
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Impact On Families And Carers
In 2019, informal carers spent on average 5 hours per day providing care for people living with dementia. This can be overwhelming . Physical, emotional and financial pressures can cause great stress to families and carers, and support is required from the health, social, financial and legal systems. Fifty percent of the global cost of dementia is attributed to informal care.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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Support For Families And Alzheimer’s Disease Caregivers
Caring for a person with Alzheimers can have significant physical, emotional, and financial costs. The demands of day-to-day care, changes in family roles, and decisions about placement in a care facility can be difficult. NIA supports efforts to evaluate programs, strategies, approaches, and other research to improve the quality of care and life for those living with dementia and their caregivers.
Becoming well-informed about the disease is one important long-term strategy. Programs that teach families about the various stages of Alzheimers and about ways to deal with difficult behaviors and other caregiving challenges can help.
Good coping skills, a strong support network, and respite care are other things that may help caregivers handle the stress of caring for a loved one with Alzheimers. For example, staying physically active provides physical and emotional benefits.
Some caregivers have found that joining a support group is a critical lifeline. These support groups enable caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. Many organizations sponsor in-person and online support groups, including groups for people with early-stage Alzheimers and their families.
Read about this topic in Spanish. Lea sobre este tema en español.
Difficulty Forming The Words To Speak
When people who used to be fluent and could speak smoothly stop being able to produce language that way, this may be a sign of dementia, says Rankin. Despite this symptom, patients are often crystal clear in other areas. They can run a business, manage their family, or draw beautifully, but they have increased difficulty actually forming the words to speak.
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Staring With Reduced Gaze And Trouble Reading
Reduced gaze is the clinical term for the dementia symptom that alters peoples ability to move their eyes normally. We all move our eyes and track with them frequently, says Rankin. But people showing early signs of dementia look like theyre staring a lot. Rankin adds that, they try to read and they skip lines. This is one of the signs of dementia that the patient might not completely be aware of, although people around them probably will be.
Can Dementia Cause Aggressive Behaviour
As a persons dementia progresses, they may sometimes behave in ways that are physically or verbally aggressive.
This can be very distressing for the person and for those around them. Looking at what causes this behaviour and being aware of the persons needs can help to reduce this behaviour or make it easier to manage.
- verbal for example, swearing, screaming, shouting or making threats
- physical for example, hitting, pinching, scratching, hair-pulling, biting or throwing things.
Some people assume that aggressive behaviour is a symptom of dementia itself. This can be true, but its more likely that there is another cause. Its important to see beyond the behaviour and think about what may be causing it. Reasons for the persons behaviour could include:
- difficulties to do with dementia for example, memory loss, language or orientation problems
- their mental and physical health for example, they may have pain or discomfort that they are unable to communicate
- the amount and type of contact they have with another person or other people
- their physical surroundings for example, if the room is too dark the person may become confused and distressed because they cant work out where they are
- a sense of being out of control, frustration with the way others are behaving, or a feeling that theyre not being listened to or understood
- frustration and confusion at not being able to do things, or at not being able to make sense of what is happening around them.
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Symptoms Specific To Frontotemporal Dementia
Although Alzheimer’s disease is still the most common type of dementia in people under 65, a higher percentage of people in this age group may develop frontotemporal dementia than older people. Most cases are diagnosed in people aged 45-65.
Early symptoms of frontotemporal dementia may include:
- personality changes reduced sensitivity to others’ feelings, making people seem cold and unfeeling
- lack of social awareness making inappropriate jokes or showing a lack of tact, though some people may become very withdrawn and apathetic
- language problems difficulty finding the right words or understanding them
- becoming obsessive such as developing fads for unusual foods, overeating and drinking
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Research Into Other Causes Of Dementia
Dementia is also associated with other conditions such as AIDS, Creutzfeld-Jakob disease, chronic alcohol abuse, Down Syndrome, Huntingtons disease and Parkinsons disease.
- A genetic component has been found for a very rare subtype of Creutzfeld-Jakob disease.
- Individuals with Down Syndrome have an extra copy of chromosome 21, which contains the gene for the Amyloid Precursor Protein, increasing their likelihood of developing Alzheimers disease.
- Huntingtons disease is caused by a mutation in the gene that codes for the huntingtin protein. Everyone who inherits the mutated version of this gene will eventually develop the disease. Dementia occurs in the majority of cases.
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Stage : No Impairment
Research now reveals that AD begins years, if not decades, before the onset of noticeable symptoms. Genetic research and much more sophisticated medical science will no doubt make this an important and focused area of study as we march into the future, searching for a cure. But, for now, most of us will never know if we are in the earliest stages of the disease. Unfortunately, doctors can only diagnose probable AD once symptoms begin to manifest. In fact, a definitive diagnosis can only be made through the post-mortem examination of brain tissue.
What Causes Aggressive Behaviour In People With Dementia
As human beings, we all have the same basic needs. These include physical, psychological and social needs. We do things consciously and unconsciously to meet these needs. The symptoms of dementia can make it more difficult for someone to do this.
For example, people with dementia can find it hard to understand whats going on around them. This can be confusing and frightening for them. It is likely that they are trying to stop feeling distressed and to feel calmer again. For example, if someone they do not know well or who they no longer recognise is trying to help them undress, they may feel threatened and try to push the person away. Aggressive behaviour may be:
- caused by the person feeling agitated because of a need that isnt being met
- the persons attempt to meet a need
- the persons attempt to communicate a specific need to others .
See below for examples of how different types of needs may cause a person with dementia to act aggressively.
Consider whether they may benefit from psychological therapies with professionals, such as cognitive stimulation therapy or counselling.
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