Balance And The Stages Of Alzheimers / Dementia
Balance issues in the early stages of Alzheimers disease is not normal. Someone with Alzheimers typically doesnt experience difficulty staying upright until the later stages, when communication between brain cells has become so compromised that most basic physical actions, including things like swallowing, become harder.
If someone with Alzheimers exhibits trouble with balance in the early stages, this could indicate a rarer form of the disease. Posterior cortical atrophy , also called Bensons Syndrome, is a variant of Alzheimers disease that disrupts the back of the brain, responsible for vision and coordination. PCA can develop earlier in a persons life than typical Alzheimers, usually in the mid-50s or early 60s. The first symptoms are changes in vision, making tasks like reading a line of text more difficult. Spacial awareness, including the ability to judge distances, becomes compromised. Someone with PCA may not be able to tell if objects are moving or not, and distinguishing multiple objects at once can also become too hard. These symptoms may combine to put a person off-balance. About five percent of cases of Alzheimers are PCA.
Can I Keep Driving If I Have Been Diagnosed With Dementia
This is very individual. Usually in the early stages of dementia it is safe to drive. In later stages it is likely that the ability to drive safely will be impaired. If you have been diagnosed with dementia in the UK, you must notify the DVLA. You may be able to continue driving a car or a motorcycle safely for some time, but you may be asked to have a driving test and/or your doctor may be asked to complete a medical report for the DVLA. Driving will then be subject to a medical assessment and will be reviewed each year.
Someone who has been diagnosed with dementia will not be able to continue to drive a bus or a lorry or large goods vehicle.
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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What Other Things Help
In addition to medications, there are various ways to help a person with vascular dementia. Research has shown that physical exercise and maintaining a healthy weight help to enhance brain health and reduce the risk of heart problems, stroke and other diseases that affect blood vessels. A balanced diet, enough sleep and limited alcohol intake are other important ways to promote good brain health and reduce the risk for heart disease. Other illnesses that affect the brain, such as diabetes, high blood pressure and high cholesterol, should also be treated if present.
Memory Loss Risk Factors
Before we break down the different kinds of memory loss, its helpful to go over risk factors. The biggest risk factor is age all older adults are at risk of developing memory issues . Other factors include:
- High blood pressure
- Down syndrome
While meeting one or more of these conditions doesnt mean someone is guaranteed to get dementia, it does indicate theyre at a higher risk .
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How Does Dementia Progress
Typically, symptoms of dementia tend to develop slowly, often over several years. In the early stages of the disease, many people with mild dementia cope with just a small amount of support and care. As the disease progresses more care is usually needed.
In the later stages of dementia, speech may be lost and severe physical problems may develop, including problems with mobility, incontinence and general frailty. This can make people more susceptible to other health problems such as infections. Often, people with dementia die from another health problem such as a severe chest infection. So, the dementia isn’t the cause of their death but has contributed to it.
Some people can live for many years after dementia has been diagnosed. However, the condition does shorten lifespan. On average, once diagnosed with dementia, people are:
- In the mild early stage for one or two years.
- In the moderate stage, needing help looking after themselves for another two or three years.
- In a severe stage by four to five years after diagnosis, being completely dependent on carers and more or less completely inactive.
The average survival after diagnosis is 3-9 years, but people can survive for up to 20 years after being diagnosed with dementia.
How Common Is Dementia
Research shows there are more than 850,000 people in the UK who have dementia. One in 14 people over the age of 65 have dementia, and the condition affects 1 in 6 people over 80.
The number of people with dementia is increasing because people are living longer. It is estimated that by 2025, the number of people with dementia in the UK will be more than 1 million.
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How Is Parkinson Disease Treated
Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.
A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.
Loss Of Mental Ability
Memory problems are usually the most obvious symptom in people with dementia. Forgetfulness is common. As a rule, the most recent events are the first forgotten. For example, a person with early stages of dementia might go to the shops and then cannot remember what they wanted. It is also common to misplace objects.
Early memories stay longest. Events of the past are often remembered well until the dementia is severe. Many people with dementia can talk about their childhood and early life. As dementia progresses, sometimes memory loss for recent events is severe and the person may appear to be living in the past. They may think of themself as young and not recognise their true age.
Someone with dementia may not know common facts when questioned . They may have difficulty remembering names or finding words. They may appear to be asking questions all the time.
Language problems can also develop. For example, someone with dementia may have difficulty understanding what is said to them or understanding written information. Problems with attention and concentration can also occur. It is common for someone with dementia not to be able to settle to anything and this can make them appear restless.
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Different Kinds Of Long
There are several different types of long-term memories stored in your brain. These include:
- Semantic Memory
- Semantic memories are part of the declarative memory and refer specifically to knowing the meaning of words and actions. An example of a semantic memory is understanding what the word “memory” means.
Caregiving In The Early Stages
Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:
- Maintain their independence
- Establish a routine to delay the disease from worsening
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What Is Mixed Dementia
It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.
Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease,vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death .
Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.
Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.
In addition, medical conditions such as stress, anxiety, depression, and delirium can cause serious memory problems that resemble dementia, as can side effects of certain medicines.
Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:
Memory Loss Related To Emotional Problems
Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful and can be mistaken for dementia. For instance, someone who has recently retired or who is coping with the death of a spouse, relative, or friend may feel sad, lonely, worried, or bored. Trying to deal with these life changes leaves some people feeling confused or forgetful.
The confusion and forgetfulness caused by emotions usually are temporary and go away when the feelings fade. Emotional problems can be eased by supportive friends and family, but if these feelings last for more than 2 weeks, it is important to get help from a doctor or counselor. Treatment may include counseling, medication, or both. Being active and learning new skills can also help a person feel better and improve his or her memory.
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Loss Of Daily Life Skills
A home that may not be as well kept as usual may be a sign that the person living there has dementia. They may lose the ability to do many of the things they normally do themselves, such as preparing meals, household chores and eating and drinking properly.
They may also struggle to maintain their personal hygiene and getting dressed. Deciding what to wear, how to put things on and in the right order may become increasingly difficult. Getting around the house without walking into furniture and other items may also be a problem.
Referral To A Specialist
Referral for the opinion of a specialist is usually needed to confirm the diagnosis of dementia. This is usually to one of the following:
- A specialist memory clinic.
- A psychiatrist specialised in looking after older people.
- A specialist in the care of elderly people.
- A neurologist.
The specialist may be able to determine the likely cause of dementia and decide if any specific treatment may be helpful . To help with this, they may suggest further investigations such as a magnetic resonance imaging scan of the brain.
Other more sophisticated tests may be done if an unusual cause of dementia is suspected.
Usually referral is made to a specialist team as early as possible. This is partly so the person developing dementia and their carers can obtain advice about advance planning. In the earlier stages, people are better able to make decisions about how they wish to be cared for. They are also better able to decide who they want to manage their affairs once they become unable to do so themselves.
Special memory clinics give lots of information on dementia and how to manage it. Sometimes before dementia is established, there is an earlier phase called mild cognitive impairment. People with mild memory symptoms are often referred to the specialist clinics, so that they can have information early. This is in case their symptoms get worse and develop into dementia.
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Can Dementia Be Prevented
Some things do show some promise.
Having risk factors for cardiovascular disease can increase your risk of developing all types of dementia. These risk factors include:
- Not doing enough physical activity.
- Being overweight.
- Having diabetes or high blood pressure.
Therefore, it would seem likely that doing something to modify these risk factors may reduce your risk of developing dementia. Stopping smoking, reducing excessive alcohol, and losing weight if you are overweight, for example, may all help to reduce your risk of dementia. Regular physical exercise is advised for all sorts of health benefits, including reducing the risk of dementia. One UK study suggested that a fifth of cases of Alzheimer’s disease might have been related to lack of physical activity. It proposed that regular exercise might have actually prevented some of these cases.
Keeping your brain active may also help to reduce your risk of developing dementia. So, for example, consider reading books, doing puzzles, learning a foreign language, playing a musical instrument, taking up a new hobby, etc.
Many studies are going on to look into treatments which may help to prevent dementia. These include certain blood pressure medicines, omega-3 fatty acids, and brain training exercises, as well as the strategies discussed above. However, there is not yet convincing evidence available for any of these.
Further research is ongoing to try to find other ways of preventing dementia.
Difficulty Completing Normal Tasks
A subtle shift in the ability to complete normal tasks may indicate that someone has early dementia. This usually starts with difficulty doing more complex tasks like balancing a checkbook or playing games that have a lot of rules.
Along with the struggle to complete familiar tasks, they may struggle to learn how to do new things or follow new routines.
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Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
Changes In Behaviour Judgement And Moods
Becoming quiet, withdrawn or restless or frustrated or angry can be early signs of dementia. Someone may develop repetitive behaviour for example, they ask the same question over and over again, do the same thing repeatedly or make multiple phone calls to the same person. They may become insecure and anxious or start hiding and losing items. They may withdraw from social activities or give up hobbies and interests they have enjoyed.
They may show poor judgement, for example putting summer clothes on in cold winter months, not knowing when a kettle is full or overfilling cups when making cold and hot drinks, putting a kettle on the hob or leaving a cooker on or tap running. Someone with dementia may become very emotional and experience rapid mood swings or become quieter and less emotional than usual.
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When To See A Doctor For Memory Loss
Its time to consult a doctor when memory lapses become frequent enough or sufficiently noticeable to concern you or a family member. If you get to that point, make an appointment as soon as possible to talk with your primary physician and have a thorough physical examination. Even if youre not displaying all the necessary symptoms to indicate dementia, now may be a good time to take steps to prevent a small problem becoming a larger one.
Your doctor can assess your personal risk factors, evaluate your symptoms, eliminate reversible causes of memory loss, and help you obtain appropriate care. Early diagnosis can treat reversible causes of memory loss, lessen decline in vascular dementia, or improve the quality of life in Alzheimers or other types of dementia.
Why Dementia Affects Balance
Memory problems and difficulty thinking are the side effects most commonly associated with Alzheimers disease and similar dementias, but loss of balance is a scary issue that caregivers should be prepared for, especially in later stages.
In earlier stages, or even before other dementia symptoms develop, losing balance while standing or walking can indicate an increased potential to develop Alzheimers. It may also be a sign that your loved one is suffering from a kind of dementia other than Alzheimers, like vascular dementia.
The part of the brain that controls body movements is the cerebellum, located near the back base of the skull. Diseases that affect the cerebellum are likely to affect balance, and certain types of dementia fit the bill. Vascular dementia, for instance, is different from Alzheimers disease because the illness is caused by a lack of blood flow carrying oxygen to the cerebellum. Some people with vascular dementia will actually experience feelings of vertigo before they have trouble with thinking and memory.
There is also a specific kind of Alzheimers, called posterior cortical atrophy, which targets the cerebellum and, as a result, affects balance. People with posterior cortical atrophy can lose their sense of knowing which direction is up, are more prone to dizziness, and may be frequently leaning to one side.
Did You Know?
Medications that Impact Balance
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