Monday 17 September 2018
Dementia is the term given to a group of diseases that affect a persons thinking, behaviour and ability to perform everyday tasks. While its commonly thought of as an older persons disease, dementia can affect people of all ages.
Early symptoms of dementia can be vague and vary between people. While some people pick up on changes in their own thinking or behaviour that might be caused by dementia, sometimes these signs are first noticed by those around them.
If youve noticed a change in someone close to you, the steps below can help you assist them in seeking diagnosis and treatment.
Stage 4: 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At this stage, individuals may start to become socially withdrawn and show changes in personality and mood.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:
- Decreased knowledge of current and/or recent events
- Difficulty remembering things about one’s personal history
- Decreased ability to handle finances, arrange travel plans, etc.
- Disorientation
- 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.
Medical Conditions That Can Mimic Dementia
While memory loss is a common symptom of many kinds of dementia, changes in memory alone do not mean that a person has dementia. Doctors will diagnose an individual with dementia only if two or more brain functionssuch as memory and language skillsare significantly impaired. Some of the diseases that can cause symptoms of dementia are Alzheimers disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntingtons disease and Creutzfeldt-Jakob disease.
Doctors have identified other conditions that can cause dementia or dementia-like symptoms, including reactions to medications, normal pressure hydrocephalus, metabolic problems and endocrine abnormalities, nutritional deficiencies, urinary tract infections, brain tumors, anoxia or hypoxia , and heart and lung problems.
What Diagnosis Falls Under Alzheimer’s Disease
Alzheimers disease is a diagnosis in itself. When it is noticeable clinically and identified early on, the formal diagnosis may be Mild Cognitive Impairment due to Alzheimers disease which may later develop into a diagnosis of dementia due to Alzheimers disease.
How Can I Support Someone With Dementia Towards The End Of Life
Knowing the person will make it easier to provide person-centred care that is focused on what they need and want. It can help to know about their likes, dislikes and their wishes for how they want to be cared for. If the person isnt able to tell you about themselves, speak to their family, friends or other people who know them well.
Its a good idea to find out if the person has a copy of This is me , a document that records information about themselves. If you cant speak to the person, ask those close to them if they have a copy. They may have these details recorded in their care plan.
There are many ways to support someone with dementia at the end of life.
What Are The Symptoms
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages.
A person with dementia will often have cognitive symptoms . They will often have problems with some of the following:
- Day-to-day memory difficulty recalling events that happened recently.
- Repetition repeating the same question or conversation frequently in a short space of time.
- Concentrating, planning or organising difficulties making decisions, solving problems or carrying out a sequence of tasks .
- Language difficulties following a conversation or finding the right word for something.
- Visuospatial skills – problems judging distances and seeing objects in three dimensions.
- Orientation – losing track of the day or date, or becoming confused about where they are.
Some people have other symptoms including movement problems, hallucinations or behaviour changes.
Why Would Anyone Want An Early Alzheimers Diagnosis
The SAGE test is useful because it helps you understand if your concerns are something to be worried about.
If the results seem to indicate that there could be a problem, you might think theres no point in talking with the doctor because theres no cure for dementia.
The most important is that a treatable condition could be the cause of cognitive impairment. Finding out sooner means getting treatment ASAP to eliminate the cognitive symptoms.
If the cognitive impairment is caused by Alzheimers or dementia, a major benefit is that starting treatment early is far more effective in managing symptoms and delaying progression of the disease.
Be Aware Of Their Eating And Drinking
The person may have lost their appetite or have difficulties swallowing safely. In the last days, the person may stop eating or drinking. This can be very distressing to watch, but it is normal for people approaching the end of life.
You should offer the person food and drink for as long as it is safe and they show an interest. Its important to keep the persons mouth comfortable provide sips of fluids and keep lips moist and clean.
Stage 2: Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Is Dementia A Mental Illness
Dementia is a mental health disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders. In 2013, the American Psychiatric Association changed the name to Major Neurocognitive Disorder, which is a mouthful. The change was made in order to provide a clearer description of the problem. Whats most important to know is that dementias can involve changes to emotions, behaviors, perceptions, and movements in addition to memory and thinking.
What Is Dementia And What Causes It
Dementia is a syndrome that causes a person to develop difficulty and problems with their memory or their ability to think. Unlike the normal changes that happen in a persons memory and thinking over time, dementia affects someones ability to function in their daily life activities and their normal routine .There are different causes of dementia. These causes are typically underlying neurological conditions . One common cause of dementia is Alzheimers disease. Other causes include diseases that impact brain blood vessels. For example, strokes may cause what is commonly termed Vascular Dementia. Some causes include Lewy Body Disease and Parkinsons disease.
Struggling To Adapt To Change
For someone in the early stages of dementia, the experience can cause fear. Suddenly, they cant remember people they know or follow what others are saying. They cant remember why they went to the store, and they get lost on the way home.
Because of this, they might crave routine and be afraid to try new experiences. Difficulty adapting to change is also a typical symptom of early dementia.
At What Age Can You Test Someone For The Signs Of Dementia
There is no one particular age that someone must meet before they can be assessed for signs of dementia, although dementia is more common in people over 65. Early-onset dementia can begin in people who are in their 30s, 40s, and 50s. Diagnosing dementia in its early stages is important as early treatment can slow the progression of symptoms and help to maintain mental functions.
Who Is This Dementia Quiz For
Below is a list of 10 questions designed for people who are concerned about memory loss. The questions relate to life experiences common among people who have been diagnosed with dementia, a neurocognitive disorder, and are based on criteria in the DSM-5 .
Please read each question carefully, and indicate how often you have experienced the same or similar challenges in the past few months.
Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
The Start Of The Dying Process
As someones condition worsens and they get to within a few days or hours of dying, further changes are common. The person will often:
- deteriorate more quickly than before
- lose consciousness
- develop an irregular breathing pattern
- have cold hands and feet.
These changes are part of the dying process. Healthcare professionals can explain these changes so you understand what is happening. The person is often unaware of what is happening, and they should not be in pain or distress.
Medication can be used to treat the persons symptoms. If the person cant swallow, there are other ways of providing this, such as medication patches on the skin, small injections or syringe drivers . Speak to a GP or another health professional about this.
Need help finding dementia information?
Find the information and support you’re looking for with our free online tool.
Rapid And Unexplained Mood Swings And/or Depression
This is different to: more typical age-related behaviours such as becoming irritable when a routine is disrupted.
Mood and personality changes can be associated with early signs of dementia. This could include becoming confused, suspicious, depressed, fearful or anxious, and your parent may find themselves getting easily upset in places they feel unsure about. Some of the dementia symptoms NHS lists include:
- Increased anxiety
- Depression
- Violent mood swings
For example, your parent may appear calm, then visibly upset, and then very angry in a matter of minutes. This is a significant sign of dementia anger and frustration specifically if its unprovoked.
Other physical signs include pacing, obsessing over minor details, agitation, fear, confusion, rage and feeling overwhelmed because theyre trying to make sense of a world thats now confusing to them.
Provide Support For Family And Friends
Keep any family or friends informed about what is happening in a gentle, sensitive and supportive way. This will help reassure them that the person is getting the care they need. You could consider signposting them to appropriate services, such as an Admiral Nurse or local Alzheimers Society. It can also help to give them an opportunity to talk about what is happening.
Early Signs Of Dementia And How To Spot Them
Spotting the early signs of Dementia can make all the difference to the progression of the disease. If it is diagnosed during the early stages there is a chance that medication will slow down the diseases that cause the damage to the brain.
Weve put together this guide to the early signs of dementia for you to look out for, and some specific symptoms you can monitor. Please use the links below to navigate the article:
Why Do Dementia Patients Stop Talking
There are many signs that can tell you death is near for a dementia payment. Even though you may be prepared for the end, it is never easy. The ten signs that death is near include:
Frequently Asked Questions About Dementia Symptoms
My dad seems to be tired all the time lately how do I know the difference between age-related changes and dementia symptoms?
Sleep disruption is common with regards to both age-related sleep patterns and signs of early onset dementia so it can be tricky to work out whats going on. But if you look out for accompanying symptoms specific to dementia you may be able to tell the difference. If you suspect it is more than just sleepiness make an appointment with your parents GP.For more information on how dementia symptoms can affect sleep please read our article on dementia and sleep.
What do I do if I think my mum or dad has dementia?
The GP should be the first point of call if you suspect your parent is suffering from signs of early onset dementia. If the doctor suspects your parent has dementia they will refer them to a memory clinic or specialist. For further details on the process please visit our guide on diagnosing dementia.
How does the dementia diagnosis process work?How are dementia symptoms treated?
Unfortunately, dementia cant be cured but it can be slowed down significantly, especially if diagnosed earlier on. For more details on drugs used, visit our guide on dementia treatment.
Discuss Test Results With A Doctor
Dont assume that the test results are equal to a diagnosis of any kind.
The SAGE test is a screening tool that helps doctors detect early signs of cognitive impairment that are typically not noticeable during a normal office visit.
When the test is repeated over time, doctors can watch for changes in cognitive ability. Being able to measure changes helps them detect and treat health conditions early.
Thats why its important to bring the completed test to the doctor to have it reviewed. If there are signs of cognitive impairment, they may recommend further testing.
What Are The Main Types Of Dementia
Alzheimers disease is the most common cause of dementia, accounting for around 2 out of every 3 of cases in older people. Vascular dementia is another common form, while dementia with Lewy bodies and frontotemporal dementia are less common.
It is possible to have more than one type of dementia at the same time. Alzheimers is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called mixed dementia.
The symptoms of dementia vary depending on the disease, or diseases, causing it. You can read more about the symptoms associated with different types of dementia on the Alzheimers Society website .
Putting Things In The Wrong Place
This is different to: more normal age-related behaviours such as losing things but being able to retrace the steps to find them.
Losing things or putting things in strange places, and then being unable to retrace steps to find them again, is on the official observation list for early signs of dementia.
Sometimes someone else might be accused of stealing which may occur more frequently over time. For example, your dad may insist that a friend keeps stealing his money, whereas its in its regular hiding place.
Other examples that may indicate potential dementia symptoms could include:
- Teabags in the fridge and leaving the milk out
- Toothbrush in the washing basket
- Remote control in the cutlery drawer
- Dirty laundry in the dishwasher
Misplacing or losing items is more common in Alzheimers Disease, rather than vascular dementia. Find out more about the different types of dementia.
Can Dementia Suddenly Get Worse
The progression of dementia depends on the underlying disease. Some diseases have a rapid progression. Others progress more slowly. Any sudden change with either slow or rapid progression should be evaluated for another cause. In most cases, changes with dementia may seem like they came out of the blue when they actually may have been slowly developing in the background. The best way to prepare for changes and manage expectations is through information. Your doctor and medical team will be a valuable resource. There are a variety of educational resources that are also available through the Alzheimer’s Association.
Talking To Others About Your Diagnosis
While support from family and friends is crucial, choosing who to tell about your diagnosis is always a very personal decision. You may want to share it with just your closest family first, for example, then with a wider group of friends and acquaintances later. Whatever you decide is right for you, its important not to try to go it alone and deny people who care about you the chance to provide support.
Its also important to be prepared for a broad spectrum of reactions. Just as you may have felt a combination of shock, anger, grief, and despair at news of your diagnosis, people close to you may have similar reactions. Remember: you dont have to cover everything all at once. Your first conversation with loved ones is likely to be just the start of an ongoing dialogue as you all learn more about the disease and the challenges youll be facing in the future.
You may find that one of the hardest things about being diagnosed with dementia is the impact it can have on your relationships. As your independence declines, you may become more reliant on your spouse, children, or friends. You may lose your role as provider, financial decision-maker, or designated driver as others take over those responsibilities. Some older friends may even pull away, your diagnosis raising uncomfortable questions about their own health.
When communicating with loved ones:
Resistance To Visiting A Doctor
Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else deny, there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate one’s memory problems. Others, with retained insight, may be afraid of having their fears confirmed.
Dealing with resistance to visiting the doctor
One of the most effective ways to overcome this problem is to find a physical reason for a visit to the doctor, preferably a check-up for a symptom that the person is willing to acknowledge, such as headaches or failing eyesight. Perhaps suggest an examination of the heart, a test for blood pressure or diabetes, or a review of long term medication. Another way is to suggest that it is time for you BOTH to have a physical check up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. Calm, caring attitude at this time can help overcome the person’s very real worries and fears.
If the person will not visit the doctor:
- Talk with other carers who may have had to deal with similar situations
- Contact the Aged Care Assessment Team
How To Diagnose Alzheimers Vs Dementia
Alzheimers is a progressive and fatal brain disorder. Dementia is not a specific disease, but an umbrella term that defines a syndrome and used to refer to a specific group of symptoms related to a decline in mental ability. Alzheimers is one of the most common causes of dementia. Both Alzheimers and dementia are diagnosed using a variety of different assessments and tests, including a physical exam, lab tests, cognitive and neuropsychological tests, and an analysis of changes in behavior.
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What Are The Early Signs Of Dementia
The onset of dementia is not obvious because the early signs can be vague and quite subtle. The early symptoms usually depend on the kind of dementia that one has and therefore can vary greatly from one person to the next.
Even though the signs can vary, there are some that are quite common and they include:
- Depression, apathy, and withdrawal
- Memory issues, especially when it comes to the most recent events
- Inability to handle the everyday tasks
At times, it is easy to miss to appreciate that the above symptoms could be an indication of something that is not right. Yet there are those who assume that the signs are normal and are associated with aging. It is also possible for one to develop the symptoms in a gradual manner and they may go unnoticed for quite some time.
People may not act even when they can tell that something is definitely wrong. It is important to have a checklist of all signs related to dementia and get the person the needed help when several of such signs are observed. It is important to get a more detailed assessment.
Memory loss and dementia: while it is normal to forget some things and remember later, persons with dementia tend to forget more frequently and they do not remember later.
Tasks: distractions can happen and you may forget to, say, serve one part of the family meal. For a person that has dementia, preparing the meal could be problematic and they may actually forget some of the steps that are involved.
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!