Different Types Of Dementia
Neurodegenerative disorders can lead to dementia which is the progressive and irreversible loss of neurons. There is no definitive cure for these disorders. The relatable disorders are called:
- Alzheimers disease – is a progressive disorder associated with tangling and accumulation of certain proteins leading to deteriorated cognitive abilities.
- Frontotemporal disorders – It is collective damage to frontal and temporal lobes of the brain that leads to brain atrophy due to neuron death.
- Lewy body dementia – it is associated with abnormal protein deposition namely alpha-synuclein and Lewy bodies. It’s the commonest dementia interfering with the production of brain signaling molecules.
- Vascular cognitive dementia – VCID arises from stroke and vascular injuries of the brain that affect memory and thinking. Cognitive function affected is directly proportional to the amount of damage taken place.
- Mixed dementia – It’s a combined effect of dementia adjoining two different types like people can have both Alzheimer’s disease and vascular dementia at the same time. It’s the most common form of dementia in elderly people.
Tests For Definitive Diagnosis Of Dementia
The following tests are made for definitive diagnosis of dementia:
- Cognitive tests: Assessing memory through different tests. Check for problem-solving and language skills. Certain personality tests are made like the Myers Brigg Type Indicator.
- Laboratory Tests: Test for different levels of hormones in the persons body. These especially include the concentration of thyroid hormones and Vitamin B12.
- Brain Scans: These are assessments of other clinical conditions like stroke and tumors. These are ascertained through CT scan which is X-ray imaging of the brain and related organs, MRI which is getting the detailed imaging of the brain structures and its tissues and PET which gives precise detail of brain activity.
- Psychiatric evaluation: It will determine depression and other mental health conditions taking part in the unprogressive mental health condition of the patient suffering from dementia.
- Genetic Tests: These are detrimental diagnoses of defective genes existing within the persons genome.
How Long Should You Spend In The Sun To Get Enough Vitamin D
Finding out how long to stay in the sun in order to produce enough amounts of vitamin D can be very tricky and is different for every person, hence there isnt one recommendation for everyone.
The reason for that is that the amount of time you need to spend in the sun for your skin to make enough vitamin D depends on a number of factors, such as how dark your skin is or how easily you get sunburnt, the thickness of the ozone layer, the time of the year and what time of day it is.
It is believed that short daily period of sun exposure without sunscreen during the summer months is enough for most people to make enough vitamin D.
Evidence suggests that the most effective time of day for vitamin D production is between 11am and 3pm. The larger the area of skin that is exposed to sunlight, the more chance there is of making enough vitamin D before you start to burn.
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Low Vitamin D And Its Association With Cognitive Impairment And Dementia
1College of Applied Medical Sciences, Umm Al-Qura University, Abdiya, Makkah, Saudi Arabia
2. Vitamin D and Brain-Evidence through Animal Studies
Developmental vitamin D deficiency and inactivated vitamin D receptor gene affect brain functioning and behavioral outcome in rodents. The studies which support this hypothesis were conducted on mice with prenatal deficiency of vitamin D and vitamin D knock-out mice. Rats born to vitamin D3-deficient mothers demonstrated a reduction in the nerve growth factor and glial-derived neurotrophic factor compared to control rats . Similarly, a study on 10-week-old rats with transient vitamin D deficiency during the early developmental stage demonstrated enlarged lateral ventricle volume and reduced nerve growth factor compared to controls . The evidence concerning the impact of vitamin D deficiency on the behavior of mice which developed later in life is sparse. However, a study investigating the effect of vitamin D-deficient diet for 10 weeks on 20-week-old mice reported behavioral and neurochemical changes . Similarly, another study reported a subtle effect on attentional tasks in 1620-week-old rats with a vitamin D-deficient diet given for 10 weeks compared to control rats .
2.1. Evidence through Cross-Sectional and Longitudinal Studies
2.2. Evidence through Meta-Analysis and Systematic Review
2.3. Vitamin D Supplementation and Cognition
Comparative Analyses Between Serum Folate And Vitamin B12 Levels With Demographic And Cognitive Characteristics
Of all participants, 151 had vitamin B12 deficiency , however there were no statistically significant differences between those in the vitamin B12 deficiency group and those in the normal B12 group in any of the groups . A total of 12 participants had folic acid deficiency in the cohort . Given the small number of participants with folic acid deficiencies, comparisons between groups were not possible.
Table 5. Demographic, clinical, and cognitive characteristics of participants with normal levels of vitamin B12 and vitamin B12 deficiency*.
Table 6. Odds ratio for the prevalence of cognitive impairment by quintiles of serum folic acid and vitamin B12 concentrations. Instituto Peruano de Neurociencias, 20142020.
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Dementia From Nutritional Deficiencies
Eating an imbalanced diet can lead to a plethora of health-related problems, but few realize that certain nutritional deficiencies can lead to the onset and development of dementia.
If you have begun to notice cognitive changes in a friend or family member, it may be worth investigating whether they are eating a nutritionally complete diet.
Assessment Of Cognitive Function
The main outcome of the current study was cognitive function, which was measured using the Chinese version of the Wechsler Adult Intelligence Scale-Revised . The WAIS-RC includes 11 sub-tests: Information, Similarities, Vocabulary, Comprehension, Arithmetic, Digit Span, Block Design, Picture Completion, Digit Symbol-Coding, Object Assembly, and Picture Arrangement. The neuropsychological assessments were administered by trained physicians at the baseline assessment and at the six- and twelve-month time points during treatment. We used age-appropriate norms from the Chinese standardization to calculate the intelligence quotient and index scores.
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Signs And Symptoms Of Nutritional Deficiencies
A poor diet lacking in B vitamins will carry a host of signs and symptoms, even before the cognitive impact begins to take hold. Individuals lacking in sufficient intake of B vitamins may notice:
- Anemia with promegaloblastosis of bone marrow, as a repercussion of inadequate DNA synthesis
- Gastrointestinal difficulties
- Sensorimotor deficiencies
- Deteriorated perception of pressure, vibration and deep touch, eventually leading to a numbed sense of touch
- Poor muscle-tendon reflexes
Dehydration can be indicated by:
- Dryness or stickiness in the mouth
- Unusual tiredness
If the nutritional deficiencies become severe enough or are chronic, a patient may begin to show signs of dementia such as memory loss, difficulty with language, a change in personality or behavior and mild confusion.
Its Not Necessarily Alzheimers
More than 50 conditions can cause or mimic the symptoms of dementia, and a small percentage of dementias are reversible. Two common examples are dementia caused by vitamin B12 deficiency or an underactive thyroid . Getting the right diagnosis is important so that you know what options you have, because symptoms subside when the underlying problem is treated.
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Assessment Of Methodologic Quality
Five domains were used to assess study quality: population, outcome, exposure, statistical analysis, and the specific domain of randomization for RCT studies. Key elements for these domains were adapted for assessing quality of diagnostic tests, from the Newcastle-Ottawa quality assessment scales for case-control and cohort studies,14 the Jadad scale15 for RCT studies, and the Quality Assessment of Diagnostic Accuracy Studies for diagnostic accuracy studies.16 Each quality item was rated as met, unmet, or unclear. For the item missing data reported, the rating of not applicable was given if there were no missing data. An overall quality score was not calculated.
Ratings Of Quality Of Evidence
We graded the quality of the available evidence in a four-part hierarchy according to the GRADE scheme . GRADE assesses the quality of evidence using four grades: high, moderate, low, and very low . Observational studies always start with a rating of low quality of evidence because of the risk of residual confounding but can be upgraded for large treatment effects, dose effect gradients, or if apparent confounding would reduce the observed effect . Criteria for downgrading the quality of evidence are risk of bias , imprecision , inconsistency , indirectness , and publication bias . We dually evaluated the overall quality of evidence for each outcome viewed as critical for decision-making by the scientific expert panel. We reconciled all disagreements in grades through consensus discussion.
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What Is Vitamin D And Why Its So Important
Vitamin D is important for a good overall health and it plays an important role in making sure our muscles, heart, lungs and brain function well.
Vitamin D is required for strong immune system. Scientific review of 25 randomized controlled studies published in the BMJ concluded that vitamin D supplementation boosts immunity and cuts rates of cold and flu.
Our body can make its own vitamin D from sunlight but many people have low levels during winter.
You can also get vitamin D from supplements, and a very small amount comes from a few foods you eat, such as some fish, fish liver oils, egg yolks and in fortified dairy, cereals and grain products.
What makes vitamin D unique compared to other vitamins is that your body can make its own vitamin D when you expose your skin to sunlight, whereas you need to get other vitamins from the foods you eat.
How Does One Differentiate Pseudodementia And Dementia
Initially by assessing the patient for symptoms of depression. Major depression is commonly associated with cognitive difficulties , and many patients in the early stages of dementia become depressed. The differentiation of pseudodementia from true dementia can be a clinical challenge. Clues that depression is the cause of cognitive difficulties include decline over weeks to months rather than years and whether the patient has overt concern for the memory loss. Referral for complete neuropsychological testing can be helpful in elucidating the diagnosis in many cases. Treatment with antidepressants will significantly improve cognitive function in patients with pseudodementia, whereas truly demented patients may see improvements in overall function but will continue to have cognitive impairment.
Rachelle Doody MD, PhD, in, 2010
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What Are The Types Of Dementia
Dementias are often broken down into two main categories — Alzheimer type or non-Alzheimer type. Dementias of the Alzheimers disease type are defined by the symptoms of memory loss plus impairment in other brain functions, such as language function inability to move the muscles associated with speech or perception, visual or other inabilities to recognize speech or name objects .
Non-Alzheimer dementias include the frontotemporal lobar degenerations, which are further broken down into two main types. One type primarily affects speech. An example is primary progressive aphasia syndromes. The other type is defined by changes in behavior, including lack of feeling, emotion, interest or concern loss of a social filter personality change and loss of executive functions . In both of these frontotemporal lobe dementias, memory loss is relatively mild until later in the course of the disease.
Other non-Alzheimers disease dementias include vascular disorders , dementia with Lewy bodies, Parkinson’s dementia, and normal pressure hydrocephalus.
How Is Dementia Diagnosed
Confirming the diagnosis of dementia can be difficult due to the many diseases and conditions that cause it as well as because its symptoms are common to many other illnesses. However, doctors are able to make the diagnosis based on the results of personal medical history, review of current symptoms, neurological and cognitive tests, laboratory tests, imaging tests and by interacting with the patient.
Current general symptoms that would indicate dementia are, by definition, a decline in such mental functions as memory, thinking, reasoning, personality, mood or behavior that are severe enough to interfere with the ability to accomplish everyday tasks. Patients undergo mental function testing to identify problems in these areas. Interviews with family members and/or close friends who may have noticed changes in these areas are helpful as well.
Laboratory tests rule out other diseases and conditions as the cause of dementia, such as thyroid problems and vitamin B12 deficiency. Similarly, brain scans can look for signs of a stroke or tumor that may be the source of the dementia. A PET scan can determine if amyloid proteins are present in the brain, a marker for Alzheimers disease.
Oftentimes, neurologists and geriatricians assist in making the diagnosis.
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Strategies To Prevent Micronutrient Deficiencies
Considering a pronounced population aging process and consequent increase in the prevalence of dementia, the search for strategies to prevent or postpone the onset of diseases such as AD is necessary. Diet is an intensively modifiable lifestyle factor that is likely to work toward a reduction in the risk of developing AD. Faced with the results discussed in this review, it seems reasonable to affirm that individuals nutritional status must be carefully considered upon the occurrence of disease and throughout ones entire life. Despite the necessity of additional studies, the adoption of healthy eating habits that allow the maintenance of blood levels of several micronutrients remains at the top of dietary recommendations.
Furthermore, it is known that AD might relate to altered taste and the ability to chew and swallow, resulting in changes in dietary patterns, which often tend to acquire monotonous characteristics. As a consequence, ingested foods might not be sufficient to provide an individuals entire nutritional need, so supplementation becomes an important strategy to ensure an adequate nutritional supply. However, it is important to evaluate the patients biochemical and clinical profile before starting supplementation. Moreover, it is suggested that the dosage used should comply with established recommendations to ensure patient safety.
Can A Tablet Really Boost Your Memory
Certain vitamins and fatty acids have been said to slow or prevent memory loss. The long list of potential solutions includes vitamins like vitamin B12, herbal supplements such as ginkgo biloba, and omega-3 fatty acids. But can a supplement really boost your memory?
Much of the evidence for these potential memory-boosting supplements isnt very strong. Here, we discuss what recent clinical studies have to say about vitamins and memory loss.
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Psychological And Psychosocial Therapies
Psychological therapies for dementia include some limited evidence for reminiscence therapy , some benefit for cognitive reframing for caretakers, unclear evidence for validation therapy and tentative evidence for mental exercises, such as cognitive stimulation programs for people with mild to moderate dementia. Offering personally tailored activities may help reduce challenging behavior and may improve quality of life. It is not clear if personally tailored activities have an impact on affect or improve for the quality of life for the caregiver.
Adult daycare centers as well as special care units in nursing homes often provide specialized care for dementia patients. Daycare centers offer supervision, recreation, meals, and limited health care to participants, as well as providing respite for caregivers. In addition, home care can provide one-to-one support and care in the home allowing for more individualized attention that is needed as the disorder progresses. Psychiatric nurses can make a distinctive contribution to people’s mental health.
Some London hospitals found that using color, designs, pictures and lights helped people with dementia adjust to being at the hospital. These adjustments to the layout of the dementia wings at these hospitals helped patients by preventing confusion.
Personally tailored activities
Vitamin D Deficiency Associated With Dementia And Alzheimers
Vitamin D, or the sunshine vitamin as it’s called, is a crucial nutrient for strong bones. Deficiency of the vitamin has also been linked to cognitive loss in the elderly, and this was proven by a study conducted by the Alzheimer’s Association on elderly Americans who took part in the Cardiovascular Health Study.
The study found that men and women who were moderately deficient in vitamin D had a 53 percent increased risk of developing dementia of any kind, and the risk increased to 125 percent in those who were severely deficient. Similarly, vitamin D deficiency can also lead to Alzheimers, with the study finding that a moderate deficiency increased the risk by 69 percent while a severe deficiency increased the risk by 122 percent.
The study, a collaboration between multiple universities and hospitals, has been published in the online edition of Neurology, the medical journal of the American Academy of Neurology. The study tracked 1,658 adults aged 65 and over, who were able to walk unaided and were free from dementia, cardiovascular disease, and stroke at the start of the study. Over the course of the next six years, the study followed the participants to investigate who went on to develop Alzheimer’s disease and other forms of dementia.
Source: Brown D, Llewellyn D, et al. Neurology. 2014.
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Differentiating Dementia From Pseudodementia
The term pseudodementia is used to describe the condition in which depression causes cognitive deficits that masquerade as dementia. Patients will often present with difficulties in memory and concentration and deny depressive symptoms. A previous history of depression can be helpful, as can the presence of vegetative symptoms, such as sleep or appetite disturbance, and lack of activity or enthusiasm for previously enjoyed pastimes. The memory disturbance in depressive pseudodementia is traditionally one in which learning is impaired but recall of learned information is relatively preserved, in contrast to early Alzheimer’s disease, in which recall is also severely affected. Performance is often patchy and inconsistent and improves with encouragement. Patients with cognitive impairment secondary to depression may have word-finding difficulty on fluency tasks but do not have impairments in naming or produce paraphasias. A reasonable approach to patients with depressive symptoms and memory impairment in whom even formal neuropsychological testing cannot differentiate depression alone from depression in Alzheimer’s disease is to give a trial of antidepressant therapy for several months before repeating the neuropsychological testing.
Neill H Anderson, Kirstie Woodburn, in, 2010