Who Is At Risk Of Getting Dementia
The older you are, the greater your chance of getting dementia. Most people are over 65 when diagnosed, although some younger people have early onset dementia.
There are some groups of people who are known to have a higher risk of developing dementia. These include people with:
- Down syndrome or other learning disabilities
- Parkinson’s disease
Are There Different Types Of Dementia
Dementias can be divided into three groups:
- Primary .
- Secondary .
- Reversible dementia-like symptoms caused by other illnesses or causes.
Types of primary dementia include:
Dementia due to other diseases and conditions
Other causes of dementia include:
Dementias due to reversible causes
Some conditions can cause dementia-like symptoms that can be reversed with treatment, including:
You’ve Been Getting Easily Confused
Another typical sign of dementia, that may seem a bit bizarre, is forgetting what to do with everyday objects. According to Jessica Zwerling, MD, MS, director of the Memory Disorders Center at the Montefiore Health System, you might momentarily forget where to put your groceries, for example, or how to use your phone.
It can be a scary experience, and is definitely something you’ll want to point out to a doctor. And the same is true if you experience other forms of forgetfulness, such as suddenly needing to follow a recipe for dishes you make all the time. It’s this inability to remember simple, everyday things that can be cause for concern.
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Current Practice In Diagnosing Dementia
The remainder of this information will provide an overview of the diagnosis process and a guide to what happens after diagnosis.
It is important to remember that there is no definitive test for diagnosing Alzheimers disease or any of the other common causes of dementia. Findings from a variety of sources and tests must be pooled before a diagnosis can be made, and the process can be complex and time consuming. Even then, uncertainty may still remain, and the diagnosis is often conveyed as possible or probable. Despite this uncertainty, a diagnosis is accurate around 90% of the time.
People with significant memory loss without other symptoms of dementia, such as behaviour or personality changes, may be classified as having a Mild Cognitive Impairment . MCI is a relatively new concept and more research is needed to understand the relation between MCI and later development of dementia. However, MCI does not necessarily lead to dementia and regular monitoring of memory and thinking skills is recommended in individuals with this diagnosis.
Medicare Coverage By Part
- any age and have a disability
- any age and have end stage renal disease
However, there are also some specific Medicare plans that people with dementia may be eligible for. In these cases, a diagnosis of dementia may be required:
- Special needs plans :SNPs are a special group of Advantage plans that specifically address the needs of people with specific health conditions, including dementia. Coordination of care is also often included.
- Chronic care management services : If you have dementia and at least one more chronic condition, you may be eligible for CCMR. CCMR includes development of a care plan, coordination of care and medications, and 24/7 access to a qualified healthcare professional for health needs.
Dementia happens when you lose cognitive abilities like memory, thinking, and decision-making. This can significantly impact social function and activities of daily living. For example, a person with dementia may have difficulty:
- recalling people, old memories, or directions
- carrying out daily tasks independently
- communicating or finding the right words
- solving problems
- paying attention
- controlling their emotions
There isnt just one type of dementia. There are actually several types, each with different characteristics. They include:
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What Medications Are Available To Manage Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, include:
- Cholinesterase inhibitors, including donepezil , rivastigmine and galantamine .
- NMDA receptor antagonist memantine .
- Anti-amyloid antibody aducanumab .
Healthcare providers use these drugs to treat people with some of the other forms of dementia.
Cholinesterase inhibitors and the NMDA receptor antagonist affect different chemical processes in your brain. Both drug classes have been shown to provide some benefit in improving or stabilizing memory function in some people with dementia.
Cholinesterase inhibitors manage the chemicals in your brain that allow messages to be sent between brain cells, which is needed for proper brain function. Memantine works similarly to cholinesterase inhibitors except it works on a different chemical messenger and helps the nerve cells survive longer.
Aducanumab targets amyloid proteins, which build up into the plaques seen in the brains of people with Alzheimers disease.
Although none of these drugs appear to stop the progression of the underlying disease, they may slow it down.
If other medical conditions are causing dementia or co-exist with dementia, healthcare providers prescribe the appropriate drugs used to treat those specific conditions. These other conditions include sleeping problems, depression, hallucinations and agitation.
Whats The Difference Between Dementia And Alzheimers Disease
Dementia is a description of the state of a persons mental function and not a specific disease. Dementia is an umbrella category describing mental decline thats severe enough to interfere with daily living.
There are many underlying causes of dementia, including Alzheimers disease and Parkinsons disease. Alzheimers disease is the most common underlying cause of dementia.
Prepare For The Future
Discuss decisions about health and finances as soon as possible to ensure you have a say and are prepared for the future.
Preparing for the future may be the last thing you want to think about. But it will be easier to think about health and finances now rather than later to make sure you have a say in future decisions.
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 tofamilies 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.
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You Suddenly Despise Any Kind Of Change
When dementia sufferers are experiencing confusion and memory changes, it’s common for them to stick to a strict routine, as a way to coping and feeling safer.
This might take the form of sticking to the same route on your way to work, or taking the same streets to get to the grocery store. But it’s not just about the routine since many people have a preferred way of getting places but the reasons why you’re always following the same path.
If you get confused when going another way, for example, or feel incredibly disoriented when deviating from your usual path, there’s a chance it’s an early warning sign of dementia.
Is Dementia Treatable
First, its important to understand the terms treatable, reversible and curable. All or almost all forms of dementia are treatable, in that medication and other measures can help manage your symptoms. However, most types of dementia cant be cured or reversed, and treatments provide only modest benefits.
Fortunately, some types of dementia, like those brought on by treatable causes, may be successfully reversed. These dementia-like symptoms are caused by:
- Side effects of medications, illicit drugs or alcohol.
- Tumors that can be removed.
- Subdural hematoma .
- Normal pressure hydrocephalus .
- Metabolic disorders, such as a vitamin B12 deficiency.
- Hypothyroidism, a condition that results from low levels of thyroid hormones.
- Hypoglycemia .
Dementias that arent reversible may still partially respond to medications that treat memory loss or behavior problems. These dementias include:
- Alzheimer’s disease.
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You Keep Getting Lost
The confusion associated with dementia can cause you to feel lost more often, possibly while on your way somewhere new. But it can even happen when heading somewhere you’ve been dozens of times.For example, as Dr. Schreiber says, “you may find that you are using your GPS to go to places that you knew how to get to previously.”
Of course, we all get turned around on occasion, so you won’t want to assume you have dementia just because you get lost while out driving or walking. And the same is true if you’ve always been bad with directions, or simply prefer sticking to a beaten path.
If you develop a new sense of disorientation, however, or find yourself getting lost on familiar roads, let a doctor know.
The Nz Dementia Framework Collaborative
This group of Health of Older People leaders from all four DHB health regions of the country is active in encouraging and ensuring there is a coordinated approach from the DHBs to put the aspirations of the New Zealand Framework for Dementia Care into action.
There are many other groups involved as well, including other key NGOs providing services, New Zealands Aged Residential Care and Home and Community Support Service providers, other cross-DHB committees such as the Mental Health of Older Persons Service Leaders Forum, professional interest groups such as the NZ Psychologists of Older People, and local Dementia Stakeholders groups in some DHBs and health regions.
Source: NZ Dementia Foundation 2019
Who Gets Early Onset Ad
Although AD isnt an expected part of advancing age, youre at increased risk as you get older. More than 32 percent of people over age 85 have AD.
You may also have an increased risk of developing AD if a parent, sibling, or child has the disease. If more than one family member has AD, your risk increases.
A showed that African Americans, Native Americans, and Native Alaskans are at higher risk for developing early onset AD compared to white people.
Prevalence of early onset AD
Early onset AD affects approximately
The exact cause of early onset AD hasnt been fully determined. Many researchers believe that this disease develops as the result of multiple factors rather than one specific cause.
Researchers have discovered rare genes that may directly cause or contribute to AD. These deterministic genes are:
- amyloid precursor protein on chromosome 21
- presenilin-1 on chromosome 14
- presenilin-2 on chromosome 1
These genes may be carried from one generation to the next within a family. Carrying these genes can result in adults younger than age 65 developing symptoms much earlier than expected.
Mutations in these genes account for only 5 to 10 percent of all Alzheimers cases but a majority of early onset AD cases.
Apolipoprotein E is another gene associated with AD. Its more commonly a factor in people who develop AD after age 65.
Lifestyle changes that help reduce risk include:
- regular physical activity
Becoming Confused In Familiar Surroundings
Your parent may forget where they are and how they got there. Along with losing track of dates, seasons and the time this is one of the most tell-tale early onset dementia symptoms.
They may also struggle to understand something if its not happening immediately. This is because the mind of someone with dementia is mostly situated in the present and they find it difficult to comprehend the passage of time.
For example, your mum may tell you shes missed you because she thinks she hasnt seen you in a long time, but in reality you visited her last week. Another example includes time passing very slowly in a general sense: ten minutes might seem like an hour, an hour might seem like a day and so on.
This is different to: getting confused about the day of the week but working it out later.
Vascular dementia differs from Alzheimers Disease in that it involves stroke-like symptoms including muscle weakness or partial paralysis.
This type of dementia can also be an after-effect of a stroke or mini stroke.
Vascular dementia symptoms can also include confusion, memory loss, low attention span and difficulty in performing everyday tasks.
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Difficulty Completing Familiar Tasks
Some people may experience a greater problem with concentration. Routine day-to-day tasks requiring critical thought may take longer as the disease progresses.
The ability to drive safely may also be called into question. If you or a loved one gets lost while driving a commonly traveled route, this may be a symptom of AD.
What Are The Signs Of Alzheimer’s Disease
Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimers disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimers disease, people seem to be symptom-free, but toxic changes are taking place in the brain.
Damage occurring in the brain of someone with Alzheimers disease begins to show itself in very early clinical signs and symptoms. For most people with Alzheimersthose who have the late-onset varietysymptoms first appear in their mid-60s. Signs of early-onset Alzheimers begin between a persons 30s and mid-60s.
The first symptoms of Alzheimers vary from person to person. Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers disease. Decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. And some people may be diagnosed with mild cognitive impairment. As the disease progresses, people experience greater memory loss and other cognitive difficulties.
Alzheimers disease progresses in several stages: preclinical, mild , moderate, and severe .
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The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
What Causes Frontotemporal Dementia
Researchers have not identified a single cause for this type of dementia, but they have some ideas. Some peoples brains develop abnormal protein structures, called Pick bodies.
Researchers have also identified abnormal proteins that may play a role. These proteins, found in brain cells of individuals who died with dementia, may affect how the brain works. Researchers dont know why these proteins develop or how to prevent them.
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Can Lifestyle Changes Help Frontotemporal Dementia
Medication can be effective for treating dementia, but lifestyle treatments can help, too. Helping people find a comfortable environment can help them cope with the symptoms of dementia.
Environment is important. Maintaining an environment that doesnt upset someone is vital. Make sure your home is well-lit and has minimal noise. People with behavior problems need to be in environments that are familiar. They may also need to avoid large crowds.
People with speech problems may need to be in environments where communication is easier. They may wish to keep tools for communicating, like a pen and paper, with them all the time.
What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
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What Can I Do To Reduce My Risk Of Dementia
Those that follow a healthier lifestyle have been shown to have a lower risk of dementia. Doing what you can to protect your heart, as well as staying active, can be beneficial. Therefore, it’s best to aim to:
- eat a varied diet containing lots of fruit and vegetables
- eat less salty and fatty foods, especially those high in saturated fat
- drink alcohol in moderation
- enjoy an active life with plenty of outside interests
- ask your doctor to check your blood pressure and cholesterol
- keep your blood glucose well controlled if you have diabetes.
How Is Dementia Diagnosed
Confirming a diagnosis of dementia can be difficult. Many diseases and conditions can cause or lead to dementia. In addition, many of its symptoms are common to many other illnesses.
Your healthcare provider will:
- Ask about the course of your symptoms.
- Ask about your medical history.
- Review your current medications.
- Ask about your family history of disease including dementia.
They may also order tests, including laboratory tests, imaging tests and neurocognitive tests .
Neurologists and geriatricians may assist in making the diagnosis of dementia.
Laboratory tests rule out other diseases and conditions as the cause of dementia, such as infection, inflammation, underactive thyroid and vitamin deficiency .
Sometimes, healthcare providers order cerebrospinal fluid tests to evaluate autoimmune conditions and neurodegenerative diseases, if warranted.
Your healthcare provider may order the following imaging tests of your brain:
During neurocognitive testing, your healthcare provider uses written and computerized tests to evaluate your mental abilities, including:
- Problem solving.
A mental health professional may check for signs of depression, mood changes or other mental health issues that might cause memory loss.
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