Is Dementia A Physiological Condition

October 1, 2021

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Mental Illness With Ad

WHO: Dementia it affects us all

Its common for mental illness, particularly depression, to happen in the early stages of Alzheimers disease and other forms of dementia. But accurate diagnosis and treatment has been known to improve cognitive function, according to Todays Geriatric Medicine. Its difficult enough living with AD, but the symptoms are compounded when it occurs in conjunction with other mental disorders like anxiety, depression, and psychotic conditions.

In fact, the CDC says that serious symptoms of depression occur in up to 50 percent of older adults with Alzheimers, and major depression occurs in about 25 percent of cases. Depression is often intermingled with the belief that this is simply an older adults reaction and awareness of progressive decline. But there is more to it than that, with some research suggesting there is a biological connection between AD and depression.

Anxiety disorders are also common, happening in about 30 percent of adults who have AD. Anxiety can include anything from generalized nervousness and fear of leaving home to agitation regarding changes of routine and feelings of suspicion or paranoia. Anxiety can also be psychologically and physically linked to AD.

Behavioral And Psychological Effects Of Coronavirus Disease

Background: In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers.

Methods: This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease , dementia with Lewy bodies , frontotemporal dementia , and vascular dementia , followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregivers stress burden were analyzed.

Quarantine induces a rapid increase of BPSD in approximately 60% of patients and stress-related symptoms in two-thirds of caregivers. Health services need to plan a post-pandemic strategy in order to address these emerging needs.

Reversible Or Treatable Causes Of Dementias

Most of the conditions that cause dementia cannot be reversed, but some can be treated and may be called reversible dementia. Treatment can often cure these dementias if the brain has not been damaged too much. If brain damage is more extensive, treatment often does not reverse the damage, but it can prevent new damage.

Conditions that cause reversible dementia include the following:

In people with Alzheimer disease or dementia with Lewy bodies, symptoms tend to worsen more steadily.
In Creutzfeldt-Jakob disease, dementia progresses rapidly and continuously.

The rate of progression also varies from person to person. Looking back at how fast it worsened during the previous year often gives an indication about the coming year. Symptoms may worsen when people with dementia are moved to a nursing home or another institution because people with dementia have difficulty learning and remembering new rules and routines.

Problems, such as pain, shortness of breath, retention of urine, and constipation, may cause delirium with rapidly worsening confusion in people who have dementia. If these problems are corrected, people usually return to the level of functioning they had before the problem.

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Drugs That May Improve Mental Function

Donepezil, galantamine, rivastigmine, and memantine are used to treat Alzheimer disease and dementia with Lewy bodies. Rivastigmine can also be used to treat dementia related to Parkinson disease.

Donepezil, galantamine, and rivastigmine are cholinesterase inhibitors. They inhibit acetylcholinesterase, an enzyme that breaks acetylcholine down. Thus, these drugs help increase the level of acetylcholine, which helps nerve cells communicate. These drugs may temporarily improve mental function in people with dementia, but they do not slow the progression of dementia. They are most useful in early dementia, but their effectiveness varies considerably from person to person. About one third of people do not benefit. About one third improve slightly for a few months. The rest improve considerably for a longer time, but the dementia eventually progresses.

If one cholinesterase inhibitor is ineffective or has side effects, another should be tried. If none is effective or all have side effects, this type of drug should be stopped. The most common side effects include nausea, vomiting, weight loss, and abdominal pain or cramps. Tacrine, the first cholinesterase inhibitor developed for treating dementia, is rarely used anymore because it can damage the liver.

Supporting Someone With Dementia Who Has Mental Health Problems

Its common for people with dementia to experience depression, anxiety or apathy . Alzheimers UK has information about how these problems might affect someone with dementia, and ways to support them and get them the right support and treatment.

Improving the mental health of someone with dementia can improve their overall quality of life, for example by helping them engage with friends and relatives, improving their appetite and sleep quality, and boosting their motivation.

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Pandemic Quarantine As Stressor Event

Studies on mental health modifications induced by COVID-19 pandemic in healthy subjects demonstrated increased symptoms of anxiety and depression . By now very few data are available for persons with special needs and increased fragility as patients with dementia . A recent study evaluated BPSD changes after 5 weeks of COVID-19 quarantine through the Neuropsychiatric Inventory questionnaire in 40 patients with AD: 20 with MCI and 20 with mild dementia . Worsening of BPSD respect to baseline pre-lockdown assessment was reported in 30% of patients and significant changes were found for apathy , anxiety in MCI, agitation, and aberrant motor behavior in mild AD. We found a higher prevalence of increased BPSD respect to what has previously been reported. In our study, family caregivers were enquired about any perceived changes of patients neuropsychiatric symptoms; we did not use a quantitative BPSD assessment and did not compare results with a previous level of BPSD burden. Furthermore, diseases with high risk of behavioral disorders such as FTD and DLB have been included. Therefore, the higher burden of BPSD in our study may be due to different study methodology and inclusion of types of dementia other than AD. On the other hand, our results confirmed the preliminary findings that apathy, agitation, and anxiety are among the most frequently reported worsening symptoms during quarantine in patients with dementia.

What Practices Need To Be Implemented

In Ireland, theeffective management of Dementia requires an action plan to be developedincluding the points of view of all the major stakeholders. The plan highlightshow individual and unique each person with Dementia is; the individual withDementia is placed at centre of the planning process in a Client Centre Caremodel developed by Dr Tom Kitwood , where he looked for a new culture ofDementia. The plan will serve as a model of Best Practice to guide policymakers that are involved in the planning and provision of services and supportthe providers of flexible and local services for individuals with Dementia. The32 HIQA standards need to be implemented in line with the recommendations inthe National Dementia Strategy.

Most of the needsof the individual with Dementia and their carers should be acquired at thePrimary and Community level of care. This should include providing a flexiblenetwork of services for the individuals with Dementia and their carers. The Autonomyand Dignity of individuals with Dementia can be maintained by developingindividualised care plans facilitated through case management structures.

Respite care bothat home and in nursing homes is of vital importance to carers as there istremendous pressure on them on a daily basis and they need respite care torecharge their batteries. The important element in Primary and Community Careis the flexibility of supply of services following the needs of the individualand their carers being expressed.

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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.

State The Current Approaches Towards Developing Quality Services For People With Dementia

Research into theneeds of individuals with Dementia has shown that they require residentialcare as the disease progresses. There is a movement towards caring forindividuals with Dementia from traditional nursing homes to that of them beingcared for in Dementia villages.

This ingeniouspioneering notion has come after De Hogeweyk, Holland, developed a cutting edgeelderly care facility in a village setting since 2009. It is located on theoutskirts of Amsterdam where all the residents have Dementia and have thechance to live highly social and almost normal lives.

The houses aredesigned to look like houses from different eras from the 1950s to 1970s;residents and their families can also choose different lifestyle modelsincluding Christian, Urban, Indonesian and Artisan.

The Dementiavillage currently have 152 residents; is mostly state funded; has its own postoffice, supermarket, town square, garden and theatre. The residents livelonger, eat better, require fewer medications and enjoy a higher standard ofliving than those in the traditional nursing homes.

In response to thesuccess of the former, countries worldwide, including Ireland, are beinginspired to follow suit. According to Journal.ie, , Irelands firstpurpose built village is under construction for individuals with Dementia inBruff, Co. Limerick. Care Bright Community, the company behind the developmenthas stated that it will change the face of Dementia Care in Ireland.

Psychiatric Disorders Foreshadow Cognitive Decline And Dementia

Primary psychiatric disorders usually develop in youth and early adulthood, although late-life variants of depression, anxiety, mania, and psychosis are recognized. In contrast, primary dementias are generally conditions of midlife and late life, although youth and young-adult presentations occur. Psychiatric disorders preceding cognitive dysfunction and dementia have long been recognized in schizophrenia, since Emil Kraepelin described dementia praecox as a chronic disintegration of cognition and conduct beginning in youth. Schizophrenia is now viewed as a heterogenous psychosis in which cognitive dysfunction is common, and progressive cognitive decline and dementia rare. Schizophrenia is believed to arise from aberrant neurodevelopment, with deficiencies in dopamine and glutamate neurotransmission culminating in the disintegration of mental function in early adulthood. Most cases of schizophrenia feature static deficits in attention, executive functions, and social reasoning from the outset, alongside the illness-defining hallucinations and delusions. These cognitive disabilities undermine treatment adherence and psychosocial adjustment.

Managing Sleeping Problems With Food And Drink

Some suggestions include:

Cut down on caffeine during the day and cut them out altogether after 5 pm.
Cut down on alcohol and discuss the effects of alcohol and medication with the doctor.
If you think the person may be hungry at night, try a light snack just before bed or when they wake up during the night.
Herbal teas and warm milk may be helpful.

Dementia Is A Psychological Disorder

Dementia: This fun exercise could help prevent cognitive ...

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Monitor on Psychology48

With improvements in neuroimaging, researchers are learning much more about the underlying processes that cause Alzheimer’s disease and other types of dementia. While increased neuroscientific knowledge is always welcome, there’s some concern that the medical community might discount the role that psychologists can play in characterizing, diagnosing and treating the disease.

Recently, the World Health Organization proposed re-classifying diagnoses for dementia as “Diseases of the Nervous System,” rather than “Mental or Behavioural Disorders,” as they are now classified. APA is concerned that this change could preclude some health-care professionals from providing diagnostic assessment and intervention, reducing access to and quality of care for people with dementia.

In February, APA President Antonio E. Puente, PhD, and Interim Chief Executive Officer Cynthia D. Belar, PhD, issued a letter to the WHO arguing that this reclassification is ill-advised. As the letter states, “the science and practice of psychology are integral to efforts to assess, diagnose, treat, and support individuals with dementia, and to lighten the burden of the families and institutions that provide their care.” Kirsten Weir

Causes Of Vascular Dementia

Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.

This can happen as a result of:

narrowing and blockage of the small blood vessels inside the brain
a single stroke, where the blood supply to part of the brain is suddenly cut off
lots of “mini strokes” that cause tiny but widespread damage to the brain

Not everyone who has a stroke will go on to develop vascular dementia.

Symptoms Specific To Dementia With Lewy Bodies

Dementia with Lewy bodies has many of the symptoms of Alzheimer’s disease, and people with the condition typically also experience:

periods of being alert or drowsy, or;fluctuating levels of confusion
visual hallucinations
becoming slower in their physical movements
repeated falls and fainting

Read more about dementia with Lewy bodies.

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Rarer Causes Of Dementia

There are many rarer diseases and conditions that can lead to dementia, or dementia-like symptoms.

These conditions account for only 5% of dementia cases in the UK.

They include:

problems with planning and reasoning

These symptoms are not severe enough to cause problems in everyday life.

MCI can be caused by an underlying illness, such as depression, anxiety or thyroid problems.

If the underlying illness is treated or managed, symptoms of MCI often disappear and cause no further problems.

But in some cases, people with MCI are at increased risk of going on to develop dementia, which is usually caused by Alzheimer’s disease.

Read more about how to prevent dementia.

Dementia With Lewy Bodies

What is dementia? Alzheimer’s Research UK

Initial symptoms: Dementia with Lewy bodies is a type of Lewy body dementia. Dementia with Lewy bodies involves both body symptoms such as motor and muscle weakness and rigidity, as well as brain symptoms like making decisions, memory impairment, and attention span.

In dementia with Lewy bodies, the brain symptoms develop before the body symptoms, at the same time or less than a year after the body symptoms present.

Progression:;Dementia with Lewy bodies can vary quite a bit, even from day to day. However, in general the disease starts slowly and worsens gradually.;

Prognosis: Average life expectancy depends on many factors but is estimated to be approximately 5 to 8 years after diagnosis.

Recommended Reading: What Is Vascular Dementia Life Expectancy

What Is Vascular Dementia

Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It’s caused when decreased blood flow damages brain tissue. Blood flow to brain tissue may be reduced by a partial blockage or completely blocked by a blood clot.

Symptoms of vascular dementia may develop gradually, or may become apparent after a stroke or major surgery, such as heart bypass surgery or abdominal surgery.

Dementia and other related diseases and conditions are hard to tell apart because they share similar signs and symptoms. Although vascular dementia is caused by problems with blood flow to the brain, this blood flow problem can develop in different ways. Examples of vascular dementia include:

Mixed dementia. This type occurs when symptoms of both vascular dementia and Alzheimer’s exist.;
Multi-infarct dementia. This occurs after repeated small, often “silent,” blockages affect blood flow to a certain part;of the brain. The changes that occur after each blockage may not be apparent, but over time, the combined effect starts;to cause symptoms of impairment. Multi-infarct dementia is also called vascular cognitive impairment.

Researchers think that vascular dementia will become more common in the next few decades because:

Managing Depression In Dementia

Try to keep a daily routine for the person with dementia.
Incorporate daily exercise, because this has been proven to have a positive impact on symptoms of depression.
Limit the amount of noise and activity in the environment if this causes a problem. This will help avoid overstimulation.
Large group situations can make some people feel worse, while others may benefit from the stimulation of a busy, active gathering. It is important to know what the person has enjoyed in the past, because it is likely that similar activities will still appeal.
Have a realistic expectation of what the person can do. Expecting too much can make both the person with dementia and the carer feel frustrated and upset.
Be aware of when the person is usually least tired and do any important tasks at that time.
Be positive. Frequent praise will help both the person with dementia and the carer feel better.
Include the person in conversation to the extent that they feel comfortable.

Memory Loss And Dementia

events the person may forget part or all of an event
words or names the person progressively forgets words and names of people and things
stories on TV, in movies or books the person progressively loses the ability to follow stories
stored knowledge over time, the person loses known information such as historical or political information
everyday skills the person progressively loses the capacity to perform tasks such as dressing and cooking.

Take Part In Dementia Research

There are many dementia research projects and clinical trials going on around the world, many of which are based in the UK.

If you have a dementia diagnosis or are worried about memory problems, you can help scientists understand more about it, and develop possible treatments, by taking part in research.

Carers can also take part, as there are studies into the best ways to care for someone with a dementia diagnosis.

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