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.
What Are The Symptoms Of Dementia
Early symptoms of dementia include :
- Forgetting recent events or information
- Repeating comments or questions over a very short period of time
- Misplacing commonly used items or placing them in usual spots
- Not knowing the date or time
- Having difficulty coming up with the right words
- Experiencing a change in mood, behavior or interests
Signs that dementia is getting worse include:
- Ability to remember and make decisions further declines
- Talking and finding the right words becomes more difficult
- Daily complex tasks, such as brushing teeth, making a cup of coffee, working a tv remote, cooking, and paying bills become more challenging
- Rational thinking and behavior and ability to problem solve lessen
- Sleeping pattern change
- Anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression increase
- More help with activities of daily living grooming, toileting, bathing, eating is needed
- Hallucinations may develop
The symptoms mentioned above are general symptoms of dementia. Each person diagnosed with dementia has different symptoms, depending on what area of the brain is damaged. Additional symptoms and/or unique symptoms occur with specific types of dementia.
How Is Lewy Body Disease Treated
There is no cure for Lewy body disease, but a doctor may treat the symptoms with:
- Alzheimers disease medications to reduce hallucinations and behavioural problems
- Parkinsons disease medications to improve rigid muscles and slow movement
- sleep medicines
Some medicines, such as antipsychotics, can make symptoms worse and may be dangerous. There are, however, other ways of dealing with symptoms, including:
- learning to manage a persons behaviour
- learning how to calm the person down
- changing their environment to help them function
- creating daily routines
- using therapies, such as physiotherapy, occupational therapy and speech and language therapy
- providing cognitive stimulation
People with Lewy body disease usually need help at home and eventually care in a nursing home. The disease progresses differently in different people. After they develop symptoms, people live on average for another 6 to 12 years, although some live much longer.
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Is Dementia A Mental Illness
Is dementia a mental illness? When you think about the symptoms of dementia, it would be very easy to classify dementia as a mental illness, but unlike conditions such as schizophrenia and bi-polar, dementia is not an actual disease as suchrather it is a term that refers to a series of non-specific symptoms.
Treatment And Care For Lewy Body Dementia
While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. An LBD treatment plan may involve medications, physical and other types of therapy, and counseling. A plan to make any home safety updates and identify any equipment can make everyday tasks easier.
A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers.
Rapid Eye Movement Sleep Behaviour Disorder is a sleep disorder characterized by repeated episodes of arousal, often associated with vocalizations and/or complex motor behaviours arising during REM sleep. Almost 90% of patients diagnosed with a REM sleep behaviour disorder will later develop a Parkinsons-plus disorder such as Parkinsons Disease , Dementia with Lewy Bodies , and Multiple System Atrophy.
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Perspectives On Clinical Management
A multidisciplinary team model involving physicians, nursing, physical therapy, and other rehabilitative services, as well as social work and caregiver/family advocacy is often required for the optimal management of patients with psychiatric disorders and dementia. At the authors institution, behavioral care, case management, pharmacologic prescriptions, and physical, speech/language, and occupational therapy are melded into an individualized treatment plan to relieve distress, provide direction, promote adaptation, and optimize quality of life. A healthy partnership with the patient and the caregiver, and their education about psychiatric symptoms, dementia, and the interventions are vital for success.
DICE approach to the examination, formulation, and management of dementia-related behavioral problems. A two-part flow diagram is shown, illustrating the socially dynamic context of the DICE approach , the progression in its implementation, and the recursive routines for managing high-acuity states. The bidirectional arrows in the triad emphasize the reciprocity of the dynamics that shape many behavioral problems encountered in dementia care.Modified with permission from Kales HC, et al, BMJ.www.bmj.com/content/350/bmj.h369. © 2015 British Medical Journal Publishing Group.
Late Onset Bipolar Disorder And Dementia: Whats The Difference
Renee was a doting 60-year-old grandma, active in her community and seeming to age well. But when she started showing signs of aggressiveness, agitation, and erratic behavior, her daughter made an appointment with a neurologist. Renee was diagnosed with dementia, and she continued to spiral downward. After further testing and an appointment with a neuropsychiatrist, Renee was diagnosed with late onset bipolar disorder.
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Why It’s Important To Get A Diagnosis
Although there is no cure for dementia at the moment, an early diagnosis means its progress can be slowed down in some cases, so the person may be able to maintain their mental function for longer.
A diagnosis helps people with dementia get the right treatment and support. It can also help them, and the people close to them, to prepare for the future.
Read more about how dementia is diagnosed.
What Complications Are Associated With Medications Used To Treat Lewy Body Dementia
Up to 50% of people living with Lewy body dementia can have severe side effects when treated with certain antipsychotic medications. These are known as the typical or traditional antipsychotics and include such drugs as thoridazine, haloperidol, chlorpromazine and perphenazine. This class of older, first-generation antipsychotics can cause sedation and make cognitive symptoms and movement problems worse. A life-threatening reaction to an antipsychotic medication, called neuroleptic malignant syndrome, is possible. Symptoms include rigid muscles, changing blood pressure, high fever, confusion and fast heart rate. Contact your healthcare provider immediately if you or your loved are taking an antipsychotic and develop these symptoms.
Visual hallucinations and behavioral changes may be treated with the newer, atypical antipsychotic medications pimavanserin , quetiapine or clozapine . However, because all antipsychotic medications both older, typical medications and newer atypical medications can increase the risk of death in elderly patients with dementia, you and your healthcare provider should carefully discuss the risks and benefits and using these medications.
Other medications, like antidepressants or sedative antihistamines, may increase confusion in people with LBD.
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Recognizing Signs And Symptoms Of Dementia
Dementia symptoms can vary depending on the part of the brain that has been affected, but common signs and symptoms include:
- Difficulty communicating or choosing words
- Difficulty with visual and spatial abilities, such as getting lost while driving
- Difficulty reasoning or problem-solving
- Difficulty with planning and preparing meals
- Difficulty with coordination and motor functions
- Confusion and disorientation
If You Want To Know Is Dementia A Mental Illness You’re Not The Only One Asking
People worldwide are having conversations about dementia. It’s becoming more common and less stigmatized to talk about in families and communities. You may wonder if its considered a mental illness or a neurocognitive disorder.
Despite the health care industrys best efforts to educate the public about dementia and mental illness, there is still a lot of misunderstanding and misinformation out in the world. Couple that with how closely dementia resembles some symptoms of depression or schizophrenia, and its no wonder theres confusion.
In 2013, the American Psychiatric Association updated the official guide for mental health professionals in the US. This book, the Diagnostic and Statistical Manual of Mental Health, was first published in 1952. The most recent version answers the question, Is dementia a mental illness? by describing dementia as a neurocognitive disorder. Scholars and scientists debated if this change was helpful or not in articles with titles like “Dementia and DSM-5: Changes, Cost, and Confusion” and “Mild Neurocognitive Disorder: An Old Wine in a New Bottle.”
Dementia and mental illness can look similar, but they are very different. Mental illnesses like schizophrenia or bipolar disorder can cause symptoms that imitate dementia. And conversely, Alzheimer’s disease or another form of dementia could be mistaken for a mental illness. This is just one reason it is so essential to get a diagnosis from a medical professional.
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Whats The Difference Between Dementia And Mental Illness
Common symptoms of dementia include memory loss, forgetfulness, difficulty in understanding language, and impaired judgment.
On the other hand, mental illnesses such as schizophrenia or bipolar disorder can cause hallucinations and delusions, which are not present with Alzheimer’s disease or another form of dementia. Dementia is also characterized by a gradual decline, while mental illness usually presents itself in episodic phases that eventually end.
The key to understanding the difference between mental illness and dementia is recognizing two different illnesses with some similar and some unique symptoms. Dementia usually progresses slowly over time it also causes memory, language skills, judgment, or dispositions. Mental illnesses like anxiety disorders , bipolar disorder, and schizophrenia can sometimes mimic the early stages of dementia because they cause difficulties in thinking for other reasons besides Alzheimer’s disease.
Professionals categorize cognition symptoms as mild or major, according to how severe they are. The most recognizable symptoms are challenges with planning, making decisions, staying focused, remembering things, and maintaining appropriate behavior around others.
As you might imagine, anyone wondering “Is Dementia A Mental Illness?” has more important questions that need to be answered and quickly.
What Medications Are Available To Treat Dementia
Drugs approved for the most common form of dementia, Alzheimers disease, are discussed below. These drugs are also used to treat people with some of the other forms of dementia.
- cholinesterase inhibitors
- NMDA receptor antagonist memantine
These two classes of drugs affect different chemical processes in the brain. Both classes have been shown to provide some benefit in improving or stabilizing memory function in some patients. 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, the appropriate drugs used to treat those specific conditions are prescribed.
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Clinical Academic Phd Southampton University
I was recently invited to be part of a Q& A panel at an evening discussing mental health at my church Lansdowne Church, Bournemouth .
The questions for me primarily focused around the issue of mental health and dementia a very under-researched, under-diagnosed and misunderstood topic! I did my best, within my knowledge and understanding, to answer the questions that came my way, but it inspired me to look a bit further into the issue and share a blog post about it I hope you find my musings helpful!
People With Dementia Can Have Good Mental Health
Alzheimer Society of Canada
Its important to remember that mental illness and mental health mean different things. Everyone can experience varying levels of mental health and well-being, regardless of whether or not they have a mental illness. We all have good and bad days, and might experience varying emotions and moods, but that doesnt mean we have a mental illness. Similarly, its possible for someone with a mental illness to have good mental health with the right treatment and the help of a supportive network.
The same is true for people with dementia. A diagnosis of dementia doesnt mean the end of good mental health. Of course, this doesnt mean that people with dementia dont experience mental illness or mental health symptoms. Some may have lived with mental illness prior to dementia others may experience depression or anxiety as they struggle to come to terms with their diagnosis. Regardless, it is possible to treat and improve ones mental health, even when living with dementia.
If you dont believe us, just read Rogers story. Roger was in a dark place after he was diagnosed with Alzheimers at 57. Now, his outlook couldnt be more different. Roger credits his doctor and his local Alzheimer Society for giving him the tools he needs to enjoy a full and happy life.
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Patients With Both Dementia And Severe Mental Illness Experience Faster Cognitive Decline
Individuals with dementia who have comorbid severe mental illness , especially bipolar disorder, experience faster decline in cognitive performance than those without comorbid SMI. However, that decline was attenuated when antidepressant medication was included in models, researchers found in a study published in American Journal of Geriatric Psychiatry. Socio-demographic, health behaviors and cardiovascular risk factors also partially explained the faster decline, the researchers said.
The researchers used data from 4718 individuals from the South London and the Maudsley NHS Foundation Trust Clinical Record Interact Search of populations of four south London boroughs, which are comparable to London in demographic factors. Individuals had primary or secondary diagnosis of dementia from 2007 to 2018, were at least 50 years old at first diagnosis of dementia, and at least 3 recorded Mini-Mental State Examination scores. The MMSE measures cognitive performance with 21 questions on orientation, immediate and delayed recall, naming, spelling and simple arithmetic, and constructional praxis.
Limitations of the study included data on health behaviors being limited to smoking status and potential selection bias associated with limiting the sample to those with at least 3 MMSE scores available as dementia can go undiagnosed in cases of SMI.
Dementia With Lewy Bodies
|Diffuse Lewy body disease, dementia due to Lewy body disease
|Microscopic image of a Lewy body in a neuron of the substantia nigra scale bar=20 microns
|After the age of 50, median 76
|Average survival 8 years from diagnosis
|About 0.4% of persons older than 65
Dementia with Lewy bodies is a type of dementia characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic bodily functions. Memory loss is not always an early symptom. The disease worsens over time and is usually diagnosed when cognitive decline interferes with normal daily functioning. Together with Parkinsons disease dementia, DLB is one of the two Lewy body dementias. It is a common form of dementia, but the prevalence is not known accurately and many diagnoses are missed. The disease was first described by Kenji Kosaka in 1976.
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Common Mental Illnesses In The Elderly
If a senior is displaying signs of mental illness, its important to recognize the symptoms and seek treatment as soon as possible. Some of the common mental illnesses the elderly experience are:
- Depression. Depression is considered the most common mental disorder among seniors. Social isolation plays a major role in emotional wellness, so when a senior spends long periods alone because they are unable to drive or live far away from friends and family, depression can easily set in. It is also a symptom of dementia and tends to get overlooked as a treatable ailment.
- Late onset bipolar. Most bipolar patients are diagnosed in early adulthood. Late onset bipolar can be difficult to diagnose because of its similarities to dementia symptoms like agitation, manic behavior and delusions.
- Late onset schizophrenia. This disorder also presents a challenge to diagnose. It can manifest in adults after age 45 and appears as the patient ages. Symptoms are similar to dementia, once again, with hallucinations and paranoia the most common, but these symptoms are milder than when this illness appears in younger adults.
Mental illnesses are treatable, but the trick is a correct diagnosis. Even if a senior had good mental health throughout their entire life, the risk of mental illness in later years is still there. Seek medical treatment as soon as possible if there are any noticeable changes beginning to occur.
Are The Symptoms Of Dementia The Same As Diseases Such As Schizophrenia
Although dementia can also cause symptoms such as delusional behavior and hallucinations that are very similar to illnesses such as schizophrenia and the manic stage of bi-polar disorder, particularly in the latter stages of a dementia-type illness, because dementia is not a specific disease, it cannot be classed as a mental illness.
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Treating Movement Symptoms In Lewy Body Dementia
LBD-related movement symptoms may be treated with medications used for Parkinsons disease, called carbidopa-levodopa. These drugs can help make it easier to walk, get out of bed, and move around. However, they cannot stop or reverse the disease itself. Side effects of this medication can include hallucinations and other psychiatric or behavioral problems. Because of this risk, physicians may recommend not treating mild movement symptoms with medication. Other Parkinsons medications are less commonly used in people with LBD due to a higher frequency of side effects.
People with LBD may benefit from physical therapy and exercise. Talk with your doctor about what physical activities are best.
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