What Does Dementia Mean In Medical Terms

What Is Missing What Is Needed In The Future

This paper has focused on the new diagnostic formulations of AD that support the earlier identification of disease based on biomarker integration. There is currently an emerging belief in the field that the failure to make progress in therapeutics of the disease is arising from interventions that occur too late in the processed pathophysiological process. The emergence of biomarkers that identify the pathology of AD ahead of its symptomatic expression may in future allow the potential for studies directed at earlier intervention, including those directed at prevention of AD/dementia.

The time may now be here to reconceptualize the functional impairment criteria for AD diagnosis given some of the significant decade-long challenges of defining the right amount of impairment. Defining functional impairment cutoff points is very difficult, and even assessing function in many cases is unworkable, given its significant social and gender context. This is clearly an area that requires further work.

Treatment Of Behavior And Mood Problems In Lewy Body Dementia

Behavioral and mood problems in people with LBD can arise from hallucinations, delusions, pain, illness, stress, or anxiety. They may also be the result of frustration, fear, or feeling overwhelmed. The person may resist care or lash out verbally or physically.

Medications are appropriate if the behavior interferes with the person’s care or the safety of the person or others. If medication is used, then the lowest possible dose for the shortest period of time is recommended.

The first step is to visit a doctor to see if a medical condition unrelated to LBD is causing the problem. Injuries, fever, urinary tract or pulmonary infections, pressure ulcers , and constipation can worsen behavioral problems and increase confusion.

Certain medications, such as anticholinergics and antihistamines may also cause behavioral problems. For example, some medications for sleep problems, pain, bladder control, and LBD-related movement symptoms can cause confusion, agitation, hallucinations, and delusions. Similarly, some anti-anxiety medicines can actually increase anxiety in people with LBD. Review your medications with your doctor to determine if any changes are needed.

Antidepressants can be used to treat depression and anxiety, which are common in LBD. Many of them are often well tolerated by people with LBD.

What Are The Causes Of Lewy Body Dementia

The precise cause of LBD is unknown, but scientists are learning more about its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the brain that produce two important chemicals that act as messengers between brain cells . One of these messengers, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood.

Scientists are also learning about risk factors for LBD. A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. Age is considered the greatest risk factor. No specific lifestyle factor has been proven to increase one’s risk for LBD.

Other known risk factors for LBD include certain diseases and health conditions, particularly Parkinson’s disease and REM sleep behavior disorder, which have been linked to a higher risk of LBD.

Having a family member with LBD also may increase a person’s risk, though LBD is not considered a genetic disease. Variants in three genes APOE, SNCA, and GBA have been associated with an increased risk, but in most cases, the cause is unknown.

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Lewy Body Dementia Research

Many avenues of research are being explored to improve our understanding of LBD. Some researchers are working to identify the specific differences in the brain between the two types of LBD. Others are looking at the disease’s underlying biology, genetics, and environmental risk factors. Still other scientists are trying to identify biomarkers , improve screening tests to aid diagnosis, and research new treatments.

Scientists hope that new knowledge about LBD will one day lead to more effective treatments and even ways to cure and prevent the disorder. Until then, researchers need volunteers with and without LBD for clinical studies.

NIH and other groups help people learn about clinical trials and studies and find research opportunities near them. Visit the following websites for details:

Vascular Dementia: Causes Symptoms And Treatments

Vascular dementia refers to changes to memory, thinking, and behavior resulting from conditions that affect the blood vessels in the brain. Cognition and brain function can be significantly affected by the size, location, and number of vascular changes.

Symptoms of vascular dementia can begin gradually or can occur suddenly, and then progress over time, with possible short periods of improvement. Vascular dementia can occur alone or be a part of a different diagnosis such as Alzheimer’s disease or other forms of dementia. When an individual is diagnosed with vascular dementia, their symptoms can be similar to the symptoms of Alzheimer’s.

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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.

What Is Alzheimer’s Disease

Alzheimers disease is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease those with the late-onset type symptoms first appear in their mid-60s. Early-onset Alzheimers occurs between a persons 30s and mid-60s and is very rare. Alzheimers disease is the most common cause of dementia among older adults.

The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps and tangled bundles of fibers .

These plaques and tangles in the brain are still considered some of the main features of Alzheimers disease. Another feature is the loss of connections between nerve cells in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimers, too.

This damage initially takes place in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex, such as those responsible for language, reasoning, and social behavior. Eventually, many other areas of the brain are damaged.

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Symptoms Of Dementia Praecox

Schizophrenia is a serious mental disorder that causes a warped interpretation of reality. Its a complex condition that can affect reasoning, speech, or behavior, and is estimated to affect from 0.25% to 0.64% of people in the United States. Individuals with schizophrenia can exhibit the following symptoms.

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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The Syndrome Of Dementia

Dementia is typically defined as a clinical syndrome of cognitive decline that is sufficiently severe to interfere with social or occupational functioning. It remains an anchor point of reference within the revised AD diagnostic criteria proposals. Routine clinical practice shows that the cognitive and functional changes of dementia are typically accompanied by changes in behavior and in personality, but these have not become core criteria as they have been considered heretofore to lack sufficient diagnostic specificity.

Dementia has been and remains a clinical diagnosis, in which laboratory or imaging tests as yet provide only supportive diagnostic evidence. Diagnosis includes a careful history. In specialist practice, this is often done using a semi-structured interview with an informant although a wide variety of assessment approaches exist. Diagnosis also involves a detailed medical and neurological examination, and a formal mental status examination including bedside cognitive testing. Brief assessment tools are often used whereas in some referral centers extensive neuropsychological testing is used as an ancillary diagnostic aid. Structured or informal functional assessment is used to establish the presence and severity of functional disability.

The 2011 NIA-AA revised core clinical criteria for dementia advance the clinical framework where dementia can be diagnosed when cognitive or behavioral symptoms meet the following :

Communicating About Dementia With Health Care Providers

Good communication with the primary care provider or neurologist affects the well-being of the person with dementia as well as the caregiver.

Communicating your concerns and describing the changes you have observed will guide the provider to investigate. In some cases, you may find yourself âeducatingâ medical staff about the symptoms of the person you care for.

It is important that your concerns are taken seriously, and you are treated with respect and dignity.

If you are not receiving the attention you feel is needed, communicate your concerns to the provider. Request a referral to a resource in the community specializing in the evaluation of people with cognitive conditions. The goal is to establish a partnership to maintain the person with dementiaâs the quality of health and to solve problems that arise. For more information, see FCAâs âPathways to Effective Communication for Healthcare Providers and Caregiversâ: https://www.caregiver.org/resource/pathways-effective-communication-healthcare-providers-and-caregivers/.

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Examples Of Dementia In A Sentence

dementiadementiasdementia clevelanddementiaPeoplemagdementiaSan Diego Union-TribunedementiaCNNdementiaNew York TimesdementiaWashington PostdementiaThe AtlanticdementiaHarper’s BAZAAR

These example sentences are selected automatically from various online news sources to reflect current usage of the word ‘dementia.’ Views expressed in the examples do not represent the opinion of Merriam-Webster or its editors. Send us feedback.

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.

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What Doctors Need To Do To Diagnose Dementia

Now that we reviewed the five key features of dementia, lets talk about how I or another doctor might go about checking for these.

Basically, for each feature, the doctor needs to evaluate, and document what she finds.

1. Difficulty with mental functions. To evaluate this, its best to combine an office-based cognitive test with documentation of real-world problems, as reported by the patient and by knowledgeable observers

For cognitive testing, I generally use the Mini-Cog, or the MOCA. The MOCA provides more information but it takes more time, and many older adults are either unwilling or unable to go through the whole test.

Completing office-based tests is important because its a standardized way to document cognitive abilities. But the results dont tell the doctor much about whats going on in the persons actual life.

So I always ask patients to tell me if theyve noticed any trouble with memory or thinking. I also try to get information from family members about any of the eight behaviors that are common in Alzheimers. Lastly, I make note of whether there seem to be any problems managing activities of daily living and instrumental activities of daily living .

Driving and managing finances require a lot of mental coordination, so as dementia develops, these are often the life tasks that people struggle with first.

Checking for many of these causes of cognitive impairment requires laboratory testing, and sometimes additional evaluation.

Behavioral Variant Frontotemporal Dementia

The most common FTD, bvFTD, involves changes in personality, behavior, and judgment. People with this disorder may have problems with cognition, but their memory may stay relatively intact. Symptoms can include:

• Problems planning and sequencing
• Difficulty prioritizing tasks or activities
• Repeating the same activity or saying the same word over and over
• Acting impulsively or saying or doing inappropriate things without considering how others perceive the behavior
• Becoming disinterested in family or activities they used to care about

Over time, language and/or movement problems may occur, and the person living with bvFTD will need more care and supervision.

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What Are The Most Common Types Of Dementia

• Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.

• Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.

• Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .

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.
• Misplacing commonly used items or placing them in unusual spots.
• Not knowing the season, year or month.
• Having difficulty coming up with the right words.
• Experiencing a change in mood, behavior or interests.

Signs that dementia is getting worse include:

• Your ability to remember and make decisions further declines.
• Talking and finding the right words becomes more difficult.
• Daily complex tasks, such as brushing your teeth, making a cup of coffee, working a TV remote, cooking and paying bills become more challenging.
• Lessening of rational thinking and behavior and your ability to problem-solve.
• Sleeping pattern changes.
• Increases or worsening of anxiety, frustration, confusion, agitation, suspiciousness, sadness and/or depression.
• Needing more help with activities of daily living, such as grooming, toileting, bathing and eating.
• Experiencing hallucinations .

These symptoms are general symptoms of dementia. Each person diagnosed with dementia has different symptoms, depending on what area of their brain is damaged. Additional symptoms and/or unique symptoms occur with specific types of dementia.

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What To Do If A Loved One Is Suspicious Of Having Dementia

• Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
• Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
• Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.

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

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Definition Of Alzheimer Disease Over Time

In 1984, the National Institute on Neurological and Communicative Disorders and Stroke and the Alzheimers Disease and Related Disorders Association criteria were created conceptualizing Alzheimer disease as a clinicopathological entity for over 30 years . With advancing technology allowing in vivo detection of amyloid with PET and CSF as well as measurement of neurodegeneration, in 2011 revised AD criteria were proposed by the National Institute on Aging-Alzheimers Association. Individuals were characterized by their clinical state with biomarkers of amyloid and neurodegeneration providing the likelihood that their clinical state was due to Alzheimer disease. For example, if amyloid and neurodegeneration biomarkers were present in conjunction with the clinical syndrome of dementia, the diagnosis of dementia due to AD with high likelihood could be made . But the diagnoses of MCI and dementia due to AD were still clinical-pathological conditions.