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What Kind Of Disorder Is Dementia

Normal Memory Changes Vs Dementia Symptoms

What is dementia?

Its something we all have to face but the inevitable changes of aging can still be both humbling and surprising. But while experiencing wrinkling skin, fading hair color, and mild, short-term memory loss is common as we age, severe and rapid memory loss is definitely NOT a part of normal aging. In fact, many people are able to preserve their brainpower as they get older by staying mentally and physically active and making other healthy lifestyle choices.

Differentiating the signs of dementia from normal aging can help to either set your mind at rest or encourage you to begin taking steps to slow the progression of symptoms. In broad terms, normal memory changes associated with aging dont significantly interfere with your ability to function in your daily life. These may include:

Slower thinking and problem solving The speed of learning slows down short-term memory takes longer to function reaction time increases.

More distractedness. All of the interruptions make learning more difficult.

Slower recall A greater need for hints to jog the memory.

Distinguishing between normal memory loss and dementia symptoms is not an exact science but there are some clues to look for:

What Are The Risk Factors For Dementia

    The risk factors for developing dementia include age and family history. Age and a family history of dementia are non-modifiable risk factors. Abnormal genes which are associated with Alzheimer’s disease have been identified, but are only rarely involved in the development of Alzheimer’s disease. Conditions such as high blood pressure, high cholesterol, or diabetes increase the risks of developing either Alzheimer’s disease or multi-infarct dementia. Some medications can lead to memory problems which look like dementia.

    Causes Of Alzheimer’s Disease

    Alzheimer’s disease is the most common type of dementia.

    Alzheimer’s disease is thought to be caused by the abnormal build-up of 2 proteins called amyloid and tau.

    Deposits of amyloid, called plaques, build up around brain cells. Deposits of tau form “tangles” within brain cells.

    Researchers do not fully understand how amyloid and tau are involved in the loss of brain cells, but research into this is continuing.

    As brain cells become affected in Alzheimer’s, there’s also a decrease in chemical messengers involved in sending messages, or signals, between brain cells.

    Levels of 1 neurotransmitter, acetylcholine, are particularly low in the brains of people with Alzheimer’s disease.

    Medicines like donepezil increase levels of acetylcholine, and improve brain function and symptoms.

    These treatments are not a cure for Alzheimer’s disease, but they do help improve symptoms.

    Read more about treatments for dementia.

    The symptoms that people develop depend on the areas of the brain that have been damaged by the disease.

    The hippocampus is often affected early on in Alzheimer’s disease. This area of the brain is responsible for laying down new memories. That’s why memory problems are one of the earliest symptoms in Alzheimer’s.

    Unusual forms of Alzheimer’s disease can start with problems with vision or with language.

    Read more about Alzheimer’s disease.

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    How Does A Doctor Test For Dementia

    There is no single diagnostic test for Alzheimers disease and other causes of dementia. Dementias are diagnosed by evaluating and understanding a persons memory and thinking patterns. Doctors will consider a persons memory, grasp of language, mood states, problem-solving skills, ability to maintain focus and perform complex tasks. Evaluation may include in-office cognitive screening , physical examination, and review of labs. Labwork helps to determine whether there are vitamin deficiencies or hormonal changes at play. In some cases, evaluation may require neuropsychological testing, brain imaging , and genetic testing.

    Early Signs And Symptoms Of Dementia

    Dementia 101: Symptoms, Types, Stages, Treatment and ...

    When you donât seem to be remembering things as well as you did in the past, it can be extremely upsetting, even frightening. Facing up to the possibility of memory loss or dementia inevitably shifts your perceptions, relationships, and priorities. But experiencing symptoms of dementia doesnât have to mean the end of normal life. Certain types of dementia can be slowed or even reversed if caught in time. The first step is to understand what distinguishes normal memory loss from dementia symptoms, and how to identify the different types of dementia. The more you understand about dementia, the more you can do to improve the outcome and preserve your sense of control.

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    Can Dementia Be Prevented Or Avoided

    There is little you can do to prevent or avoid dementia. If you have a head injury or brain tumor, ask your doctor if there are lifestyle changes you can make. Youll want to take precautions to avoid additional head trauma or concussions. If youre at risk of stroke, talk to your doctor about possible preventions.

    Currently, the American Academy of Family Physicians concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.

    What Is Alzheimers Disease

    Alzheimers disease damages your brain, gradually destroying memory and thinking skills. Researchers believe that the damage begins up to a decade before symptoms appear. Abnormal deposits of proteins form hard plaques and tangles throughout the brain. These deposits interfere with normal brain function.

    As they grow, plaques can interrupt communication between neurons, the messengers in your brain. Eventually these neurons die, damaging your brain so much that parts of it begin to shrink.

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    There Are Many Causes Of Dementia

    Any of these symptoms can be caused in multiple ways. Alan, for example, was found to suffer from cognitive impairment related to his HIV infection Martha had Alzheimers disease interfering with her short-term memory and comprehension. Bert, after his diagnostic work up, was recognized to have frontotemporal dementia leading to difficulty controlling behavior and aphasia . Mary had vascular cognitive impairment following her stroke. Bill had suffered brain damage due to oxygen deprivation during his drowning. Each was considered to have dementia, yet the differences between them were huge. In each case, however, an injury or disease process was responsible for destruction of brain cells.

    Causes of dementia may include:

    Risk Factors And Prevention

    Types of Dementia

    Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.

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    What Are The Early And Later Signs And Symptoms Of Dementia

    Early signs of dementia may include:

    • Simple forgetfulness
    • Problems performing tasks or activities that were previously done without effort.
    • Difficulty with learning new material is frequently one of the earliest signs of dementia.

    Many patients with early Alzheimer’s disease or other types of dementia are unaware that they have any problem. As the disease progresses, behavioral changes can become evident.

    • Patients have difficulty performing basic tasks, such as getting dressed or using the bathroom.
    • Some patients begin to forget pieces of information about themselves, including their address or telephone number, or even their date of birth.
    • They may have difficulty understanding what is occurring around them.
    • Some patients have problems remembering to eat and may develop pronounced weight loss.
    • In the late stages of dementia, patients often cannot recognize family members and their ability to communicate effectively is markedly impaired.
    • They are no longer able to effectively care for themselves and require assistance for all activities of daily living.
    • Over time, patients can forget how to walk or even how to sit up.

    The stages of dementia are loosely grouped into mild, moderate, and severe categories by some doctors. However, there is another system of staging for dementia.

    The Genetics Of Alzheimers Disease

    Robert C. Barber

    1Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA

    Abstract

    Alzheimers disease is a progressive, neurodegenerative disease that represents a growing global health crisis. Two major forms of the disease exist: early onset and late onset . Early onset Alzheimers is rare, accounting for less than 5% of disease burden. It is inherited in Mendelian dominant fashion and is caused by mutations in three genes . Late onset Alzheimers is common among individuals over 65 years of age. Heritability of this form of the disease is high , but the etiology is driven by a combination of genetic and environmental factors. A large number of genes have been implicated in the development of late onset Alzheimers. Examples that have been confirmed by multiple studies include ABCA7, APOE, BIN1, CD2AP, CD33, CLU, CR1, EPHA1, MS4A4A/MS4A4E/MS4A6E, PICALM, and SORL1. Despite tremendous progress over the past three decades, roughly half of the heritability for the late onset of the disease remains unidentified. Finding the remaining genetic factors that contribute to the development of late onset Alzheimers disease holds the potential to provide novel targets for treatment and prevention, leading to the development of effective strategies to combat this devastating disease.

    1. Introduction

    2.2. Presenilins 1 and 2

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    Types Of Alzheimers Disease

    Nearly everyone with Alzheimerâs disease will eventually have the same symptoms memory loss, confusion, trouble with once-familiar tasks, and making decisions. While the manner of the disease development remains unclear, all forms of Alzheimers appear to share overproduction and/or decreased clearance of a type of protein called amyloid beta peptides. Though the effects of the disease are similar, there are two main types.

    • Early-onset Alzheimers. This type happens to people who are younger than age 65. Often, theyâre in their 40s or 50s when theyâre diagnosed with the disease. Itâs rare up to 5% of all people with Alzheimers have early-onset. People with Down syndrome have a higher risk for it.Scientists have found a few ways in which early-onset Alzheimerâs is different from other types of the disease. People who have it tend to have more of the brain changes that are linked with Alzheimerâs. The early-onset form also appears to be linked with a defect in a specific part of a personâs DNA: chromosome 14. A form of muscle twitching and spasm, called myoclonus, is also more common in early-onset Alzheimers.
    • Late-onset Alzheimers. This is the most common form of the disease, which happens to people age 65 and older. It may or may not run in families. So far, researchers havenât found a particular gene that causes it. No one knows for sure why some people get it and others donât.

    Genes: A Blueprint For Health And Disease

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    The genes encoded in our DNA are profoundly involved in many aspects of our health. They act as a sort of blueprint for the construction, operation, and repair of our bodies throughout life. Genes provide instructions for the creation and regulation of our bodys building blocks. We inherit one copy of each gene from each of our parents, which is one reason why every person has a unique appearance and metabolism.

    The effects of a gene can be dramatically changed by mutation of even one pair of its molecules. Specific versions of genes, called alleles, are passed down through a familys lineage, potentially creating an entire population of people who share a healthy characteristic such as resistance to cancer a more neutral characteristic such as eye color or a heightened risk for a specific disease such as Alzheimers disease .

    Many of us have learned about Mendel, who was an Austrian monk, and the pea plants he bred as he discovered basic principles of genetic inheritance. Just as with Mendels plants, some physical characteristics can be transmitted to our offspring through inheritance of even one version of a gene. Many diseases are inherited this way, too.

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    Where To Get Help

    • Your local community health service
    • Your local council
    • National Dementia Helpline Dementia Australia Tel. 1800 100 500
    • Aged Care Assessment Services Tel. 1300 135 090
    • My Aged Care Tel. 1800 200 422
    • Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
    • Carers Victoria Tel. 1800 242 636
    • Commonwealth Respite and Carelink Centres Tel 1800 052 222
    • Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers

    What Happens In Dementia

    People with dementia may have different symptoms, depending on the type and stage of their particular dementia. A persons symptoms depend on which part of the brain is affected by the disease process, and they may change over time as the diseases progress to involve different areas of the brain. Different types of dementia tend to target particular parts of the brain. For example, the part of the brain that is important for the formation of new memories is usually affected early on in AD, which is why short-term memory loss is often one of the first symptoms of AD. Other common symptoms in dementia include difficulties with communication, planning and organization, navigation, personality changes, and psychiatric symptoms such as depression, anxiety, delusions and hallucinations.

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    What Is The Treatment For Dementia

      Treatment options for Alzheimer’s disease and other dementia are limited. While there are medications available to try to improve the symptoms of Alzheimer’s disease, the effect of these medications is limited. Physical exercise has been shown to be of some benefit in helping to maintain cognition. Staying engaged and participating in social events may also be of some help. To date, no treatment which can reverse the process of Alzheimer’s disease has been identified.

      Genes And Dementia With Lewy Bodies

      What is frontotemporal dementia?

      Dementia with Lewy bodies is caused by a build-up of abnormal proteins in the brain and may have symptoms similar to those seen in Parkinsons disease. Age is currently the biggest known risk factor for dementia with Lewy bodies, although research is underway to find out whether genes may also play a role.

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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.

      Causes Of Frontotemporal Dementia

      This is an important cause of dementia in younger people. It’s most often diagnosed between the ages of 45 and 65.

      It’s caused by an abnormal clumping of proteins, including tau, in the frontal and temporal lobes at the front and sides of the brain.

      The clumping of these proteins damages nerve cells in the frontal and temporal lobes, causing brain cells to die. This leads to shrinking of these areas of the brain.

      Frontotemporal dementia is more likely to run in families than other, more common causes of dementia.

      Read more about frontotemporal dementia.

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      Genetic Testing And Counseling

      In contrast, EOFAD, with an age at onset before 60 to 65 years old, has an autosomal dominant mode of inheritance in which 20% to 70% of cases are estimated to have a PSEN1 mutation, 10% to 15% of cases are estimated to have an APP mutation, and PSEN2 mutations are rare., Indeed, approximately 60% of patients with EOAD have another known affected family member. The remaining 40% of patients with EOAD may lack a family history because of an early death of a parent, failure to recognize the disorder in family members, or, very rarely, a de novo mutation. If the parent of a patient with EOAD has a mutant allele, then the risk to the patients sibling of inheriting the mutant allele is 50%. The child of a patient with EOAD who carries a mutation has a 50% chance of transmitting the mutant allele to each of their children.

      In this article, we have reviewed the genetics of AD. Further molecular genetic investigations should clarify the roles of additional known genes in the pathogenesis of both common sporadic as well as rare familial forms of AD. Already, investigations of the normal and aberrant functions of A protein and ApoE has provided insight into the underlying mechanisms for AD. Such research will continue to provide new strategies for therapeutic interventions.

      Frontotemporal Dementia With Parkinsonism

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      One form of familial FTD, also known as frontotemporal dementia with Parkinsonism-17 , is caused by genetic changes in the gene for tau protein, located on chromosome 17. No other risk factors for this condition are known.

      FTDP-17 is rare and accounts for only three per cent of all cases of dementia. Symptoms progressively get worse over time and usually appear between the ages of 40 and 60. The condition affects both thinking and behavioural skills and movements such as rigidity, lack of facial expression and problems with balance .

      It can be distressing to be told that you have a genetic disorder or are at risk of having one. Genetic counselling provides the person and their family with information about a genetic disorder and its likely impact on their lives. This can assist a person with FTDP-17 to make informed medical and personal decisions about how to manage their condition and the challenges it presents to their health and wellbeing. Prenatal genetic counselling is also available for parents to help them decide about a pregnancy that may be at risk of FTDP-17.

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