How Dementia Affects Various Lobes Of The Brain
- Where planning occurs
- Ability to comprehend a complex idea
- Ability to change a behavior
- Ability to focus attention
- Control urges- may desire to be close and show affection
- Where personality traits reside- may have subtle personality changes
- Safety awareness
- Ability to get along in a new situation
- Interpret sounds: language vs. non-language
- Ability to write/draw
- Internal maps of the world
- Ability to sequence
- Understand consequences of behavior
- Difficulty knowing the correct purpose of an object
- Knowledge of numbers and their relatio
- Depth perception- high-stepping over surfaces
- Peripheral vision- many persons with dementia cannot see to the sides. This is why we do not approach from the side.
- Process movement- go slow and hold palms out
- Fine visual discrimination- Use vivid colored plates, cups and table tops because those with dementia cannot see things that are too similar in color. Red, navy blue, black and turquoise are good colors.
- Retrieval of short-term memory and long-term memory
- Retrieve and store information
Dementia: What Part Of The Brain Is Under Attack
Part 2 in our series on Dementia. Check out Part 1.
In the diagnosis list, dementia can be clearly stated or there may be other disorders highly linked to dementia, causing the resident to present with the same signs and symptoms. I want you to be able to recognize the types of dementia and the disorders linked to dementia so you can be adequately prepared to understand the residents needs and modify the treatment approach accordingly.
The Alzheimers Association recognizes these types of dementia:
- Alzheimers dementia: most common, 60-80% of known cases
- Vascular dementia: second most common, 10% of known cases
- Dementia with Lewy bodies
- Mixed dementia: commonly Alzheimers with Vascular dementia
- Frontotemporal dementia
Chemical Changes To The Brain
Within the different regions of the brain, the work of forming thoughts and moving our bodies happens on a cellular level. Chemically, tiny electrical charges or signals move through individual cells and parts of the brain. When these processes are compromised, so too are basic brain tasks, such as thinking, feeling, and forming and recalling memories.
In an individual with dementia, neurons carrying signals to and from the brain are destroyed. Signals transmitted between brain cells carried by neurotransmitters are interrupted, and connections between nerve cells of the brain become broken. This is why someone with dementia has problems with thoughts and movement: The communication between cells in their bodies has broken down.
Beta-Amyloid Plaques and Tau TanglesTwo toxic proteins appear to be responsible for the cellular brain damage: beta-amyloid and tau.
When Alzheimers disease begins to develop, part of the neuron that normally helps promote cell growth and survival breaks down in an abnormal way and begins producing a toxic protein called beta-amyloid. Beta-amyloid plaques, which form between neurons, damage neurons in at least two ways: They affect the neurons receptor for a particular neurotransmitter, and that, in turn, interferes with the cells ability to function and send messages to other neurons.
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Alzheimer’s Stages And Progression
In the early stages of Alzheimers disease and dementia, neurons and their connections are destroyed in the areas of the brain which support memory. In later stages, brain functions involving language, reasoning, and regulating behavior become affected. In most cases, the patient will eventually lose their ability to safely live independently.
In the late stages of Alzheimers, as more neurons are lost, many areas of the brain shrink in size. This process is referred to as widespread brain atrophy, resulting in a significant loss of nerve tissue and severely impaired brain function2.
What Are Vascular Issues
Many people with Alzheimers disease also have other changes to their brain, including vascular issues. If there is any kind of vascular issue, like a mini-stroke or hardening of the arteries, this can lead to a breakdown of the blood-brain barrier, leaving the brain vulnerable to harm. If the blood-brain barrier is compromised in someone with Alzheimers disease, glucose doesnt properly reach the brain, which stops it from getting rid of beta-amyloid and tau proteins, both of which are toxic to the brain in excess amounts.2 This, in turn, causes more inflammation, which contributes to vascular problems and the cycle continues.
Medical research is focused on identifying changes to the brain early and discovering new treatments to stop progression of Alzheimers disease.
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Understanding Parts Of The Brain
Learn about the parts of the brain and how dementia damages them, as well as about the symptoms the damage causes.
Dementia is caused when the brain is damaged by diseases, such as Alzheimers disease or a series of strokes. Alzheimers disease is the most common cause of dementia, but not the only one.
A person with dementia will experience symptoms depending on the parts of the brain that are damaged, and the disease that is causing the dementia.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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The Brain And Body Connection
Though the cause of Alzheimerâs is not known, doctors think the symptoms of the disease are caused by a buildup of harmful proteins in your brain called amyloid and tau. These proteins form large clumps, called tangles and plaques. They get in the way of normal brain function and kill healthy cells.
The damage usually starts in the area of your brain that forms memories. People with early-stage Alzheimer’s disease often have trouble remembering things. As the disease gets worse, the plaques and clusters also appear in the parts of the brain in charge of bodily behaviors.
Everyday activities like walking, eating, going to the bathroom, and talking become harder.
The effects of the disease will differ for each person as it gets worse. The pace can be slow. Some people live up to 20 years after a diagnosis. The average life expectancy, though, is 4 to 8 years.
What Will The Doctor Do
It can be hard for a doctor to diagnose Alzheimer disease because many of its symptoms can be like those of other conditions affecting the brain. The doctor will talk to the patient, find out about any medical problems the person has, and will examine him or her.
The doctor can ask the person questions or have the person take a written test to see how well his or her memory is working. Doctors also can use medical tests to take a detailed picture of the brain. They can study these images and look for signs of Alzheimer disease.
When a person is diagnosed with Alzheimer disease, the doctor may prescribe medicine to help with memory and thinking. The doctor also might give the person medicine for other problems, such as depression . Unfortunately, the medicines that the doctors have can’t cure Alzheimer disease they just help slow it down.
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The Role Of Inflammation
Inflammation has long been thought to be a side effect of dementias such as Alzheimers, as the body ramps up its immune system in response to the disease. But recent research has confirmed that inflammation actually contributes to the disease process. One clue was a report that people treated with anti-inflammatory drugs for arthritis had a lower incidence of Alzheimers. This has now been backed up by large genetic studies.
Normally, the brains inflammatory cells help to prevent damaging build-up of amyloid-ß by clearing it away, and its thought that mutations in inflammatory genes hamper this process. Inflammation is a sign of the immune system kicking into gear, and in the initial stages of disease, this is beneficial. However, in the case of Alzheimers, when the disease becomes more advanced, chronic inflammation can set in and add to the toxic insult the brain receives. The brains immune response to inflammation is therefore believed to play two critical roles in developing Alzheimers disease.
Does Dementia Impact The Brains Emotional Center
People living with dementia are experiencing deterioration of brain functions. How does dementia impact the brains emotional center?
The COVID-19 pandemic has caused mass hysteria that has touched all parts of the globe. For some, fear of not knowing when or if society will return to normal is debilitating. Others are amped up about restrictions on personal freedoms and commerce. Even the most cool-headed of us is experiencing uncertainty on some level. Whichever concerns we carry, we are all processing these circumstances the same way: via the brains amygdala region, the emotional center.
Now, if the average adult is experiencing fear, anger, or other negative emotions in response to the way life has changed during this health crisis, imagine what a person living with dementia may be experiencing.
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The Basics Of Alzheimers Disease
Scientists are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimers disease. Advances in brain imaging techniques allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimers symptoms appear. Findings from these studies will help in understanding the causes of Alzheimers and make diagnosis easier.
One of the great mysteries of Alzheimers disease is why it largely affects older adults. Research on normal brain aging is exploring this question. For example, scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimers damage. These age-related changes include atrophy of certain parts of the brain, inflammation, blood vessel damage, production of unstable molecules called free radicals, and mitochondrial dysfunction .
Key Biological Processes In The Brain
Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.
- The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cells activities.
- Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
- The axon is a cable-like structure at the end of the cell body opposite the dendrites and transmits messages to other neurons.
The function and survival of neurons depend on several key biological processes:
Neurons are a major player in the central nervous system, but other cell types are also key to healthy brain function. In fact, glial cells are by far the most numerous cells in the brain, outnumbering neurons by about 10 to 1. These cells, which come in various formssuch as microglia, astrocytes, and oligodendrocytessurround and support the function and healthy of neurons. For example, microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. To carry out these functions, glial cells often collaborate with blood vessels in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best.
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How Alzheimers Disease Affects The Brain
Everyone who cares for someone with Alzheimer’s disease knows all too well that this condition is a thief who slowly steals the most precious parts of those they love. Their memories, ability to communicate, self expression, thinking and planning skills, and personality transform, fade, or eventually disappear.
Caring for someone throughout the stages of AD can leave caregivers feeling powerless, unprepared, and frustrated. Understanding how the disease affects the brain can help caregivers know more about what to expect as it progresses and how to prepare for the later stages. Reducing the amount of surprise involved can make this process less stressful and help caregivers to better look after themselves and their loved ones.
Remember that Alzheimer’s disease is not natural aging. It is a progressive disease that causes the abnormal death of brain cells. The initial signs of dementia often include memory loss, but as the disease progresses, it affects more of the brain until the person is unable to move, swallow or breathe.
The Role Of Neurofibrillary Tangles
The second major finding in the Alzheimer’s brain is neurofibrillary tangles. These tangles are composed of Tau proteins, which play a crucial role in the normal structure and function of the neuron. In people with Alzheimer’s disease, the formally straight Tau proteins have mutated, due to overactive enzymes, resulting in twisted strands that aggregate together and become tangles. These tangles acculumulate inside the neuron, disrupt cell activity , and result in the death of the neuron.
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Loss Of Neuronal Connections And Cell Death
In Alzheimers disease, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of Alzheimers, this processcalled brain atrophyis widespread, causing significant loss of brain volume.
Learn more about Alzheimer’s disease from MedlinePlus.
Support For Family And Friends
Currently, many people living with Alzheimers disease are cared for at home by family members. Caregiving can have positive aspects for the caregiver as well as the person being cared for. It may bring personal fulfillment to the caregiver, such as satisfaction from helping a family member or friend, and lead to the development of new skills and improved family relationships.
Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimers disease at home can be a difficult task and may become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimers disease often need more intensive care.
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More Details About The Lobes Of The Brain
The temporal lobes are on either side of the brain, nearest to the ears. Their main roles involve memory processing, hearing and language.
Both temporal lobes store general knowledge. General knowledge is different from the types of memory that relate to day-to-day experiences. The left temporal lobe helps to understand language, and usually stores facts and the meanings of words. The right temporal lobe deals with visual information, such as recognising familiar objects and faces.
Within each temporal lobe is a region called the hippocampus, which processes memories to allow them to be stored and found when needed. Damage to the hippocampus makes it difficult to learn new things. The hippocampus also sends important information to be stored in other parts of the cerebral cortex. It is important for memory of events and experiences .
The temporal lobes also help to understand what is being heard. Damage to the temporal lobes, particularly to an area called the auditory cortex, can make it more difficult for the hippocampus to form memories of what has just been heard.
Alzheimers disease often starts in and around the hippocampus, before it spreads to other parts of the brain. This is why one of the first symptoms many people notice is memory loss.
What Causes Alzheimers Disease
In recent years, scientists have made tremendous progress in better understanding Alzheimers and the momentum continues to grow. Still, scientists dont yet fully understand what causes Alzheimers disease in most people. In people with early-onset Alzheimers, a genetic mutation may be the cause. Late-onset Alzheimers arises from a complex series of brain changes that may occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimers may differ from person to person.
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Medications To Maintain Mental Function In Alzheimer’s Disease
Several medications are approved by the U.S. Food and Drug Administration to treat symptoms of Alzheimers. Donepezil, rivastigmine, and galantamine are used to treat the symptoms of mild to moderate Alzheimers. Donepezil, memantine, the rivastigmine patch, and a combination medication of memantine and donepezil are used to treat moderate to severe Alzheimers symptoms. All of these drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs dont change the underlying disease process. They are effective for some but not all people and may help only for a limited time.