Who Can Diagnose Dementia
Visiting a primary care doctor is often the first step for people who are experiencing changes in thinking, movement, or behavior. However, neurologists doctors who specialize in disorders of the brain and nervous system are often consulted to diagnose dementia. Geriatric psychiatrists, neuropsychologists, and geriatricians may also be able to diagnose dementia. Your doctor can help you find a specialist.
If a specialist cannot be found in your community, contact the nearest medical school neurology department for a referral. A medical school hospital also may have a dementia clinic that provides expert evaluation. You can also visit the Alzheimers Disease Research Centers directory to see if there is an NIA-funded center near you. These centers can help with obtaining a diagnosis and medical management of conditions.
Can Dementia Be Prevented
No known way to prevent irreversible dementia or even many types of reversible dementia exists. The following may help prevent certain types of dementia:
- Maintaining a healthy lifestyle that includes a balanced diet, regular exercise, moderate use of alcohol, and no smoking or substance abuse
- Taking precautions to prevent infections
- Using protective equipment such as a seat belt or motorcycle helmet to prevent head injury
The following may allow early treatment and at least partial reversal of dementia:
- Being alert for symptoms and signs that suggest dementia
- Early recognition of underlying medical conditions, such as hypoxia, HIV infection, low glucose levels, or low sodium levels
How Is Dementia Fatal And Why
An increasing leading cause of death among the elderly today is dementia. Dementia is a group of brain degenerative diseases that cause memory and thought impairment. There are different types of dementia that can affect people at various stages throughout old age.
Although there is no specific known cause of dementia, many times it results from the gradual deterioration of the brain which causes a severe impact on cognitive function over time. Its helpful to know what to expect if you care for someone with dementia.
If left unaddressed, the symptoms of dementia and the changes it causes can be overwhelming and sometimes frightening. Why exactly is dementia so fatal? How does dementia eventually kill you?
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Dementia With Young Onset
Most studies on prevalence of dementia focus on subjects aged over 65 years. Although age is well established as its most important risk factor, dementia may also affect people under the age of 65. Few data exist on the prevalence of dementia in younger people. A recent study in the UK was designed to determine the prevalence of dementia in people under the age of 65 in a large catchment area and use these figures to estimate the number of younger people affected by dementia in the UK. The prevalence of dementia in those aged 3064 was 54 per 100 000. For those aged 4564, the prevalence was 98 per 100 000. Like the studies mentioned above describing prevalence over the age of 65, there was a strong age dependency: from the age of 35 years onwards, the prevalence of dementia approximately doubled with every five year increase in age. In contrast with studies describing populations over 65, males seem at a higher risk to become demented before they reach the age of 65 than females.
Causes of dementia with young onset . Based on Harvey et al.
Planning For The Future
Planning early makes it easier for someone with younger onset dementia to manage their financial, legal and medical affairs now and in the future.
If you have been diagnosed with younger onset dementia, it is important to make important decisions while you still can and while you are legally competent to sign any documents.
Things to think about include:
- your living arrangements into the future
- who can have access to your financial accounts
- having joint signatures on all financial accounts
- arranging when and how you will access your finances
- talking to a financial adviser
- sorting out superannuation, health and income insurance
- writing or updating your will
If you have been diagnosed with dementia, its important to nominate a trusted person to manage your affairs in the future. You can do this through an Enduring Power of Attorney .
A financial EPA enables a nominated person to look after your financial affairs if you become unable to do so. A medical EPA covers only medical decisions. The laws regarding EPAs vary between states and territories, so it’s important to seek legal advice before the agreement is completed, or if you are moving interstate.
Some states also have medical guardianship . This allows someone to choose a person to make medical decisions for them. For more information on guardianship and administrators, visit the My Aged Care website.
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Making Life Easier For Dogs With Dementia
The most important aspect of caring for a dog with dementia is trying to make them as comfortable as possible.
Meeting your dogs needs can help them immensely in maneuvering through life with CCD, and can improve their quality of life for as long as possible.
Some of the best ways to make life easier for a dog with dementia include:
Difficulty In Calculating Numbers And Handling Money Or Balancing The Cheque Book
This is different to: common age-related issues such as missing a couple of debt repayments due to low income, making occasional errors with number calculations.
Consistent financial problems and money struggles are high on the early signs of dementia checklist. These dementia symptoms include changes in an ability to develop and follow a plan or work with numbers. This could include:
- Spending money more frivolously than usual
- Having difficult following a recipe with measurements
- Being uncharacteristically generous with money
- Struggling to keep track of monthly bills
If youre concerned about your parents ability to handle their finances, read our guide on setting up a power of attorney for someone with dementia.
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What Are Potentially Treatable Causes Of Dementia
The dementia in treatable conditions may be reversible or partially reversible, even if the underlying disease or damage is not. However, readers should note that if underlying brain damage is extensive or severe, these causes may be classified as irreversible by the individual’s physician.
There is no specific test for dementia. However, dementia may be diagnosed if at least two of the following core mental functions are significantly impaired, according to some researchers:
- Memory
- Attentiveness/focus on a problem or subject
- Reasoning/Judgment
- Visual perception
In some people, the signs and symptoms of dementia are easily recognized in others, they can be very subtle. A careful and thorough evaluation is needed to identify their true cause.
An assessment of dementia symptoms should include a mental status evaluation. This evaluation uses various “pencil and paper,””talking,” and physical tests to identify brain dysfunction. A more thorough type of testing, performed by a psychologist, is called neuropsychologic testing.
Lab tests may be used to identify or rule out possible causes of dementia.
In some cases, imaging studies of the brain may be necessary to detect conditions such as normal pressure hydrocephalus, brain tumor, or infarction or bleeding in the brain.
Difficulty Finding The Right Words
Another early symptom of dementia is struggling to communicate thoughts. A person with dementia may have difficulty explaining something or finding the right words to express themselves. Having a conversation with a person who has dementia can be difficult, and it may take longer than usual to conclude.
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Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Disorientation
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
What Is Parkinson Disease
Parkinson disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinsons disease also have tremors and may develop cognitive problems, including memory loss and dementia.
Parkinson disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, it’s called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. It’s also much more common in men than in women.
Parkinson disease is a chronic and progressive disease. It doesn’t go away and continues to get worse over time.
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Changes In Behaviour Judgement And Moods
Becoming quiet, withdrawn or restless or frustrated or angry can be early signs of dementia. Someone may develop repetitive behaviour for example, they ask the same question over and over again, do the same thing repeatedly or make multiple phone calls to the same person. They may become insecure and anxious or start hiding and losing items. They may withdraw from social activities or give up hobbies and interests they have enjoyed.
They may show poor judgement, for example putting summer clothes on in cold winter months, not knowing when a kettle is full or overfilling cups when making cold and hot drinks, putting a kettle on the hob or leaving a cooker on or tap running. Someone with dementia may become very emotional and experience rapid mood swings or become quieter and less emotional than usual.
Early Signs Of Dementia
Its not easy to spot the early signs of dementia in someone we are caring for. If a person is struggling to remember a name, follow a conversation or recall what they did yesterday, many of us may put it down to the fact that the person is getting older. But it may well be a warning that they are in the early stages of dementia.
Family, friends and care workers are likely to be the first to see the signs and play a key role in encouraging a person receiving care to see a GP.
Because I was with my wife continuously, I think I was less likely to recognise some of the changes that were taking place than people who saw her less regularly.
A carer speaking about his wifes early signs of dementia, healthtalk website
A doctor can help establish whether a person has dementia or a treatable illness or condition that can cause dementia-like symptoms, such as depression, a urinary infection or nutritional disorders.
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How Long Does Sundowning Last In Dementia Individuals
Sundowning doesnt usually start occurring until the mid to late stage of dementia. However, once it does start, its something that can potentially happen every afternoon/evening.
Additionally, while a sundowning episode is happening, it can last for many hours or through the night. If it lasts through the night, it can greatly affect sleep for both the caregiver and person with dementia.
Because the person with dementia may be awake at night, the family caregiver will also need to stay alert in case their loved one wanders or experiences an onset of confusion.
It may be okay for the person with dementia to forgo nighttime sleep. But for family caregivers who may have other personal responsibilities, watching a loved one 24/7 isnt possible. And even though we provided some ways to help decrease the risk of sundowning, these practices wont be 100% effective.
So, how can you ensure high-quality around-the-clock care for a dementia patient who wont sleep or regularly suffers from sundowning?
What Causes Canine Dementia
Similar to dementia in humans, there is no exact cause for dementia in our canine companions.
This condition is most often believed to develop as a result of brain atrophy, which is a normal aging process of the canine brain.
Though its likely that CCD develops due to death of cells within the brain, there are a few other possibilities that have been linked to the condition.
First, some experts believe there may be a genetic link to canine cognitive dysfunction.
This means that a predisposition to the condition may be passed on from dog to dog, causing some lines of dogs to be more at risk than others.
There is also ongoing research on whether or not its more common in small breed dogs, but it could be due to the fact that they typically live longer lives.
Another potential cause of canine dementia is the presence of other neurological conditions.
Conditions such as brain tumors or seizure disorders may cause a dog to be more at risk of developing the condition later on in life, but this possibility is still being researched.
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Dementia With Lewy Bodies
Dementia with Lewy bodies is caused by the build-up of tiny protein deposits in the brain. DLB is less common in younger people with dementia than in older people. Lewy bodies also cause Parkinsons disease and about one-third of people with Parkinsons eventually develop dementia.Symptoms of dementia with Lewy bodies can include hallucinations and varying levels of alertness. People can also develop the features of Parkinsons disease .
What is dementia with Lewy bodies?
Find out more about dementia with Lewy bodies, diagnosis and how to treat it.
Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
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Being Confused About Time Or Place
Dementia can make it hard to judge the passing of time. People may also forget where they are at any time.
They may find it hard to understand events in the future or the past and may struggle with dates.
Visual information can be challenging for a person with dementia. It can be hard to read, to judge distances, or work out the differences between colors.
Someone who usually drives or cycles may start to find these activities challenging.
A person with dementia may find it hard to engage in conversations.
They may forget what they are saying or what somebody else has said. It can be difficult to enter a conversation.
People may also find their spelling, punctuation, and grammar get worse.
Some peoples handwriting becomes more difficult to read.
A person with dementia may not be able to remember where they leave everyday objects, such as a remote control, important documents, cash, or their keys.
Misplacing possessions can be frustrating and may mean they accuse other people of stealing.
It can be hard for someone with dementia to understand what is fair and reasonable. This may mean they pay too much for things, or become easily sure about buying things they do not need.
Some people with dementia also pay less attention to keeping themselves clean and presentable.
Dementia & Alzheimer’s Infographic
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What Causes Vascular Dementia
Vascular dementia is caused by a lack of blood flow to a part of the brain. Blood flow may be decreased or interrupted by:
- Blood clots
- Bleeding because of a ruptured blood vessel
- Damage to a blood vessel from atherosclerosis, infection, high blood pressure, or other causes, such as an autoimmune disorder
CADASIL is a genetic disorder that generally leads to dementia of the vascular type. One parent with the gene for CADASIL passes it on to a child, which makes it an autosomal-dominant inheritance disorder. It affects the blood vessels in the white matter of the brain. Symptoms, such as migraine headaches, seizures, and severe depression, generally start when a person is in his or her mid-30s but, symptoms may not appear until later in life.
Symptoms In The Later Stages Of Dementia
As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.
The most common symptoms of advanced dementia include:
- memory problems people may not recognise close family and friends, or remember where they live or where they are
- communication problems some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
- mobility problems many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
- behavioural problems a significant number of people will develop what are known as “behavioural and psychological symptoms of dementia”. These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
- bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
- appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems. Alzheimer’s Society has a useful factsheet on eating and drinking
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