Dementia is an umbrella term for all diseases that relate to a loss of memory, language, problem-solving, and thinking skills (often called cognitive abilities) that impact the overall ability to function.
Dementia is a progressive disorder that degenerates the brain cells and destroys memory. Normally, it begins mildly and matures to severe over time. Without proper diagnosis or dementia treatment, the illness can make life challenging, even doing daily tasks could become difficult. Before understanding the options for treatment of dementia, let’s understand a few things about dementia.
Doctors often define senility to understand dementia better. Senility is more commonly referred to as dementia and is characterized by a decrease in cognitive abilities or mental decline. Dementia is not constrained by age, anyone can get dementia. Many of the individuals believe that dementia is a disease that only affects the aged and is irreversible. However, early diagnosis and intervention is key to effective management.
It is somewhat disappointing that more information regarding Dementia is not in the mainstream media. While millions of families suffer in silence, the numbers continue to increase as more people continue to be diagnosed with this insidious disease. According to the research studies, In India, only 1 out of 10 people with dementia receive a diagnosis, dementia treatment, or care.
Moreover, the number of younger patients with early-onset Alzheimer’s is also on the rise. While the typical age for diagnosing Alzheimer’s is 80 years old, today doctors are seeing people as young as 45 with early signs of dementia. For families with minor children still living at home, having a parent diagnosed with early-onset dementia affects social and emotional development and places family dynamics under an incredible amount of stress.
Hence, continued research and commitment towards dementia treatment, and ultimately a cure, for Alzheimer’s and other forms of dementia are essential.
Most dementias are progressive i.e. their symptoms start slowly and over time get worse. Some of the most common symptoms of Dementia include:
As stated earlier, Dementia is a broad term that covers multiple diseases like Alzheimer’s disease, vascular dementia, frontotemporal dementia, and others. It is usually caused by brain cell death, and neurodegenerative disease (progressive brain cell disease that happens over time). In some cases, dementia can also be triggered due to a head injury, a stroke, infection in the central nervous system, excessive alcohol consumption, or a brain tumour.
Most individuals have the belief that if they’re forgetting things, it’s just a sign of confusion and work pressure. Consulting a doctor for immediate assistance is often considered out-of-line. However, in reality, there’s no single test for dementia diagnosis. Doctors and psychiatrists diagnose all forms of dementia by analyzing your medical history, performing physical checkups, laboratory tests, and by tracking any abrupt changes in your behaviour, character, or day-to-day functions.
In most cases, doctors figure out the probable causes by running multiple tests and then reading your symptoms. However, at times, identifying the exact type of dementia becomes trickier as the symptoms can often overlap. In case your doctor doesn’t specify a type, you can consult with a neurologist.
If dementia is diagnosed earlier, the psychiatrist may help in the management of dementia and treating it by reversing its symptoms. By following the proper medications, dementia therapies, and early treatments one can reduce the severity and minimize the symptoms.
Brain cell death or neurodegenerative disease is often found in patients with dementia. Although it is not known whether brain cell death causes dementia or it’s the other way around. Some of the causes of dementia are head injury, stroke, brain tumour, prion diseases, HIV infection, Reversible factors etc.
Mostly dementia occurs due to age-related factors or because of existing family history. Different forms of dementia impact your daily life in myriad ways and the treatment depends on the type of dementia you have. Some of the most common forms of dementia include:
It’s one of the most well-known and common types of dementia. In the initial stages, the symptoms might not be even visible, but as time progresses, the following symptoms are visible and start hindering the daily schedule of an individual:
The exact cause of why Alzheimer’s disease triggers is still unknown, but many psychiatrists and doctors conclude that it’s because of a brain cell death. As the cells start dying, the person starts experiencing a memory loss. Earlier, the usual age of Alzheimer’s development was more common in senior citizens (above 7), but of late, the onset of the disease is now more common in people who’re in the range of 40 – 50 years.
Doctors may recommend multiple diagnostic tests for dementia that increase the chances of improvement in an individual suffering from Alzheimer’s disease. Early intervention has been proven to be effective in slowing down the disease.
Also called the “multi-infarct dementia” or “post-stroke dementia”, it’s the second most common form of dementia. It primarily triggers when there’s a lack of blood flow within the brain leading to a silent stroke and is more common in individuals who’re aged. Its symptoms include:
Vascular dementia shortens a person’s lifespan and lack of oxygen can often impair the functioning of your brain. If you develop an aneurysm (or a blood clot), it can further prevent blood-flow within your veins. Depending on which side of the brain gets damaged, the treatment will take place.
In general, there’s no specific cure for vascular dementia, but the doctors can surely treat the ailment to prevent further brain injury. In severe cases, they can also recommend suitable dementia medications and therapies to manage the symptoms.
People with Lewy body dementia have abnormal balloonlike clumps of a protein called Lewy bodies in their brain. This condition is one of the most common types of progressive dementia. Symptoms include visual hallucinations, fluctuations in cognitive ability, difficulty paying attention, and alertness, difficulty in movement and walking, and REM sleep behaviour disorder, where people act out their dreams by yelling, punching bed partners, and falling out of bed.
This is one of the rarest forms of dementia and unlike above-discussed forms, there’s no memory loss in this type. In Frontotemporal dementia (also called the Pick’s disease), you undergo multiple behavioural and emotional changes rather than cognitive impairment. The most common symptoms include:
There are subtle signs of muscle weakness too that often trigger problems with swallowing, chewing, and controlling bladder or bowel movement.
Frontotemporal dementia is most common in individuals who are nearly 45 years old and run in families that have certain mutations in their genes. It also occurs when the frontal lobe of the brain is damaged or shrinks.
Frontotemporal dementia treatment guidelines include the usage of certain medicine for dementia to reduce agitation, signs of irritability and depression, and improve the general quality of life.
Often there is more than one reason which causes dementia. People with dementia of over the age of 80 are found to have several causes such as Vascular dementia, Alzheimer’s disease, and Lewy body dementia. Such a condition is known as mixed dementia. Mixed dementia symptoms depend on the brain regions affected and types of brain changes involved. Symptoms might be similar to those of Alzheimer’s or another type of dementia. Symptoms include slowness of thought, difficulty with planning, changes to your mood or behaviour, trouble with understanding, problems with concentration, memory and language. Some of these symptoms are not as common as they are in people with Alzheimer’s disease.
Often people confuse the two but Dementia and Alzheimer’s disease isn’t the same. Memory impairment is an important symptom of dementia, but a memory impairment with no other cognitive impairments is called Amnesia. Dementia is not a disease, but a syndrome.
Symptoms like impairment of judgement and abstract thinking, impairment of higher cerebral functions such as aphasia, apraxia, and agnosia, or personality changes in addition to short-term and long-term memory impairments are diagnostic standard for dementia. Whereas Amnesia develops from drugs, psychogenic causes, cerebrovascular disorders localized in the hippocampus and others. Unlike Dementia, Amnesia can be temporary and curable. When the condition of Amnesia persists for a long time, it might lead to dementia. Mild amnesia often seen in normal elderly people is called BSA. The two main symptoms of amnesia are:
While there is currently no known cure for Dementia, it is encouraging to know that there are treatments you can avail to improve the brain and memory function. Some of the dementia treatments are-
Dementia Medications: A number of drugs are available today for improving brain function. A combination of dementia medications such as psychotropic drugs (antipsychotics medications), anti-anxiety medications, antidepressants helps in the improvement of cognitive and behavioural symptoms.
Antipsychotic medications for dementia treatment can be effective in reducing persistent feelings of aggression. Anti-anxiety medications help reduce feelings of restlessness and agitation. Likewise, antidepressant medication alleviates the symptoms of depression in people with dementia. Doctors also use medicine for memory for improvement in some of the symptoms.
Psychotherapy: Psychotherapies, in particular, behavioural approaches help in reducing the severity of problematic behaviours in people with dementia, such as aggressive behaviours. This method also identifies the triggering elements of this problematic behaviour that can help in devising an intervention that can be effective in managing them.
Medication regime: Dementia care with certain drugs to prevent strokes help reduce the risk of brain damage. In the case of a brain stroke, certain drugs used to improve memory in Alzheimer’s disease have proven helpful in recovery. Most risk factors leading to the development of cardiovascular dementia are the same as ones that can develop a cerebrovascular disease.
These include cholesterol problems, diabetes, atrial fibrillation, hypertension, blood pressure. Hence any preventive action, as well as treatment of these problems, can help manage or even prevent cardiovascular dementia.
Support groups: Support groups are a popular form of encouragement and education for family members who are also serving as the primary caretaker of people with dementia. These groups allow members to share experiences, and even more important, provide an outlet to socialize with others in similar circumstances.
Along with a healthy balanced diet, herbal remedies and dietary supplements including vitamin B9, vitamin B12, and vitamin E, are promoted as treatments for dementia as these have shown some effectiveness in prevention.
Other natural therapies with regular activities of daily living help with dementia care. Also, physical therapy improves body movements and helps people learn to use walkers or sticks properly. Occupational therapy, music, art activities as well as aromatherapy (the therapeutic use of pure plant essential oils), may be helpful and have a fulfilling and calming effect on people with dementia.
While it is sad to see any person impacted in such a negative manner from a cognitive and physical standpoint, we must realize this disease also affects families and not just the individual. The condition gets progressively worse as time goes on. Hence it is crucial for the family member to improve care proportionately.
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