Dementia is an overall decline in memory and other thinking skills sever enough to reduce a person’s ability to perform everyday activities. It is characterized by the progressive and persistent deterioration of cognitive function. Patient with dementia have problems with cognition, behaviour and functional activities of everyday life.
Dementia is not a disease. It may be caused by a variety of illnesses or injuries. Mental impairment may range from mild to severe. It may also cause personality changes.
Some dementias are progressive. This means they get worse over time. Some dementias are treatable or even reversible. Some experts restrict the term dementia to irreversible mental deterioration.
Symptoms
Dementia affects each person in a different way. In most cases, dementia is progressive, getting worse over time.
However, most people experience symptoms of the following stages of dementia:
Mild cognitive impairment.
Older individuals may develop mild cognitive impairment (MCI) but may never progress to dementia or any other mental impairment.
People with MCI commonly experience:
Forgetfulness
trouble recalling words
short-term memory problems
Mild dementia.
At this stage, people with mild dementia may be able to function independently. Symptoms includes:
️ short-term memory lapses
️ personality changes, including anger or depression
️ misplacing things or forgetfulness
️ difficulty with complex tasks or problem solving
️ struggling to express emotions or ideas
Moderate dementia.
As dementia progresses to this stage, the signs and symptoms become clearer and interfere with daily tasks and activities.
Symptoms include:
poor judgment
increasing confusion and frustration
memory loss that reaches further into the past
needing help with personal care
significant personality changes.
Severe dementia.
At this late stage of dementia, the mental and physical symptoms of the condition continue to decline.
Symptoms include:
inability to maintain bodily functions, including walking and eventually swallowing and controlling bladder
inability to communicate
requiring full-time assistance
becoming unaware of the time and place
having difficulty recognizing relatives and friends
experiencing behaviour changes that may escalate and include aggression.
increased risk for infections
Causes.
Dementia is caused by damage to or loss of nerve cells and their connections in the brain. Depending on the area of the brain that's damaged, dementia can affect people differently and cause different symptoms.
Several conditions can cause dementia, including diseases of the brain. The most common such causes are Alzheimer’s disease and vascular dementia.
Some of the more common causes of dementia include:
️ Neurodegenerative diseases
️ Alzheimer’s disease
️ vascular dementia
️ medication side effects
️ chronic alcoholism
️ certain tumors or infections of the brain
️ Parkinson’s disease with dementia
️ frontotemporal lobar degeneration
Dementia may also be caused by other conditions, including:
structural brain disorders, such as normal-pressure hydrocephalus and subdural hematoma
metabolic disorders, such as hypothyroidism, vitamin B-12 deficiency, and kidney and liver disorders
toxins, such as lead
Risk factors
Many factors can eventually contribute to dementia. Some factors, such as age, family history, Down syndrome can't be changed. Others can be addressed to reduce your risk.
Age - The risk rises as you age, especially after age 65. However, dementia isn't a normal part of aging, and dementia can occur in younger people.
Family history - Having a family history of dementia puts you at greater risk of developing the condition.
Down syndrome - By middle age, many people with Down syndrome develop early-onset Alzheimer's disease.
Diet and exercise - Research shows that lack of exercise increases the risk of dementia. And while no specific diet is known to reduce dementia risk, research indicates a greater incidence of dementia in people who eat an unhealthy diet compared with those who follow a Mediterranean-style diet rich in produce, whole grains, nuts and seeds.
Excessive alcohol use - Drinking large amounts of alcohol has long been known to cause brain changes.
Cardiovascular risk factors - These include high blood pressure (hypertension), high cholesterol, buildup of fats in your artery walls (atherosclerosis) and obesity.
Depression
Diabetes
Smoking
Air pollution - traffic exhaust and burning wood is associated with greater dementia risk.
Head trauma - People who've had a severe head trauma have a greater risk of Alzheimer's disease. People age 50 years or older who had a traumatic brain injury (TBI), the risk of dementia and Alzheimer's disease increased. The risk increases in people with more-severe and multiple TBIs.
Sleep disturbances - People who have sleep apnea and other sleep disturbances might be at higher risk of developing dementia.
Vitamin and nutritional deficiencies - Low levels of vitamin D, vitamin B-6, vitamin B-12 and folate can increase your risk of dementia.
Medications that can worsen memory
Physical therapy management.
Physiotherapy can be used in the prevention of dementia and minimising the effects of dementia. A physiotherapist can play a role in customizing exercise programmes. Exercise can prevent or delay the onset of dementia, by slowing down the cognitive decline. This can lead to improved quality of life and slowing down of functional decline expected with the disease process.
References:
https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019
https://www.healthline.com/health/dementia#causes
https://www.who.int/news-room/fact-sheets/detail/dementia
Dilki Karunathilake.
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