Dementia, the brain disease giant is a collective term used to describe the problems that people with various underlying brain disorders or damage can have with their memory, language and thinking. Alzheimer's disease is the best known and most common disorder under the umbrella of dementia.
What is dementia?
Dementia is not a single disease in itself, but a general term to describe symptoms such as impairments to memory, communication and thinking.
While the likelihood of having dementia increases with age, it is not a normal part of aging. Before we had today's understanding of specific disorders, "going senile" used to be a common phrase for dementia ("senility"), which misunderstood it as a standard part of getting old.
Light cognitive impairments, by contrast, such as poorer short-term memory, can happen as a normal part of aging (we slowly start to lose brain cells as we age beyond our 20s. This is known as age-related cognitive decline, not dementia, because it does not cause the person or the people around them any problems.
Dementia describes two or more types of symptom that are severe enough to affect daily activities.
But as well as progressive brain cell death like that seen in Alzheimer's disease, dementia can be caused by a head injury, a stroke or a brain tumor, among other causes.
Some of the causes are simpler to understandin terms of how they affect the brain and lead to dementia:
- Vascular dementia: this results from brain cell death caused by conditions such as cerebrovascular disease, for example stroke.
This prevents normal blood flow, depriving brain cells of oxygen.
- Injury: post-traumatic dementia is directly related to brain cell death caused by injury.
- Some types of traumatic brain injury: particularly if repetitive, such as received bysports players - have been linked to certaindementias appearing later in life. Evidence is weak, however, that a single brain injury willraise the likelihood of having a degenerativedementia such as Alzheimer's disease.
Dementia can also be caused by:
- Prion diseases: from certain types ofprotein, as in CJD (Creutzfeldt-Jakobdisease) and GSS(Gerstmann-Straussler-Scheinker syndrome).
- HIV infection: when the problem is simplytermed HIV-associated dementia. How thevirus damages brain cells is not certain.
- Reversible factors: some dementias can betreated by reversing the effects ofunderlying causes, including medicationinteractions, depression, vitamindeficiencies (for example, thiamine/B1,leading to Wernicke-Korsakoff syndrome,which is most often caused by alcoholmisuse), and thyroid abnormalities.
Symptoms
The symptoms of dementia experienced bypatients, or noticed by people close to them,are exactly the same signs that healthcareprofessionals look for. Therefore, detailedinformation on these is given in the nextsection about tests and diagnosis.
A person with dementia may show any of thefollowing problems, mostly due to memoryloss - some of which they may notice (orbecome frustrated with) themselves, whileothers may only be picked up by carers orhealthcare workers as a cause for concern.
The signs used to compile this list arepublished by the American Academy of FamilyPhysicians (AAFP) in the journal AmericanFamily Physician
- Recent memory loss: a sign of this mightbe asking the same question repeatedly,forgetting about already asking it.
- Difficulty completing familiar tasks: forexample, making a drink or cooking a meal,but forgetting and leaving it.
- Problems communicating: difficulty withlanguage by forgetting simple words orusing the wrong ones.
- Disorientation: with time and place, gettinglost on a previously familiar street close tohome, for example, and forgetting how theygot there or would get home again.
- Poor judgment: the AAFP says: "Even awell person might get distracted and forgetto watch a child for a little while. Peoplewith dementia, however, might forget allabout the child and just leave the house forthe day."
- Problems with abstract thinking: forexample, dealing with money.
- Misplacing things: including putting themin the wrong places and forgetting aboutdoing this.
- Mood changes: unlike those we all have,swinging quickly through a set of moods.
- Personality changes: becoming irritable,suspicious or fearful, for example.
- Loss of initiative: showing less interest instarting something or going somewhere.
Be sure to see your doctor if you have any of the above symptoms.
Source: MNT/Tbthealth
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