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Understanding dementia

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PHOTO: Berkely Lab

Dementia is a broad description which includes many different symptoms, including memory loss, word-finding difficulties, impaired judgment, and problems with day-to-day activities, which are caused by injury or loss of brain cells (neurons).

Signs and symptoms of dementia are varied, but typically include: memory loss; problems with speaking or communicating (word-finding difficulties, repetition); problems focusing; impairments in judgment; struggles completing tasks; and has difficulty comprehending what is seen.

Causes of dementia are factors, which lead to damage to neurons. Once the brain cells are injured, they lose their ability to communicate with other cells, leading to dysfunction.

The types of dementia include Lewy body dementia, vascular dementia, and frontotemporal dementia. Other types include dementia associated with Parkinson’s disease or Huntington’s disease. Senile dementia (senility) is a term that was once used to describe all dementias; this term is no longer used as a diagnosis.

The stages of dementia are used when a progressive dementia has been diagnosed. The stages include:

Stage 1: No impairment. The patient has no problems.

Stage 2: Questionable impairment. The patient begins to have some difficulty but can still function independently.

Stage 3: Mild impairment. The patient has obvious, but still mild difficulty with daily activities.

The stages of dementia are used when a progressive dementia has been diagnosed. The stages include:

Stage 1: No impairment. The patient has no problems.

Stage 2: Questionable impairment. The patient begins to have some difficulty but can still function independently.

Stage 3: Mild impairment. The patient has obvious, but still mild difficulty with daily activities.

Stage 4: Moderate impairment. The patient needs help with caring for him or herself as well as with carrying out daily activities.

Stage 5: Severe Impairment; patients are unable to function independently.

Risk factors for dementia include: age, family history, heavy alcohol use, hardening of the arteries, high blood pressure, diabetes, high cholesterol, and smoking.

Dementia is diagnosed after a series of assessments, including a physical evaluation and determination of the history of any problems. Memory tests, imaging studies, and blood work may exclude other problems, which might mimic dementia. The diagnosis of dementia can take a long time.

The treatment for dementia is primarily supportive. Prescription medications cannot reverse or stop the process. Environmental changes, a structured schedule, regular exercise, and staying engaged with others could all be beneficial.

Home care for dementia can be beneficial for patients and families, as a way for patients to remain close to family members. However, caregivers should confirm that they have help to avoid burnout. Prescription drugs to treat dementia include donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), and memantine (Namenda). A new combination of donepezil and memantine (Namzaric) was recently approved by the FDA. Although there is no way to absolutely prevent dementia, modifying the risk factors of high blood pressure, high cholesterol, alcohol intake, and keeping diabetes as well-controlled as possible, as well as exercising regularly can help.

The prognosis for a person with dementia is individual. Some patients have a rapidly progressive course, while others progress very slowly. Factors, which contribute to the progression of dementia, haven’t been fully identified.

*Dr. Anthony Nwaoney is an epidemiologist, the Medical Director Richie Hospital and CEO Elshaddia group


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