Dementia
Dementia is a term used to describe a group of symptoms affecting memory, thinking and social abilities that are severe enough to interfere with daily life beyond what might be expected from the usual consequences of biological ageing.
Causes
Dementia is caused by a variety of diseases that cause damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected. There are many other conditions that can cause symptoms of cognitive impairment but that aren't dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.
Symptoms
Dementia symptoms vary depending on the cause and are progressive, which means that the signs of cognitive impairment start out slowly and gradually get worse over time, leading to dementia.
Cognitive changes
- Memory loss, which is usually noticed by someone else.
- Problems communicating or finding words.
- Trouble with visual and spatial abilities, such as getting lost while driving.
- Problems with reasoning or problem-solving.
- Trouble with planning and organizing.
- Poor coordination and control of movements.
- Confusion and disorientation.
Psychological changes
- Personality changes
- Depression
- Anxiety
- Agitation
- Inappropriate behavior
- Being suspicious, known as paranoia
- Delirium
- Seeing things that aren't there, known as hallucinations
TYPES
Alzheimer’s disease is a brain disorder that slowly destroys memory, thinking skills and eventually the ability to carry out the simplest tasks. This is the most common cause of dementiaThe disease is named after Dr.Alois Alzheimer. People with Alzheimer’s disease have plaques and tangles in their brains. Plaques are clumps of a protein called beta-amyloid. Tangles are fibrous masses made up of tau protein. It’s thought that these clumps damage healthy brain cells and the fibers connecting them. Memory problems are typically one of the first signs of Alzheimer’s, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease.As the disease progresses, some people become worried, angry or violent known collectively as behavioral and psychological symptoms of dementia, or BPSD.
Vascular (formerly arteriosclerotic) dementia, which includes multi infarct dementia, is distinguished from dementia in Alzheimer’s disease by its history of onset, clinical features, and subsequent course. This type of dementia is caused by damage to the vessels that supply blood to the brain. The most common symptoms of vascular dementia include problems with problem-solving, slowed thinking, and loss of focus and organization. These tend to be more noticeable than memory loss
A progressive dementia, commencing in middle life (usually between 50 and 60 years), characterized by slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and (occasionally) extrapyramidal phenomena. The neuropathological picture is one of selective atrophy of the frontal and temporal lobes, but without the occurrence of neuritic plaques and neurofibrillary tangles in excess of that seen in normal aging.
Lewy bodies are balloon like clumps of protein. They have been found in the brains of people with Lewy body dementia, Alzheimer’s disease and Parkinson’s disease. Lewy body dementia is one of the more common types of dementia. In the early stages, there may be fluctuations in alertness, Hallucinatitions and difficulty judging distance. The impact on short-term memory may be less severe than it is with Alzheimer’s disease. Other signs include uncoordinated or slow movement, tremors, and stiffness, known as parkinsonism.
In some cases more than one type of dementia is present in the brain at the same time, especially in people aged 80 and older due to various causes. People with mixed dementia can have Alzheimer’s disease, vascular dementia and Lewy body dementia. Studies are ongoing to determine how having mixed dementia affects symptoms and treatments.
Other disorders linked to dementia
A progressive dementia with extensive neurological signs, due to specific neuropathological changes. This rare brain disorder usually occurs in people without known risk factors. This condition might be due to deposits of infectious proteins called prions. Symptoms of this fatal condition usually appear after age 60.
Huntington’s disease is caused by a genetic change. A dementia occurring as part of a widespread degeneration of thebrain. Huntington’s disease is transmitted by a single autosomaldominant gene. Symptoms typically emerge in the third and fourthdecade, and the sex incidence is probably equal. In a proportionof cases, the earliest symptoms may be depression, anxiety, or frankparanoid illness, accompanied by a personality change. Progressionis slow.
This condition is a accumulation of fluid in the cavities in the brain called ventricles. It can result in walking problems, loss of bladder control and memory loss.
Parkinson’s disease dementiais a decline in thinking and reasoning skills that develops in some people living with Parkinson’s at least a year after diagnosis. Dementia with Lewy Bodies (DLB) is diagnosed when cognitive decline happens first, or when Parkinson’s motor symptoms and cognitive decline occur and progress closely together. The brain changes caused by Parkinson’s disease begin in a region that plays a key role in movement, leading to early symptoms that include tremors and shakiness, muscle stiffness, a shuffling step, stooped posture, difficulty initiating movement and lack of facial expression. As brain changes caused by Parkinson’s gradually spread, the person may also experience changes in mental functions, including memory and the ability to pay attention, make sound judgments and plan the steps needed to complete a task.
Stress and Dementia
Stress is a complex and pervasive factor in our lives that can have a significant impact on our overall health, including cognitive health. While stress itself may not directly cause dementia, it is increasingly recognized as a potential risk factor that can contribute to its development and progression. Here are some key points to consider regarding the relationship between stress and dementia:
- Biological Mechanisms: Chronic stress can lead to the release of stress hormones like cortisol, which, when consistently elevated, can have detrimental effects on the brain. High cortisol levels have been associated with changes in the brain’s structure and function, including the hippocampus, a region crucial for memory and learning.
- Cognitive Impact: Stress can impair cognitive function, particularly memory and attention, in the short term. Prolonged or chronic stress may accelerate cognitive decline in individuals already at risk of dementia.
- Risk Factor: While genetics and age are significant risk factors for dementia, stress may interact with these factors, potentially increasing the risk further. Individuals with a genetic predisposition to dementia may be more susceptible to its effects.
- Lifestyle Factors: Stress often leads to unhealthy coping mechanisms such as poor diet, lack of exercise, inadequate sleep, and increased alcohol or tobacco use. These lifestyle factors are also linked to a higher risk of dementia.
- Management and Prevention: Managing stress through relaxation techniques, mindfulness, social support, and a healthy lifestyle may help reduce the risk of cognitive decline. Additionally, early intervention and stress management strategies can be beneficial for individuals already diagnosed with dementia.
Some researchers looking into long-term stress and dementia have focused on people who are affected by Post Traumatic Stress Disorder (PTSD).This is a diagnosed condition that occurs when a person has been through a life-changing or distressing event. Alzheimer’s Society-funded research has also analysed the literature related to the link between PTSD and dementia. They found that people with PTSD have up to twice the risk of developing dementia. However, this increased risk isn’t fully understood and it is important to note that having PTSD does not mean you will definitely develop dementia.
In summary, while stress alone may not be a direct cause of dementia, it can contribute to its development and progression through various biological and lifestyle mechanisms. Recognizing the role of stress in cognitive health is essential, and efforts to reduce chronic stress and promote overall well-being can play a valuable role in dementia prevention and management.
