Dementia is not a single disease. It is a group of conditions that cause progressive cognitive decline. Most often diagnosed in the elderly, there are over 50 million people worldwide struggling with these conditions. This article will offer an overview of what seniors and their families need to know about dementia, whether there has been a diagnosis or not.
What is Dementia?
In general terms, dementia refers to conditions that cause cognitive decline. People struggling with these conditions typically have problems with memory, language, problem-solving, and thinking. Although Alzheimer’s disease (AD) is the most common and best-known form of dementia, there are over 100 different forms of dementia.
Because dementia impacts so many people, many Americans assume it is a normal and inevitable part of the aging process. Thankfully, that is not the case. This group of disorders affecting behaviors, relationships, feelings, and the ability to maintain independence does not affect all seniors.
Common Types of Dementia
AD is by far the best-known and most common form of dementia. However, several other types are common enough to garner recognition within societies. They include:
- Vascular dementia
- Dementia with Lewy bodies
- Frontotemporal dementia
- Mixed dementia
- Creutzfeldt-Jakob disease
- Huntington’s disease
- And others
The reason these diseases and disorders can all be found under one umbrella term is that, although they affect different regions of the brain in diverse ways, they produce a similar set of symptoms.
Causes of Dementia
Dementia is caused by one or more diseases that damage brain cells, called neurons. The damage reduces the neurons’ ability to communicate effectively with each other, which can wind up affecting almost every part of someone’s life, including their personality and ability to perform basic tasks.
AD accounts for almost 80% of all dementia cases in seniors, so it’s unsurprising that researchers have uncovered a good deal about this condition. They know it causes progressive damage to the cells in a brain’s hippocampus, which is the part of the brain responsible for learning and memory.
As neurons in this area fail to make healthy connections, the condition causes a buildup of proteins, which form abnormal structures referred to as “plaques” and “tangles.” These, in turn, affect the ability of the neurons to send signals between cells by reducing the number of chemical messengers used to do so. As the condition progresses, people continue to develop worsening symptoms.
Risk Factors for Dementia
Dementia is much more likely to affect older adults, with over three-quarters of cases occurring in people over the age of 75. It’s also more common in people who have a family history of one or more of the diseases.
There’s nothing people can do about being born into families with high dementia risk, nor can anyone stop the aging process. However, recent research uncovered some other risk factors for dementia that can be better controlled. They include:
- Living an inactive lifestyle
- Having untreated high blood pressure
- Having diabetes
- Being chronically or severely depressed
- Consuming alcohol in excess
- Social isolation
Understanding these risk factors allows older adults and their families to reduce the chances of developing dementia or slow its development. While no one can control the genes they are born with, most can treat underlying diseases and commit to living a healthier, more active lifestyle.
Signs and Symptoms of Dementia
People suffering from dementia rarely recognize the early symptoms in themselves. Instead, relatives and other loved ones typically notice the signs first. Learning to spot those early signs can make a difference in how the disease progresses and in whether someone gets appropriate care. Be on the lookout for common warning signs like:
- Loss of interest in previous hobbies
- New or worsening difficulty speaking or recalling words
- Struggling to manage finances
- Missing appointments
- Repeating questions or phrases
- Behavioral and personality changes
- Increased stress or agitation
- Social withdrawal
- Poor hygiene
- Significant weight loss
- Unexplained injuries, especially when living alone
Just one strained conversation or missed appointment should not be considered cause for concern. These new, unusual behaviors become patterns in people with dementia. Loved ones can keep track of their progress by starting a journal and writing down both problems and their severity, which can be helpful to geriatricians tasked with diagnosing dementia.
Because there is no single test that conclusively diagnoses cognitive decline, doctors need to know about the warning signs. Some will be noticeable during scheduled appointments, especially if a brief mental status exam is performed. Others will only be obvious to people who know the person well.
Seeking medical attention as early in the progression of dementia is important. This gives doctors the chance to create reliable baselines, making it easier to track memory loss and other symptoms. Acknowledging the signs and symptoms of dementia and sharing them with a loved one’s doctors can be stressful, or even scary, but seeing a doctor as early in the process as possible is crucial to the successful management of the disease or diseases.
The Seven Stages of Dementia
Dementia is a progressive disease, and while that progression looks a little different for everyone, there are expected timelines of symptoms. Most healthcare providers use the Reisberg Scale or the Global Deterioration Scale (GDS) to evaluate patients and determine what stage of dementia they are in. Those stages are:
- Normal function with no cognitive decline
- Age-associated memory impairment
- Mild cognitive impairment
- Mild dementia
- Moderate dementia
- Moderately severe dementia
- Severe dementia
Most people are diagnosed at stage three. At this point in the progression of the disease, they may start experiencing difficulty with recalling names or words, orienting themselves in space, and maintaining optimal work performance. In most cases, though, dementia sufferers don’t require ongoing assistance until they reach stage five on the GDS.
At this point, it becomes difficult if not impossible for people with dementia to perform all of the crucial activities of daily living (ADLs). Seniors with stage five dementia can still use the bathroom and eat independently, but they have problems with personal grooming, selecting clothing, preparing meals, and other essentials.
Planning for the Future
One of the many reasons it’s so important to get an accurate diagnosis early is that doing so gives seniors and their families the chance to plan for the future. These kinds of conversations can be challenging, as no one wants to imagine their loved ones suffering from cognitive decline, but the unfortunate truth is that dementia is degenerative and currently has no cure.
Coming up with an effective plan for managing symptoms is currently the best way to ensure that a dementia patient will continue to have a good quality of life as the disease progresses. Try not to put off difficult conversations. It’s better to have them while someone is still relatively lucid and able to make their own informed decisions. While that’s still the case, be sure to ask what the person’s priorities are regarding future care.
Most seniors, when asked how they want to spend their golden years, indicate that they want to age in place at home. Dementia makes that very difficult. As the disease progresses, people need more specialized care and, eventually, around-the-clock supervision. It’s best not to ignore that unpleasant truth. While someone may not be able to choose whether they wind up needing memory care, they could still indicate a strong preference as to where and how it is administered.
It’s also relevant to note that dementia patients eventually become cognitively impaired to the point they are unable to make important medical and financial decisions for themselves. Assigning power of attorney before that happens ensures the person will have appropriate representation and the right person making decisions on their behalf as dementia progresses.
Living Well with Dementia
Researchers are hard at work looking for a cure for dementia, and while they have yet to uncover a real, permanent solution, there are now treatments and supports available that make it possible for seniors with dementia to continue to lead active and fulfilling lives. Medication therapies ease symptoms and slow the progression of some forms of dementia, and non-drug approaches are almost universally helpful.
Keeping seniors with dementia engaged with their communities, families, and the world should be a top priority for caregivers. Research shows that remaining active not just physically but also mentally and socially boosts self-esteem, improves memory, and helps people avoid depression, which can worsen existing dementia symptoms.
Knowing When to Get Help
Family caregivers often derive satisfaction from helping their loved ones maintain a high quality of life during the early stages of dementia. Eventually, there will come a time when it is no longer safe for a senior struggling with cognitive decline to remain at home. People with stage five dementia can benefit from assisted living. Those with stage six or stage seven dementia may need memory care. It can be very difficult to give up control over a loved one’s personal care plan, but no one should remain at home aging in place when it is no longer safe for them to do so.