Dementia: Stages, Causes, Symptoms and Treatment

Dementia is a cognitive disorder that doctors and health care professionals use to describe various symptoms of cognitive decline.

Most often it is a symptom of the underlying disease and brain disorder.

It is important to note that dementia is not a disease in itself, however, a general term to describe symptoms of memory problems, communication, and thinking.

While the likelihood of dementia increase with age, it is not a normal part of aging.

A study suggests that 4.7 million people in the USA at the age of 65 or older are living with Alzheimer‘s disease in 2010.

Although dementia generally involves memory loss or memory problems,  however, memory loss has different causes.

Having memory loss does not mean that you have Dementia.  Alzheimer’s is one of the most common causes of dementia but there are other causes of dementia as well.

Depending on the cause, some types of dementia are even reversible.

What is Dementia?

Many things can cause Dementia.

It happens when the part of your brain that is responsible for learning, memory, decision making, and language has damage or disease.

Doctors often term it as Neurocognitive Disorder. However, it is not a disease. Instead, it is one of the signs and symptoms of other conditions.

Adults of age 65 or above have some form of Dementia. It is about 5%- 8% and this doubles every 5 years.

To put it in simple terms, half as many people in their 0s have mild to moderate dementia.

What is Cognitive Impairment?

Cognitive Impairment is a part of life during which people suffer from mild to moderate memory loss.

Sometimes it can be a more serious form of Dementia. Most often doctors characterize it with memory, language, thinking, and judgment.

If a person has mild to moderate cognitive impairment, they are often aware of it and term it as something ‘slipped’ of their mind.

However, it can increase the risk of developing dementia in later stages of life. However, in most cases, it does not get worse and a few eventually gets better.

Types of Dementia

Doctors divide Dementia into two major groups and it depends on the part of the brain that it is affecting.

The types of Dementia include:

Cortical Dementias: It happens because of problems in the cerebral cortex of your brain, which is the outer layer.

It plays a critical role in memory and language and people with this type usually have severe memory loss and cannot remember words or understand language.

Two forms of this type are Alzheimer’s and Creutzfeldt Jakob Disease.

Subcortical Dementias: This happens because of problems in the part of your brain beneath the cortex.

People with is disorder tend to show changes in the speed of thinking and ability to start activities.

Usually, people with subcortical dementias do not have problems like forgetfulness and language. However, diseases like Parkinson‘s, Huntington’s disease, and HIV are the cause of this type.

Other Types

Other types of Dementia are signs and symptoms of certain conditions and are as follows:

Alzheimer’s Disease: It is due to plaques between the dying cells in the brain and tangles within the cells due to protein abnormalities.

In a person with Alzheimer’s the brain tissue has progressively fewer nerve cells and connections and the brain size shrinks in total.

Dementia with Lewy Bodies: It is a neurodegenerative disorder. Dementia with Lewy Bodies is linked to abnormal structures in the brain.

The brain changes involve a protein, Alpha-Synuclein.

Mixed Dementia: It refers to a diagnosis of two or three types occurring altogether.

For instance, a person may be suffering from both Alzheimer’s and vascular dementia at the same time.

Parkinson’s Disease: The presence of Lewy bodies can cause Parkinson’s and Dementia is a symptom of it.

Although Parkinson’s is linked to movement, however, it can lead to the symptoms of dementia.

Huntington’s Disease: Doctors characterize it as a disorder of movement or one individual is not able to control, however, it also includes dementia.

Stages of Dementia

Doctors roughly divide dementia into four stages. Some of these are as follows:

Mild Cognitive Impairment: It is often characterized by general forgetfulness. This affects many people as they tend to age however, it only progresses to dementia for some.

Mild Dementia: People with this stage will experience cognitive impairments and can impact their daily life.

Symptoms of this disease include memory loss, confusion, personality changes, getting lost, and difficulty in planning and carrying out daily routine tasks.

Moderate Dementia: In this Stage, daily life routine becomes more difficult to carry out and the individual needs support.  Symptoms are similar to mild dementia however, they increase or worse with time.

People with this type show significant changes in personality and are also likely to feel sleep disturbances.

Severe Dementia: At this stage, the symptoms worsen considerably and there may be a loss of ability to communicate. Individuals with this type are more dependent on support and need full-time care.

Simple tasks like sitting, and holding one’s head up become impossible. Moreover, they might lose bladder control as well.

Signs and Symptoms

The Signs and symptoms vary depending on the causes, however, health care professionals divide it on the basis of Cognitive and Psychological Changes. These are as follows:

Cognitive Changes: A person with dementia may show certain cognitive changes and the signs and symptoms include memory loss, difficulty in communication, changes in visual and spatial abilities.

It also includes difficulty in reasoning and solving problems, panning, coordination and motor function, confusion, and disorientation.

Psychological Changes: These include personality changes, depression, anxiety, and inappropriate behavior.

Moreover, paranoia, agitation, and hallucinations are signs and symptoms of Psychological changes.

Causes of Dementia

The main cause of this disease is damage to or loss of nerve cells and their connections in the brain.

It also depends on the part of the brain it is affecting and can affect people differently and cause different symptoms.

Doctors often group this disease by what they have in common such as protein or deposits of protein in the brain or the part of the brain that is affected.

Some of these are due to certain medications or vitamin deficiencies, however, they tend to go away with treatment.

In some cases, traumatic brain surgery can also cause Dementia. This surgery can be due to falls, being struck by an object, or motor vehicle crashes.

Some common causes of Dementia are as follows:

Progressive Dementias

There are two types of progressive dementias and these are not reversible. These include:

Alzheimer’s Disease: It is the most common cause of dementia.

However, it is important to note that not all causes of Alzheimer’s are known. Experts suggest that a small percentage is related to the mutation of 3 genes and passes down from parents to their children.

One important gene that mutates is Apoliproprotein E4 (APOE).

People with this disease have plaques and tangles in their brains. Doctors refer to plaques as clumps of protein, Beta-Amyloid and tangles are fibrous tangles made of tau protein.

This damages the healthy neurons and the fibers that connect them.

Other genetic factors also develop in people with Alzheimer’s

Vascular Dementia: This is due to damage to the vessels of the brain that supply blood.

It can cause strokes or damage to the brain in other ways like damaging the fibers.

The most common signs and symptoms are difficulties in problem-solving, slow thinking, focus, and organization. However, they are more noticeable with memory loss.

Lewy Body Dementia: Lewy Bodies are abnormal clumps of protein found in parts of the brain.

Common signs and symptoms include sleep disorders, hallucinations, problems with focus and attention. Other signs include slow movement, tremors, and rigidity.

Reversible Conditions

Some causes of Dementia or with the same symptoms are reversible with treatment. These are:

Infections and Immune Disorders: The symptoms of this disease can result from fever or other side effects of the body’s attempt to fight infections.

Multiple Sclerosis and other conditions cause the immune system to attack the cell’s within the body and cause Dementia.

Metabolic Problems: People who have thyroid problems, low blood sugar, little or excessive calcium or sodium, or problems with absorbing vitamin B-12 can lead to Dementia and other personality changes.

Nutritional Deficiencies: Dehydration, lack of vitamin B-1 in the body, not getting enough vitamin B- and B-1 can cause Dementia.

Moreover, Copper and Vitamin E deficiencies can cause this disease as well.

Medications: Certain medications or interactions with several medications can cause dementia.

Subdural Hematomas: Bleeding between the surface of the brain and other covering of the brain can cause symptoms similar to dementia.

Poisoning: If an individual is exposed to certain heavy metals like lead or other poisons like pesticides can cause dementia. However, they tend to resolve with treatment.

Diagnosis of Dementia

Diagnosis of dementia depends on the causes of it and it is most challenging for doctors to diagnose it.

Doctors need to recognize the pattern of loss of skills and functions and determine what the individual still can do in order to diagnose this disease.

Most often to diagnose it, they refer to the medical history of an individual, signs and symptoms, and physical examination.

They will also order certain tests to help pinpoint the problem. Some of these tests are as follows:

Cognitive and Neuropsychological Tests: These tests evaluate the individual’s thinking or cognitive functions.

These memory factors like memory, orientation, reasoning and judgment and language skills, and the attention span of a person.

Neurological Evaluation: This evaluation includes evaluating a person’s memory, language, visual perception, attention, problem-solving, movement, senses, and other areas.

Brain Scans: Certain brain scans or image tests of the brain that include CT or MRI check for tumors or evidence of stroke in the brain.

Moreover, they can order a PET Scan that shows brain activity if the cause of dementia is due to Alzheimer’s.

Laboratory Tests: Simple blood tests can show vitamin deficiencies that can affect the brain.

These tests check vitamin B-12 deficiencies or underactive thyroid gland.

In some cases, doctors may order an examination of spinal fluid to determine if the cause is due to infection, inflammation, or other degenerative diseases.

Treatment Options

Most types of Dementia are not curable however, doctors can manage the symptoms and recommend medications and therapies.

These medications are as follows:

Cholinesterase Inhibitors: These medications include Aricept, Exelon, and Razadyne.

These work by boosting levels of chemical messenger that are involved in memory and judgment.

This medication is recommended to treat Alzheimer’s and vascular dementia, Parkinson’s, and Lewy body dementia.

Memantine: This medication works by regulating glutamate which is involved in the functioning of the brain.

Other Medications: Your doctor may prescribe certain medications to treat symptoms or other conditions like depression, sleep disturbances, hallucinations, or agitation.

In case your doctor diagnoses traumatic brain surgery as a cause of your dementia, the treatment depends on the type of it.

Therapies for Dementia

Doctors also recommend non-drug therapies to treat severe symptoms and behavior problems.

 

These therapies include:

Occupational Therapy: These therapies incorporate techniques as to how to make your home safe and coping behaviors.

The purpose is to prevent accidents and prepare an individual for progressive dementia.

Environment Modification: Modifying the environment by reducing noise and clutter, can help manage the symptoms.

Hiding objects and monitoring symptoms can alert if the person goes missing.

Simplifying Tasks: By making daily routine tasks simple and breaking them into simpler steps can help people with dementia.

Alternative Medications

Several alternative medications like dietary supplements, herbal remedies, and therapies can help manage the signs and symptoms.  However, it is important that you discuss this with your doctor.  Some studies also suggest that vitamin E is very helpful for patients with Alzheimer’s.

Other Therapies

Certain techniques and therapies can help reduce agitation and relax people with Dementia.

These are  Music therapy, Pet therapy, Visual aid, Aromatherapy, Massage therapy, and Art therapy.

Lifestyle Changes

Certain lifestyle changes can help a person with Dementia. These are as follows:

Communication: Maintain eye contact and speak slowly and in simple sentences. present one idea or instruction at a time and you can use cues and gestures as well.

Exercise: It helps improve strength, balance, and cardiovascular health.

Research suggests that physical activity might slow the progressions of impaired thinking and lessen the symptoms of depression.

The Takeaway

There is no cure for the type of Dementia that results from the death of Brain Cells.

However, managing the signs and symptoms of Alzheimer’s can help in treating dementia.

The treatment is possible in case of reversible and non-degenerative causes and the medications treat injury to the brain, vitamins, and changing medications that are causing dementia.

Age is the biggest factor of Dementia however, certain underlying conditions can also lead to it. It is important to consult the doctor as they can diagnose the cause of dementia and treat it accordingly.