Dementia

Dementia is the general term for symptoms that disrupt daily life by affecting memory, thinking, and social skills to a significant degree. Dementia is not a disease name. Multiple diseases can cause dementia. Although dementia is generally associated with memory loss, memory loss can have different causes. Having memory loss alone does not mean you have dementia. While Alzheimer's disease is the most common cause of dementia developing in the elderly, there are many other causes of dementia. Depending on the cause, some dementia symptoms can be prevented.

Symptoms of Dementia

Although dementia symptoms vary depending on the cause, common symptoms include:

• Cognitive changes
• Memory loss
• Difficulty communicating or finding words
• Impaired visual and spatial abilities
• Difficulty reasoning and problem-solving
• Difficulty managing complex tasks
• Difficulty with motor functions and coordination
• Confusion and inability to focus
• Psychological changes
• Personality changes
• Depression
• Anxiety
• Inappropriate behavior
• Paranoia
• Hallucinations

When Should You See a Doctor for Dementia?

If you have memory problems or other dementia symptoms, you should consult your doctor. Some treatable medical conditions can cause dementia. Therefore, understanding the underlying causes is important.

Causes of Dementia

Damage or loss of nerve cells and their connections causes dementia. Depending on which area of the brain is damaged, dementia can affect people in different ways and cause different symptoms.

Other Conditions Related to Dementia

Huntington's disease, caused by genetic mutation, leads to degeneration of certain nerve cells and the spinal cord. Symptoms, including severe impairment of thinking skills, usually appear around ages 30–40.

Traumatic Brain Injury results from repeated head trauma. Boxers, football players, and soldiers may experience this. Depending on the part of the brain that is damaged, it can cause dementia symptoms such as depression, memory loss, and speech disturbances. TBI can also cause Parkinson's disease. Symptoms may appear years after the trauma.

Creutzfeldt-Jakob disease is a rare brain disease. This condition can result from the accumulation of infectious proteins called prions. The cause of Creutzfeldt-Jakob disease is usually not found, but it can be genetic. It can also be transmitted from brain or nervous system tissue of a person with the disease, such as through corneal transplant. Symptoms of this fatal disease usually begin to appear after age 60.

People with Parkinson's disease will develop dementia symptoms as the disease progresses.

Preventable Dementia

Some causes of dementia and dementia symptoms can be prevented with treatment. Some of these include:

Infectious and Immune Diseases

Dementia symptoms can arise from high fever and the body's fight against infection. MS (multiple sclerosis) and other immune diseases targeting nerve cells can cause dementia.

Metabolic and Endocrine Abnormalities

People with thyroid problems, low blood sugar, too little or too much sodium and calcium, or B12 absorption problems may experience dementia-like symptoms or personality changes.

Nutritional Deficiencies

• Insufficient water intake (dehydration)
• Thiamine (vitamin B-1) deficiency (common in chronic alcoholics)
• Vitamin B-6 and B-12 deficiency
• Copper and vitamin E deficiency

Medication Side Effects: Medication side effects, drug reactions, and interactions between multiple drugs can cause dementia symptoms.

Subdural Hematoma: Bleeding between the brain surface and its covering can cause pressure on the brain and dementia symptoms.

Poisoning: Heavy metals such as lead, pesticides, recreational drugs, and excessive alcohol consumption can cause dementia symptoms.

Brain Tumors: Brain tumors can rarely cause dementia.

Oxygen Deprivation: Also called anoxia, this is a condition where organ tissues do not receive enough oxygen. Anoxia can occur in situations such as severe sleep apnea, asthma, heart attack, and carbon monoxide poisoning.

Normal Pressure Hydrocephalus: This condition, which can occur from enlargement of the ventricles in the brain, can cause walking problems, urinary issues, and memory loss.

Risk Factors

Many risk factors can contribute to dementia. Dementia has both modifiable and non-modifiable risk factors.

Non-Modifiable Risk Factors

Age: Risk begins to increase with age, especially after 65. However, dementia is not a normal consequence of aging and can also occur in younger people.

Family History: A family history of dementia puts you at risk. However, many people with a family history of dementia may not develop it, and people with no family history can also develop dementia. Tests exist that can identify specific genetic mutations.

Down Syndrome: Many people with Down syndrome may develop early Alzheimer's disease in middle age.

Modifiable Factors

Diet and Exercise: Research shows that lack of exercise increases the risk of dementia. Although no specific diet is known to reduce dementia risk, people who eat unhealthily have a higher likelihood of dementia compared to those following a Mediterranean diet.

Excessive Alcohol Consumption: Excessive alcohol consumption increases your risk of dementia.

Cardiovascular Risk Factors: Cardiovascular risk factors such as hypertension, high cholesterol, increased arterial fat, and obesity increase your risk of dementia.

Depression: Depression in later life may be seen alongside the development of dementia.

Diabetes: Diabetes, especially when uncontrolled, can increase the risk of dementia.

Smoking and Tobacco Use: Smoking can increase the risk of dementia and vascular diseases.

Vitamin and Nutritional Deficiencies: Deficiencies in vitamins D, B-6, B-12, and folic acid can increase the risk of dementia.

Diagnosis of Dementia

To diagnose dementia, your doctor needs to identify deficits in function and skills. Recently, biomarkers have become available for accurate diagnosis of Alzheimer's disease. Your doctor should review your medical history and symptoms, perform a physical examination, and speak with family members about symptoms. There is no single test for diagnosing dementia. Therefore, doctors perform many different tests to identify the problem. Tests performed include:

Cognitive and Neuropsychological Tests: Your thinking functions are evaluated. Tests exist that measure skills such as memory, concentration, reasoning, judgment, language skills, and attention.

Neurological Evaluation: Your memory, language, visual perception, attention, problem-solving, movement, senses, balance, and reflexes are evaluated.

PET Scan: This scan detects brain activity and whether the amyloid protein that causes Alzheimer's disease has accumulated in the brain.

Laboratory Tests: Physical conditions affecting brain function, such as thyroid dysfunction and vitamin B-12 deficiency, can be detected with simple blood tests. Cerebrospinal fluid testing can be used to detect infections, inflammation, and degenerative diseases.

Psychiatric Evaluation: A mental health professional can determine whether depression or other mental health conditions are contributing to your symptoms.