About Dementia

Dementia is an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving and other thinking skills that affect a person’s ability to perform everyday activities. Memory loss is an example. Alzheimer’s is the most common cause of dementia.

Dementia is not a single disease; it’s an overall term — like heart disease — that covers a wide range of specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behaviour, feelings and relationships.

Alzheimer’s disease accounts for 60 to 80 per cent of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as “senility” or “senile dementia,” which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

People who suffer from Dementia may experience:

Cognitive: memory loss, mental decline, confusion in the evening hours, disorientation, inability to speak or understand language, making things up, mental confusion, or inability to recognise common things

Behavioural: irritability, personality changes, restlessness, lack of restraint, or wandering and getting lost

Mood: anxiety, loneliness, mood swings, or nervousness

Psychological: depression, hallucination, or paranoia

Muscular: inability to combine muscle movements or unsteady walking Other common symptoms: falling, jumbled speech, or sleep disorder

Causes of Dementia:

Dementia is caused by 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, behaviour and feelings can be affected.

The brain has many distinct regions, each of which is responsible for different functions (for example, memory, judgment and movement). When cells in a particular region are damaged, that region cannot carry out its functions normally.

Different types of dementia are associated with particular types of brain cell damage in particular regions of the brain. For example, in Alzheimer’s disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other. The brain region called the hippocampus is the centre of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That’s why memory loss is often one of the earliest symptoms of Alzheimer’s.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed:

  • Depression
  • Medication side effects
  • Excess use of alcohol
  • Thyroid problems
  • Vitamin deficiencies

Diagnosis of dementia:

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer’s and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behaviour associated with each type.

Doctors can determine that a person has dementia with a high level of certainty. But it’s harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnose “dementia” and not specify a type. If this occurs, it may be necessary to see a specialist such as a neurologist or gero-psychologist.

Does your family member need assisted living for their dementia?

It’s never an easy decision to move a parent or family member into assisted living. Here are some signs that it may be time to consider moving them into a specialised dementia care facility, where they can receive professional care on a day-to-day basis.

Signs include:

1. Aggression

Physical, sexual or violent aggression frequently happen in people with dementia, and caregivers or other family members may begin to feel resentful or stressed.

2. Caregiver stress.

Caregiver symptoms like increased stress can be just as telling a sign as the dementia behaviours described above.

3. Escalating care needs.

If the person’s care needs extend beyond your physical abilities or if the health of the person with dementia or your health as a caregiver at risk, then it might be time to have that tough family conversation.

4. Home safety.

Consider your senior loved one’s health and your own abilities to care for them. Is the person with dementia unsafe in their current home?

5. Sundowning.

“Sundowners syndrome” — very agitated behaviour that becomes more pronounced later in the day — is a common characteristic of those with dementia. This can take a heavy toll on caregivers and when it begins to severely disrupt family routines, this may be a sign that the caregiving burden is too difficult to handle.

6. Wandering.

In later stages of dementia, the risk posed by wandering becomes much greater. They can wander even if you just take the time to go to the bathroom, and the probability of falls and injuries increases as well.

If you would like more advice on determining the best course of action for your family member, please contact us for a confidential and no-obligation discussion.