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Dementia is a medical condition characterized by the rapid decline in different types of brain functions such as memory, problem solving, attention, language, orientation, and decision making.
It can be triggered by various diseases or injuries that directly or indirectly affect the brain, but Alzheimer’s accounts for 60–70% of all dementia cases. (1) It can even be triggered by illnesses that start in other parts of the body. (2)
Dementia is most prevalent among the geriatric (old age) population and makes their brain degenerate much faster than what is considered biologically normal.
However, frontotemporal dementia (FTD) affects younger people with dementia much more than older patients. It is most commonly diagnosed in people between the ages of 45 and 65 years. (3)
This condition is basically a group of neurocognitive syndromes characterized by reduced executive functioning, behavioral changes, and loss of language proficiency.
Of all the diseases, dementia figures as the seventh leading cause of mortality worldwide. Plus, it accounts for a lot of disability and dependency among older people globally. (4)
Dementia affects nearly 55 million people around the world with more than 60% of the patients living in low- and middle-income countries. Since the percentage of the older population is growing in almost all countries, it is estimated that dementia cases will increase to 78 million by 2030 and 139 million by 2050. (5)
Signs and Symptoms of Dementia
Dementia is a fast-progressing disease, so it is important to diagnose it early and seek timely treatment. Unfortunately, the absence of any physical symptoms makes it hard to detect.
Here are some warning signs that you should look out for to catch the illness in the initial stages.
1. Loss of memory
Memory loss is one of the initial symptoms of Alzheimer’s disease, which gets progressively worse. This form of dementia is quite common among the elderly population, and its incidence increases as one gets older. It affects nearly 5% of 70-year-olds and 50% of those who have crossed the age of 90 years. (6)
The inability to remember the most basic things can render you totally dependent on others. Thus, a majority of patients with Alzheimer’s disease require round-the-clock assistance to perform their daily tasks. (7)
2. Misplacing things
Another major symptom of Alzheimer’s disease is that patients often misplace objects. This is largely related to the memory lapse associated with dementia, which makes it difficult for the patients to remember where they last put an object.
Some patients also develop a tendency to place objects in weird places or deliberately hide them.
It is normal for older people to forget things once in a while because of age-related decline in memory, but dementia makes it considerably worse. This neurodegenerative disorder makes you lose all sense of your surroundings and severely diminishes your recall ability.
As the disease progresses, the patients will find it more and more difficult to remember where they kept a thing, where they had it last, and where it might be.
The constant misplacing of objects and the inability to remember where they are can significantly hamper their everyday life and functioning. (8)
3. Trouble communicating
People with dementia find it increasingly difficult to express themselves and comprehend others as the disease progresses.
This gradual loss of comprehension and communication can also be the result of impaired vision or hearing, (9) which routinely affects geriatric adults, so it’s best to rule that out first.
The cognitive decline brought on by dementia will inadvertently impair the patient’s ability to think, speak, and understand over time.
4. Swallowing difficulties
Damage to the esophagus over the years can make it difficult for the patient to swallow in their old age.
Moreover, the nerves and muscles that control swallowing tend to become weaker or dysfunctional as they grow older. Thus, it is common for the elderly to have trouble swallowing, more so if they have dementia.
Dementia speeds up the onset of this kind of swallowing impairment and makes it more severe. (10) Nearly 13%–57% of all patients with dementia suffer from this problem, while it affects as many as 53%–60% of those in long-term care. (10)
5. Aggression and agitation
Almost 90% of dementia patients experience behavioral and psychological symptoms such as aggression, agitation, psychosis, anxiety, depression, and apathy, which tend to be more distressing than memory decline.
Patients that become too agitated or aggressive can be hard to control without strong medications that typically come with serious side effects. The drugs that are routinely prescribed to curb such harmful behaviors are known to increase the risk of falls, heart disease, stroke, and even death. (11)(12)
6. Eating difficulties
The cognitive and behavioral dysfunction triggered by dementia can adversely impact the patient’s eating pattern.
The mental decline makes it difficult for the patients to buy groceries or prepare meals by themselves, and the condition only gets worse with time. They may not even remember to eat or don’t understand the need for it, which will result in skipped meals.
In the advanced stages of dementia, patients may find it hard to recognize foods and eat on their own. They often get distracted while eating and wander off. (13)(10)
Someone else has to remind them to eat, keep an eye on them to make sure they finish the meal and even feed them.
7. Sleeping problems
Patients with dementia usually suffer from sleep disturbances during the night.
The lack of restful uninterrupted sleep at night renders them drowsy throughout the next day. So, they take multiple short naps during daytime to compensate for the loss of proper nighttime slumber.
Moreover, dementia can also make the patient more prone to medically diagnosed sleep disorders such as obstructive sleep apnea. (14)
8. Poor reasoning and judgment
Dementia compromises the patient’s ability to think logically, which results in poor decision making.
It is completely normal for people to make occasional errors in judgment, especially as they get older and their mental faculties are not as sharp as before. But dementia makes a person take absurd decisions so frequently that it begins to compromise their personal, professional, and social lives.
This inability to take control of their life might even reflect in their physical appearance, which will become quite shabby and unkempt. (15)
Risk Factors for Dementia
Here are some things that can make a person susceptible to dementia:
- Old age (over the age of 65 years)
- Family history
- Genetic predisposition
- Poorly managed diabetes (16)
- High cholesterol levels (16)
- Mid-life obesity (16)
- High blood pressure
- History of brain or head trauma (1)
- Sleep apnea (17)
- Deficiency of vitamin D, vitamin B6, vitamin B12, and folate (18)
- People who do not remain active in meeting different people and learning different things
- Excessive intake of red meat, processed meats, high-calorie foods, saturated fatty acids, refined grains, sweets, alcohol, and desserts (19)
Additional Tips for Caring for a Patient With Dementia
- Make sure that the patient’s eyeglasses and hearing aid are in good condition, as these two play an important role in old age regardless of dementia.
- Let the elderly person do as much of his/her personal work as possible.
- Dignity is so important – bathe the elderly patient with underpants on.
- Make sure there are no falls.
- Establish a regular toilet routine with love.
- Limit intake of fluids at bedtime.
- Consider special pads for incontinence of urine.
- Feed food in small portions. Give the patient finger foods and fruits cut into small pieces.
- Patients who tend to wander away from home should always have an identification card with phone numbers on their person.
- Keep the patient away from the sight of doors, keys, and shoes as they may be taken by the patient as a sign to go out.
When to See a Doctor
The earlier, the better, and there are no simple answers as to when to see a doctor.
Still see a doctor immediately if the patient:
- Gets violent
- Refuses to eat and even take water, leading to dehydration
- Exhibits the first signs of infection, falling, or facial droop
Most-Asked Questions About Dementia
Can dementia be prevented?
Some of the risk factors associated with dementia are beyond your control such as age, family history, and genes. However, there are things you can do to manage the controllable risk factors to lower your odds of developing dementia.
- Take extra precautions to avoid head injuries or trauma, especially if you have suffered one previously or if you have a brain tumor.
- There isn’t much research about ways to lower the risk of dementia, but experts emphasize the need for proper nutrition to keep your brain healthy and prevent this condition. So, it is very important to consume a healthy well-balanced diet.
- Stay active and exercise regularly.
- Maintain a healthy weight.
- Properly manage chronic conditions such as diabetes, hypertension, heart disease, hyperlipidemia, and obesity as they can make you more susceptible to dementia in old age if left untreated. (16)
- Quit smoking.
- Limit your alcohol intake.
- Consult your doctor for additional lifestyle changes, especially if you are already at high risk of dementia.
What are the foods that can help prevent dementia?
Leafy greens, berries, nuts, olive oil, flaxseeds, fatty fish such as tuna and salmon, broccoli, cauliflower, spices such as turmeric and cinnamon, sunflower seeds, flaxseeds, and pumpkin seeds all contain antioxidants and nutrients such as vitamin E, zinc, omega-3s, and choline that reduce cognitive decline.
What are the treatment options for dementia?
As mentioned earlier in this article, the most important ways to reduce your risk of dementia are to manage your blood pressure, control your weight, and engage in regular physical activity along with reading books and newspapers and interacting with different people.
The doctor may prescribe certain medications to help control the severity and worsening of dementia symptoms. Since Alzheimer’s disease is the most prevalent variant of dementia, you mainly get drugs for this condition. Donepezil, rivastigmine, memantine, and galantamine are often used to treat mild to moderate Alzheimer’s disease.
Only take medicine and medical advice from a neurologist rather than trusting the recommendation of others.
Some counselors also recommend nonpharmacological interventions such as cognitive stimulation therapy (CST) to manage dementia. It basically entails participating in group activities and exercises designed to improve language ability, memory, and problem-solving skills.
Is there any chance of dementia in younger patients?
AIDS in younger patients can be a cause of dementia.
How is dementia diagnosed?
The doctor will look for medical causes of dementia such as diabetes and heart, kidney, lung, or liver disorders as well as infection, followed by a neurological examination.
In many cases, loss of smell (1st cranial nerve) may be an early symptom of dementia or frontal lobe lesion. Diagnostic tests are based on suspected etiology and usually include ESR, complete blood count, vitamin B12 and folate assays, chest X-ray, and CT scan.
Dementia affects a lot of people around the world and its incidence is only expected to rise. This is not a specific illness, but a collection of symptoms that severely hinder your cognitive function and social abilities to render you dependent on others.
It can be triggered by various diseases, which can manifest differently from one another, but the above-listed symptoms are common in most cases.
Alzheimer’s disease is the leading cause of dementia, and it largely affects people above the age of 65 years. There is no cure for Alzheimer’s disease and its associated dementia, but it may be reversible if the underlying cause is treatable.
Dementia is generally managed through a multidimensional, interprofessional approach that includes medication, therapies, and other interventions. Early treatment can help reduce the need for hospitalization and emergency department visits. (13)
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