Everyone forgets things now and then, especially when under stress or when we have numerous overlapping obligations. It is also normal for us to become more forgetful as we age. Some degree of mild memory loss in seniors that is not severe enough to affect their daily functioning is not abnormal and does not, in and of itself, indicate that someone has dementia. While many people associate dementia with memory problems, this is only one of a collection of symptoms that fall under this diagnostic category. This term isn’t an actual diagnosis, but refers to a collective term for such symptoms as memory, communication, and thought related symptoms resulting from an underlying disease or disorder. The most recognized type of disorder that results in the symptoms of dementia is Alzheimer’s disease.
Prior to the research that resulted in our current understanding of dementia, it was assumed that memory loss was just a standard part of getting old. It was accepted that while different people experienced a different severity of symptoms, everyone developed some degree of these difficulties in old age. Those with severe symptoms were frequently referred to as “senile,” and the word “senility” was an established term in our lexicon. With advances in medicine and health-related research, it was recognized that while some mild cognitive decline ,such as slightly poorer short-term memory, may be normal in aging, the symptoms that define what we now refer to as dementia are not a standard part of the aging process.
Dementia refers to a collection of symptoms including memory loss, personality changes, mood changes, and problems with communication and reasoning. The symptoms of dementia are caused by damage to the brain that results from specific diseases or conditions, such as Alzheimer’s disease and chronic small strokes or other conditions that damage blood vessels and lead to decreased blood flow and oxygen supplied to the brain (vascular dementia).
Dementia is a chronic disorder, meaning it will get worse over time. However, the specific symptoms and progression of these symptoms depend on the underlying condition and individual differences. Each person who has dementia experiences the symptoms somewhat differently and the ultimate severity of symptoms is dependent on numerous factors both related to the individual and the environment. It is not unusual that family and friends may be more concerned with the symptoms than the individual themselves.
The most recent census data indicated that over 4.7 million people in the U.S. over the age of 64 had Alzheimer’s disease. This translates into over a tenth of those in this age group. This data also showed that rates increase significantly with age, until reaching numbers that show that a third of those in the U.S. over the age of 84 have Alzheimer’s.
Alzheimer’s disease accounts for the largest group of those with dementia symptoms, with between 60% and 80% of all cases of dementia resulting from this cause, while vascular dementia caused by stroke accounts for the second largest number of individuals with symptoms of dementia.
There are various psychiatric and medical disorders that co-occur with the symptoms of dementia. These include:
- Anxiety Disorders
- Obsessive Compulsive Disorder
- Diabetes mellitus
- Atrial fibrillation
- Congestive heart failure
Causes of Dementia
There are a number of conditions that lead to the symptoms of dementia. These include:
Alzheimer’s disease – People most often first develop this disease after the age of 60. However, in certain individuals the symptoms of dementia caused by this disease may develop earlier. Early onset forms of Alzheimer’s have been linked to a faulty gene, while the causes of the disease in older individuals are less clear. A definitive diagnosis of the disorder can’t be made until after death, as the characteristic signs of the disorder in the brain cannot be seen using current technology, and can only be seen upon physical examination. The brains of many Alzheimer’s patients have been found to contain what are referred to as plaques and fibrous tangles, which are types of abnormal clusters of proteins. It has yet to be determined how or if these protein clusters lead to the symptoms of dementia in individuals with Alzheimer’s diseases.
Lewy Body Dementia – Similar to Alzheimer’s disease, Lewy body dementia is caused by an abnormal mass of proteins. This type of dementia accounts for about 10% to 22% of people with the condition. The symptoms of Lewy body dementia are similar to Alzheimer’s except they are more likely to alternate between periods of lucidity with dementia. Additionally, individuals with this type of dementia experience REM sleep disorders, including the tendency to act out their dreams in their sleep.
Vascular Dementia – Vascular dementia is caused by death of neurons and other cells within the brain, due to decreased or cut off blood flow to the brain, which deprives it of oxygen. The symptoms of this type of dementia may also result from strokes leading to damaged blood vessels, infections of heart valves, or other conditions. This type of dementia is frequently the result of high blood pressure and often occurs in those with a history or heart attacks or strokes. The onset of vascular dementia is usually sudden and like other types of dementia, the course is progressive.
Frontotemporal Dementia -This type of dementia is not as common as the dementia caused by Alzheimer’s disease, Lewy Body dementia, or vascular dementia. It also is different from these types as it often occurs at a significantly younger age, with it not being unusual for symptom onset to occur between the ages of 40 and 65. Dementia symptoms in these cases are the result of a collection of diseases, all of which involve nerve cell destruction specifically in the temporal lobes of the brain. As these brain areas are connected to personality, behavioral responses, and language, when cells in these lobes begin to die, the classic symptoms of dementia result.
Signs and Symptoms of Dementia
The symptoms of dementia can vary widely depending on the cause of the symptoms and individual and environmental factors. While memory loss is the first and most prominent symptom, the individual must have two or more symptoms for the diagnosis to be given. These include:
Effects of Dementia
While there are numerous effects resulting from the symptoms of dementia, like other areas related to these conditions, the specific effects a person may experience depend on the underlying disease, individual, and environmental influences. Some of the more common effects of dementia include:
- Loss of early abilities
- Lack of an adequate support network
- Abuse by an overstressed caregiver
- Abuse of a caregiver when the individual becomes stressed and confused
- Increased infections anywhere in the body
- Loss of ability to function or care for self
- Loss of ability to interact with others
- Regression to an earlier time
- Inability to encode and store new memories
- Anger due to the absence of childhood possessions no longer owned
- Complex grief experienced from re-experiencing the loss of significant others due to forgetting the deaths
- Decreased lifespan
- Side effects of medications used to treat the disorder