What is dementia?
Dementia is a condition which includes a collection of symptoms. Dementia is generally considered to be a condition which affects elderly people, and with people having ever-increasing life expectancy it is a condition which more and more people are becoming concerned about. Here we take an all-round overview of dementia, its causes, symptoms, diagnosis and available treatment and self-help.
The term dementia is used to describe a collection of symptoms which include memory loss, difficulty with communication and reasoning and as it progresses it can reduce a person’s ability to carry out normal daily activities such as cooking, washing and dressing, and generally caring for oneself.
Dementia is a progressive decline of the brain. It is not simply one disease but a syndrome. This means that it is a term that is used to describe a group of symptoms which could be caused by one or many different diseases. The most common of these diseases are:
- Alzheimer’s disease
- Vascular dementia
- Dementia with Lewy bodies
- Frontotemporal dementia
One of the first symptoms that people notice may be memory loss. The people close to someone with the early onset of dementia may notice that their loved one has started to forget things that have happened recently, even earlier on that day. They may become confused about messages and about who people are. It is not uncommon for people with early onset of dementia to get lost when they are out, even in familiar surroundings. They may begin to repeat themselves and appear not to pay attention to other’s conversations.
Some people with dementia have difficulty with expressing themselves. They may get their words muddled and use the wrong words for everyday items or mix their words up. It may be that a dementia patient has difficulty with reading and understanding written text.
Dementia is a progressive condition which means that the symptoms will gradually worsen. The extent of decline varies from person to person with each individual experiencing dementia in a different way. Although a dementia patient will have some of the above symptoms they may not have them all and the degree to which these symptoms affect each individual will also vary.
Dementia is a gradual decline of the brain which is generally associated with old age. It does not affect everyone and there are other causes that can be associated with dementia or some of the symptoms of cognitive impairment. For example Creutzfeldt-Jakob disease (CJD), Korsakoff’s syndrome, Huntington’s disease and HIV and AIDS related cognitive impairment. Dementia-like symptoms can be experienced for several reasons which are listed under 'diagnosis'. These symptoms do not necessarily persist and the causes should be eliminated during the diagnostic assessment.
If you think that you may have dementia or if you suspect that a person you know may be affected with the condition it is important that they see their doctor as soon as possible to receive a diagnosis.
Your GP will be able to refer you to a specialist for a proper assessment. This assessment should include a full physical examination. The individual should have their heart and lung function assessed as well as their blood pressure, blood count, thyroid testing and glucose testing. It may also include vitamin B12 testing and a mid-stream urine assessment.
There is currently no definitive medical test for dementia but a diagnosis must exclude other conditions and life-circumstances which can cause confusion and could mean that an individual could display symptoms similar to those of dementia. It is a good idea to invite a relative or friend to attend the assessment with you as they may be able to help with information about your history.
Other conditions which can cause similar symptoms to those of dementia are listed below:
- Chest and urinary infections
- Severe constipation
- Side effects from medication
- Taking medications incorrectly or taking medication that has not been prescribed
- Vitamin and thyroid deficiencies
- Brain tumours and normal pressure hydrocephalus
- Infected pressure sores
- Sudden life changes such as moving house or bereavement
- Poor sight or hearing
- Alcohol – even when taken in small amounts
Your assessment will be carried out by either a specialist working for a dedicated memory service or your local mental health service. This will depend on what services are available in the area where you live. It could be that your doctor refers you to a neurologist for assessment. Neurologists are specialists in brain disorders and it may be possible for them to make a home visit for the assessment.
Some specialists will also conduct a brain scan during the assessment process. A scan can help with the diagnostic process.
Treatment and self-help
Although there are several different medications which are available to slow the deterioration of dementia, the use of these medications has been restricted to people who have mid-stage dementia. You should discuss the possible use of medication with the person who makes the diagnosis.
The support that is available for dementia patients varies in different areas of the country. It may include attending a day centre or support group. Support groups can be extremely helpful for those with a recent diagnosis. Some areas have Alzheimer’s Cafes where both dementia patients and their carers can meet others with the condition and enjoy receiving support in a social atmosphere.
Social Services are responsible for putting a range of services in place. This could include a carer coming to a dementia patient’s home to help with daily tasks such as washing, dressing, cooking and going to bed. Age Concern is able to assist with other aspects of daily life such as benefits and attendance allowance claims.
Others that can help support you are your doctor, psychiatrist and community mental health nurse. Your GP should advise you of services that are available in your area and they should keep you informed about the support that you require. Your local social services will also be able to inform you of services and they can also refer you to these services. The Alzheimer’s Society are there to help and can give you information about all the services which are available in your area.
Although one of the effects of dementia is the loss of recent memories, recollections from long ago are still there and should be encouraged. A dementia patient can feel comfort in talking about their childhood for example. There are games and jigsaw puzzles that are available to encourage these memories which can also be a source of pleasure for the patient.