The Many Faces of Dementia
When memories start to fade, common questions come up. What is the difference between dementia and Alzheimer's disease? What can I do to possibly prevent this from happening to me?
Dementia is a term that describes a group of health problems related to memory. Think of it as an umbrella, and under it are the specific diagnoses of different types of memory and neurological problems. According to WebMD there are up to 50 forms of dementia, although many are rare. The types of dementia are generally grouped by which part of the brain is affected, which are actually due to damage to the cells of the brain, which are reversible or have causes such as side effects of medications or a primary health condition. There are even some that are due to genetic causes or vascular changes. Except for the reversible type of dementias, dementia is NOT a normal or expected result of aging.
The most common type of dementia is Alzheimer's disease, which makes up 50-80% of the cases. Alzheimer's disease is due to cell death from plaques and damage to brain cells. Changes in memory and how the person thinks may start in their 60's, starting with vague symptoms such as misplacing items or getting lost while driving. As the disease progresses, the person may exhibit symptoms of loss of memory, paranoia or suspicion, difficulty performing daily tasks, difficulty with abstract thinking, disorientation of time or place, mood swings, and changes in personality.
The second most common type of dementia is called vascular dementia, and is often due to a stroke.
Other dementias include:
Lewy Body dementia- a progressive dementia due to clumps of abnormal protein
Fronto-temporal dementia- a degeneration of the nerves in the frontal or
temporal lobe of the brain that leads to personality changes and/or
Mixed dementia- where the combination of the aforementioned occurs
(usually in persons over the age of 80)
Traumatic Brain Injury- head injuries (concusssions) in boxers, football players etc
Huntington’s disease dementia- a genetic condition that starts in the 30-40s where
there is a severe and progressive decline in thinking
Creutzfeldt Jacobs dementia- an inherited disease where there is abnormal proteins that
build up in the brain
Reversible type dementias are often due to:
Infection- which can be seen with fever or urinary tract infections in the elderly
Immune system- multiple sclerosis
Metabolic- thyroid disease, low blood sugar, low (or high) sodium or calcium
Nutrition related- deficiency of vitamin B 1 (seen in alcoholism for instance),
dehydration, or when vitamin B6 or B12 is deficient
Medication side effects
Subdural hematoma- a bleeding around the covering of the brain
Anoxia- a lack of oxygen such as during a severe asthma attack, heart attack or with
carbon monoxide poisoning
Diagnosis of dementia is made after a thorough intake of history, a physical examination, and lab work to rule out other causes for the symptoms.
Progressive types of dementia and Alzheimer’s disease have no cure, but in some cases there are medications that may temporarily alleviate some of the symptoms. The medications may slow the worsening of the symptoms by about 6-12 months for about one half of the persons taking them.
So, you may ask what are the risks or dementia, and how can it be prevented. Although we can’t avoid aging or genetics, we can control the cardiovascular factors and keep active. Just like the heart, the brain is rich in vessels that nourish it. Anything that damages the blood vessels in the body (or blocks them, such as cholesterol), reduces the flow to the brain, reducing oxygen that is carried through these fragile vessels. Controlling the cholesterol, blood sugar, blood pressure, and maintaining a healthy diet is key to prevention. Smoking is also a significant risk, so if you smoke, consider this as one additional reason to stop. Exercise, such as daily walking, improves the blood flow through the brain, and brings oxygen to it. Therefore, regular exercise reduces the risk of some types of dementia. Our diet may have the greatest impact on both the brain and heart. The Mediterranean Diet (or a similar heart healthy diet) may be protective. Limit your intake of red meat, and increase your intake of whole grains, fish, vegetables, healthy nuts, olive oil and other healthy fats are encouraged. You may have also seen the recent news about the risks related to diet soda. Researchers found that drinking more than one diet soda a day can increase your risk of strokes and dementia. Replace the diet soda with water, which is a healthier option.
Researchers are working diligently to find new ways to detect symptoms of dementia early, ways to identify those at risk earlier, new treatments, and ways to prevent these devestating diseases. I hope you return to the blog next week so see more articles on memory changes associated with aging, and health related to our brains.
Alzheimer’s Association. Alzheimer’s myths. www.alz.org/alzheimers-disease-myths-about-alzheimers.asp. Retrieved on 4 22/17.
Alzheimer’s Association. What is dementia. www.alz.org/what-is-dementia.asp. Retrieved on 4/23/17.
Mayo Clinic (2016). Dementia. http://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/dxc-20198504. Retrieved on 4/23/17