Dementia

June is Alzheimer's and Brain Awareness Month. I thought we could start our series on this subject this week by talking about dementia in general. Next week we will talk more about the most common type of dementia, which is Alzheimer's disease.

What is dementia?

Dementia refers to a group of symptoms related to a decline in memory, thinking, and social abilities. The term dementia applies when these symptoms are severe enough to interfere with your daily life. It is not simply memory loss, although that can be one of the early signs of dementia. Dementia does not refer to a specific disease. There are several diseases that can cause dementia.

What are the symptoms of dementia?

Symptoms can be broken down into 2 categories.

Cognitive changes, those related to the mental processes of perception, memory, judgement, and reasoning can include:

• Memory loss – Usually noticed by others
• Difficulty with problem solving
• Difficulty with visual or spatial abilities – Such as getting lost in familiar areas
• Difficulty finding words or other communication problems
• Trouble handling complex tasks or following multi-step directions
• Decreased organizational skills or trouble planning things
• Confusion and/or disorientation
• Trouble with coordination or movement of the body

Psychological changes, those relating to emotions, awareness, feeling, or motivation can include:

• Personality changes
• Depression or anxiety
• Paranoia
• Agitation
• Hallucinations
• Inappropriate behavior

What is the difference between dementia and delirium?

Dementia is a chronic process that usually comes on gradually and is progressive. Delirium is a state much like dementia, with confusion, memory loss, personality changes, etc., which develops over a shorter period of time, often caused by an acute illness or infection, as a side effect of a medication, or even as a result of severe sleep deprivation. Delirium is reversible if the underlying cause is treated appropriately.

What are the different causes of dementia?

Diseases that cause a primary progressive dementia include:

• Alzheimer's disease – The most common cause of progressive dementia. We'll talk more about it next week.
• Vascular dementia – Caused by damage to blood vessels that supply your brain. This may be due to multiple strokes causing damage to the brain or from chronically low blood perfusion to the brain causing the brain to shrink.
• Lewy body dementia – Caused by clumps of protein, called Lewy bodies, that are deposited in the brain. It causes a dementia that has features of both Alzheimer's and Parkinson's disease.
• Frontotemporal dementia – Caused by nerve degeneration in the frontal and temporal parts of the brain. It often causes more personality and behavior changes early on.
• Mixed dementia – Some people have a combination of more than one of these diseases.

Diseases that may cause dementia as a secondary feature of the underlying disease include:

• Huntington's disease
• Traumatic brain injury – Especially multiple small traumatic injuries like concussions.
• Parkinson's disease
• Creutzfeldt-Jakob disease – A rare brain disease caused by infectious proteins deposited in the brain.

As we continue the series, we will discuss Alzheimer's disease in more depth, as well as talking more about the risk factors for dementia and how you might be able to decrease your risk of developing dementia.

If you have any questions about Dementia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor