Charlotte, NC
Mukesh Yadav, MD
Roshni Bhandari, MD
Mrs. Smith is a 65-year-old woman. She is currently retired and lives by herself. She has started noticing that she sometimes forgets things lately. She went grocery the other day and missed paying her bills. Her mother has Alzheimer’s dementia, and she is concerned about whether she’s developing dementia.
Dementia is a progressive degenerative brain disorder that slowly destroys memory and affects one or many domains of cognitive skills. Along with memory issues, the patient starts having difficulties with language (word-finding difficulties), attention span, orientation, decision-making, and plans.
Dementia presents in different forms and is commonly seen in older people. It may start with you needing to remember previous conversations or having difficulty with routine activities like preparing a meal or making a phone call.
You may have increased forgetfulness that may cause you to lose objects frequently. Some people experience a feeling of being disoriented while out walking or driving. Your family might notice personality changes, such as;
The symptoms of dementia are commonly noticed first by family or close friends or the affected person. One symptom that becomes apparent is short-term memory loss. Your family might notice you forget where you have placed things around the house or recent conversations.
Forgetfulness, confusion, or trouble remembering a name can be seen as normal behavior. However, when memory loss or unusual behavior starts to interfere with everyday activities such as working, preparing meals, or handling finances, you know it is time to see your doctor. These could be signs of dementia. Dementia is a progressive disease, although it often seems sudden to the person with the illness and the people in their lives.
Dementia is caused mainly by brain degeneration or injury. It can also result from arteriosclerosis (hardening of the arteries) in the brain or stroke that blocks blood flow to the brain, affecting a person’s thinking.
The two most common causes of dementia in older people are Alzheimer’s disease and vascular dementia. Many conditions, such as depression, anxiety, mild cognitive impairment, age-related memory loss, and hearing or eyesight problems, mimic dementia.
Your doctor might evaluate you with verbal and written tests to assess your cognitive function. The complete evaluation might involve laboratory tests and imaging of the brain. A doctor can refer you to evaluate your hearing and vision and get a neuropsychiatric test or a psychological assessment before diagnosing you with dementia.
It is the most common cause of dementia in older adults. Alzheimer’s dementia involves the build-up of abnormal proteins in the brain. These proteins stop the function of previously healthy nerve cells, causing neurons to lose connections with each other and eventually kill off nerve cells. As more brain cells die, additional brain parts are affected, and the brain tissue shrinks significantly.
Alzheimer’s dementia usually can be found in the mid-60s or later. Less than 10% of people can have early-onset Alzheimer’s, affecting people between their 30s to mid-’60s. Many cases of Alzheimer’s are caused by gene mutations or a genetic variant of the apolipoprotein E (APOE) gene. There are still multiple ongoing studies to identify additional genetic risk variants.
Please note: A family history of Alzheimer’s does not necessarily mean you will have it for sure, but it may mean you are more likely to develop it.
Suppose you have had previous strokes or hardened small blood vessels. In that case, your brain might slowly have an issue connecting ‘wires’ that are critical for relaying messages between different brain regions. Vascular dementia refers to changes to memory and behavior resulting from conditions that affect the blood vessels in the brain.
Your doctor might order a CT scan or MRI of the brain to look for evidence of a prior stroke, which is often small and sometimes without previous symptoms. Vascular dementia refers to changes to memory and behavior resulting from conditions that affect the blood vessels in the brain.
Research studies involving dementia show a strong link between diseases affecting the heart, blood vessels, and brain. Your doctor will treat modifiable risk factors like abnormal heart rhythm, high blood pressure, diabetes, obesity, and high cholesterol to prevent additional strokes.
Treatment of dementia varies for people. A treatment plan for dementia depends on the type of dementia you have. We suggest opting for a patient and family-centered care plan. Talk to your doctor regarding dementia and a long-term care plan.
The most common causes of dementia are Alzheimer’s and vascular dementia, which are incurable. Some reversible causes of dementia are more common than you think and can affect your memory and thinking abilities. Your doctor can treat you with depression with antidepressants or supplement you with vitamin B12 or thyroid hormone, depending on if you have any deficiencies. Discuss with your doctor if you need these supplements. Depending on your need, you may also need proper eyeglasses or hearing aids. Since dementia is progressive, your treatment will focus on controlling your symptoms and avoiding harm.
Regular medical checkups will optimize your well-being and body function. Your doctor may suggest a home safety assessment or a driving assessment to help you evaluate whether you can still cook, drive, keep track of medications, and do other daily activities independently.
Medicines are available to treat dementia symptoms. However, they are only mildly effective and have side effects. Talk to your provider about what is best for you.
Spend meaningful time with your family member who has dementia. Participate together in activities your loved one enjoys, which can help improve their quality of life. Your help can be crucial in managing behavior changes that may come with the disease, such as sleep problems, aggression, and agitation. Please encourage your family members to work on advance directives that list how you want your medical and financial decisions to be made just in case you lose decision-making abilities.
Here are some things to do if you have been diagnosed with dementia
Arvanitakis, Z., & Bennett, D. A. (2019). What is dementia? Jama, 322(17), 1728-1728.
Health Topics A-Z. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/topics
What Is Dementia? Symptoms, Types, and Diagnosis. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/what-is-dementia
