Dementia is a very wide term that includes many different diseases associated with cognitive abilities and neurologic function. This type of disease is a life-changer, not only for the patient, but also for his or her family members. It is very difficult to see how dementia takes away what you loved from your relatives, and how memory loss starts affecting the relationships in everyone in your family. This type of disease is based on neurologic dysfunction, and may be caused by several problems, including vascular abnormalities and accumulation of waste products.
The most common form of dementia is Alzheimer’s disease, and they are all more prevalent as we age. There are some forms of senile dementia with a mild decay in cognitive abilities, but severe cases become in turn a cause of disability and mental health problems.
The most widely studied form of dementia is Alzheimer’s disease because two-thirds of cases are diagnosed as such. In these patients, amyloid plaques start to form in key regions of the brain, and even though there are asymptomatic individuals, the majority start displaying a series of signs and symptoms as the amyloid plaques become larger.
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The most important symptoms are as follows:
Memory loss
One of the key manifestations of dementia is memory loss. It is a shared symptom in Alzheimer’s disease and the rest of dementias. It is often the reason why patients detect senile dementia, because they start forgetting about things and have problems collecting and maintaining new memories.
Memory loss is a symptom that is present in every phase of dementia, even in mild cases and early phases of Alzheimer’s disease. Patients will forget things they learned moments ago, and it becomes increasingly difficult to retain memories and learn new things. Thus, they feel forced to rely on others or write every single thing that happens or needs especial attention as a measure to stop forgetting important things.
Difficulty to solve problems
Solving problems is a complex cognitive function that requires the interaction of various types of brain connection. It is essential to have accurate memories about the problem and several details that will contribute to figuring out a solution. Then, we should plan ahead and take in consideration our environment and people involved in the solution of a given issue. Patients with dementia will have a severe compromise of each function we mentioned above, and it becomes very difficult to solve problems.
Since patients with dementia have a difficulty in developing ideas and following plans, they have problems, not only solving every day issues and plans but also arithmetic problems and space-time coordination.
Difficulty to complete daily tasks
As dementia progresses, it becomes increasingly difficult to complete daily tasks that should not require any type of assistance. These tasks become a challenge for patients with dementia, and simple things such as going out for dinner or creating a shopping list can become a real problem. Since they tend to have slow movements, they can take hours in cleaning or organizing their pantry, and in severe cases, they will require help to complete their hygiene rituals as well. As such, dementia can be a crippling disease affecting not only the patient but the relationships with his family, too.
Confusion
There are different degrees of confusion, and in dementia they all depend on the severity of the patient’s memory problems. During early phases, when they start experiencing mild memory problems, they become confused because they lose track of what happened in the past or have trouble remembering details about their past. As the disease advances, patients may also confuse space and time, and strongly believe they are in other place and stuck in their memories about their past.
Confusion in patients with Alzheimer is very severe in a late phase of the disease. It ends up affecting the relationship of the patient with his relatives, and causes emotional breakdowns in their loved ones as they realize the patient is no longer able to recognize them.
Difficulty to interpret visual stimuli
As the disease progresses, and depending on the type of dementia, patients may have difficulty to interpret visual stimuli. When a task requires visual coordination, they fail to complete it and lose interest. Even patients who were experts in sewing or knitting may start losing their skills and feeling upset about it.
Driving is another important skill that becomes compromised as dementia progresses, and it is not a good idea to have a patient with dementia driving, even when he seems to be in an early phase. Other visual skills that become compromised are reading and organizing, which contributes to the dependence of the patient and his difficulty to learning new things.
Speaking and writing problems
As memory loss continues, these patients start displaying problems when they write and speak. For example, they may have difficulties remembering name of items or people, and when they do remember, they may also have difficulties putting thoughts into words. Even expert writers may start having grammar problems and change their writing style.
As the disease becomes more advanced, patients with Alzheimer’s disease and other types of dementia start having severe problems trying to talk with others around them. They are speaking and lose track of what they were saying in the middle of the sentence, and need to go back and say the same thing once again to remember and complete their ideas.
Misplacing objects
This is a typical problem in patients with dementia. Even though all people may have problems remembering where they left the car keys, patients with dementia have exaggerated problems in this regard. Moreover, when they finally find the item they are looking for, it is usually located in the most strange places, and they do not remember how they got there.
As the disease continues, misplacing objects in patients with dementia becomes a source of confrontation. They become paranoiac and accuse others from stealing or hiding their things on purpose.
Poor judgement
We mentioned above how solving problems becomes increasingly difficult as the disease advances. Another function that is compromised in Alzheimer’s and other types of dementia is the capacity of decision. Making choices is not easy for a patient with dementia, and they tend to make several mistakes, especially when it has to do with using money appropriately and deciding what action to take during emergencies.
Poor judgement in dementia is progressive, and even though not all patients display severe problems, it is not a good idea to feel overconfident. That’s why communication is so important to make tough decisions in early phases of the disease, and they should be delegated to the caregiver in the late phase of the disease.
Social withdrawal
Patients with dementia have difficulty to remember people and places, they have difficulties to talk to others and most of them start losing their hobbies and interests because of visual coordination problems. All of this in the same patient usually results in social withdrawal of the patient because they do not feel comfortable when speaking with others and showing off their cognitive problems. Even patients who formerly organized social activities start having problems teaming up with others and using their leadership skills.
Mood and personality changes
One of the most crushing signs of dementia in its advanced states is how it causes alterations in the personality and mood of the patients. It usually starts with mood swings and changes in interests. Patients become more susceptible to feeling anxious or depressed, and they may start having violent and unexpected changes in their state of mind. Then, in a late stage of the disease, patients become irritable and family members may report that it seems they are now talking with a completely different person. That is because dementia starts affecting the interconnection of neurons in the frontal lobe and other areas associated with personality.
Without a doubt, dementia is one of the worst cognitive problems in older adults. But even though there’s a genetic predisposition to it, the majority of risk factors are modifiable. In other words, there is much we can do to prevent Alzheimer’s disease and other types of dementia or slow down their progression and the severity of the symptoms.
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Preventing dementia is possible through lifestyle habits such as quitting smoking, which triggers around 14% of cases of Alzheimer’s disease. Living an active life and increasing your daily dose of physical activity has been shown to reduce the incidence of dementia, too. Other studies show that challenging your mind with crossword games and arithmetic problems can stimulate your mental acuity and exercise your cognitive function to prevent dementia.