What is Dementia?What are the key symptoms of Dementia?
All people start to forget things as you get older. Many older people have a slight memory loss which affects their daily life. But memory loss that worsens may be a sign of onset of dementia.
Dementia is a loss of mental skills that affect the daily life of the person. It can cause problems with thinking and memory and the capacity of abstraction. Dementia usually worsens with time. Duration increase awareness of symptoms varies from person to person.
Some people remain long in a stationary period. Others have a fast loss of skills.
Probability of dementia increases with age. This does not mean that all people have dementia. Many elderly people will not ever dementia. Around 85 years, approximately 35 100 people have dementia. This means that 65 out of 100 people this age have the disease.
If your partner or someone close shows memory loss worsens, please consult a doctor. May be nothing worrisome. But if dementia, treatment may be helpful.
Causes
After Alzheimer’s the most common cause of dementia is multi-infarct dementia. This condition, which is also known as vascular dementia, is developing a stroke if that is blocking blood flow towards certain areas of the brain. Loss of mental function in case of multi-infarct dementia may be resumed in turn can prevent a new injury in the future, reducing the risk of cardiovascular disease.
Other common causes of dementia can not be recovered are:
- Parkinson's disease, a movement disorder, dementia occurs in 30% of people with this disease
- Dementia with Lewy bodies, which consist in the formation of protein deposits (Lewy bodies) in neurons. This disease has some symptoms similar to those of Alzheimer's or those of Parkinson's disease, but has some different symptoms such as visual hallucinations
- Front-temporal dementia, in which the main symptoms may be changes in personality or behavior
- Severe trauma to the skull, with loss of consciousness.
Less common causes of dementia can not be recovered include:
- Huntington's disease, which is a rare disease, Inherited
- Leucoencefalopaty, which are deep-tissue disorders of the brain white matter
- Binswanger's disease, a type of vascular dementia can occur in people who have a long or a high blood pressure in people with severe stiffening of the arteries (atherosclerosis)
- Creutzfeldt-Jakob disease, a rare and fatal disease that destroys brain tissue
- Brain injury due to accidents or boxing
- Some cases Multiple Sclerosis (MS) or amyotrophic lateral sclerosis (ALS)
- Multi-systems atrophy, a group of degenerative brain that affect speech, movement and autonomous functions
- Infections such as mad cow disease or syphilis in an advanced stage. Antibiotics can effectively treat syphilis at any stage, but that brain damage has already occurred can not be recovered.
Doctors can treat some cases of dementia, restoring mental function. These are:
- Hypo activity thyroid gland (hypothyroidism)
- Deficiency of vitamin B12 or folic acid
- Poisoning by heavy metals such as lead
- Adverse effects of drugs or drug interactions
- Some brain tumors
- hydrocephalus normal pressure, which occurs when fluid builds up in the brain too much, creating pressure on tissue cerebral
- Some cases of chronic alcoholism
- Cases of encephalitis, a brain infection
- Infection HIV / AIDS.
Some diseases that cause dementia can be inherited in families. Doctors often suspect an inherited cause if the symptoms of dementia in a person younger than 50 years.
It is important to know that memory loss can be caused by other causes outside of dementia, such as depression or seizures, and that these conditions can be treated. Also, the presence of occasional memory disorders (such as forgetting someone's name for a short period of time) may be a normal part of aging. However, if these are troubling memory loss, or worsen, please consult a specialist.
Symptoms of Dementia
Symptoms of dementia vary depending on its cause and location of affected brain area. Memory loss is usually the earliest symptom and most easily noticed.
Other key symptoms of dementia are:
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Difficulty in remembering recent events
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Acknowledge familiar people and places
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Difficulty in finding adequate words to express thoughts or to name objects
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Difficulty in making mathematical calculations
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Problems in planning and carrying out tasks such as carrying out the instructions of a recipe, writing a letter or keeping a checkbook
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Quick thinking difficulties, such as react appropriately to emergency situations
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Difficulty in controlling their behavior or dispositions,
depression is common, and agitation and aggression may occur
- Self care such as toilets or showers.
Some types of dementia have symptoms:
- People with dementia with Lewy bodies often have highly developed visual hallucinations, detailed, they can often fall
- Early symptoms of front-temporal dementia may be personality changes or unusual behavior. People with this disorder can not have empathy toward others (ability to understand) or say rude things or malicious, to have moments of exhibitionism or make sexual comments.
Symptoms of dementia that starts suddenly suggests a possible vascular dementia or delirium as possible - short title, a disease caused by a new or old diseases that become more severe.
Fiziopathogenic mechanism
How quickly evolving dementia depends on its cause and location of affected brain area. Some types of dementia progress slowly over several years. Other types may progress more rapidly.
If vascular dementia is caused by a series of small strokes, loss of mental abilities can be achieved in a stepwise fashion. If it is caused by a single stroke, a large blood vessel, loss of function can occur suddenly.
Evolution of dementia varies greatly from person to person. Early diagnosis and treatment with drugs used in Alzheimer's disease may lead to the preservation of mental functioning for a while in people with vascular dementia or dementia with Lewy bodies. Even without these medicines, some people may remain in a stable condition for several months and even years, while others may have a rapid degradation.
Many people with dementia are unaware of their mental deterioration. They may deny their condition and to accuse others for problems they encounter. Instead people can realize their condition may complain of loss of their abilities and become hopeless and depressed.
Depending on the type of dementia, behavioral ones can get out of control sometimes. The person may become angry, agitated and combative or catch on, adhesive and behaving like a child. He or she can wander and drifts. These problems can make home care by family members or other persons to become increasingly difficult.
Even if they can be cared for as well, people with dementia tend to have a shorter lifespan than the average person the same age. Death is usually due kidney infections or lungs, caused by prolonged stay in bed.
Note!
Many elderly have a slight loss of mental skills (usually recent memory is affected), but they do not affect their daily functioning. This situation is called mild cognitive impairment. People with mild cognitive impairment may be in the early stage of dementia or may remain in that stage of the skills for a long time.
Risk Factors
Aging is the main risk factor for all types of dementia. Some diseases that cause dementia (such as early onset Alzheimer's disease and certain types of front temporal dementia) can be inherited.
Chances to develop vascular dementia are higher if the following factors exist:
- Male
- High blood pressure (hypertension)
- A myocardial infarction past
- atherosclerosis, Which consists of fat and calcium deposit in artery walls that can cause coronary artery disease
- diabetes
- High blood cholesterol
- A stroke or a transient ischemic attack (TIA) in the past.
Other factors that may increase the risk of dementia include:
- Low blood pressure for a long time, people aged over 75 years. Researchers believe that this risk could result from the fact that not oxygenates the brain. We need more studies to determine which optimal blood pressure value is for the elderly, that value has a low risk of heart disease but ensure a sufficient intake of blood for normal brain function
- Increased level of homocysteine. Homocysteine which is an amino acid normally found in small quantities in blood. There is the hypothesis that elevated levels of hemocysteine can cause formation of blood vessel wall plates. Over time this can lead to serious diseases such as stroke, myocardial infarction and pulmonary embolism. Also can decrease mental abilities. Hemocysteine levels are generally stable until around the age of 40 years, and then usually begin to grow, especially after age 70 years
- Administration of hormone therapy by women older than 65 years. In the past it was thought that hormone replacement therapy (HRT) - a combination of estrogen and progesterone - may provide protection against dementia or cognitive impairment. However, the Association for Women's Health in the U.S. provided evidence that, in contrast, HRT actually increases the risk for Alzheimer's disease and other types of dementia in women 65 years and older who took this treatment on a longer period of four years.
Only administration of estrogen (estrogen replacement therapy) has similar effects. Not yet known if any of these treatments could help to reduce the risk of dementia late when used around the age of entry into menopause.
Consult specialist
We recommend calling an ambulance immediately or to another service call for emergency interventions if the signs occur suddenly a stroke or a transient ischemic attack (TIA). These may be:
- Numbness, weakness or inability to move the face, arm or leg, especially on one side
- Vision problems at an eye or both, such as blur, dark / blurred vision, spots, double vision, loss of vision or feeling like a shadow over his left eye
- Confusion, speech disorder or other words of understanding
- Gait, dizziness, loss of balance or coordination
- Severe headache with no known cause.
It is necessary to call a doctor immediately if a person suddenly becomes confused, emotionally disturbed or not seems to know who he is or where he was. These are signs of delirium, which may be caused by a reaction to a medicine or a medical condition that gets worse the older or new one appeared.
It is necessary to consult a doctor if your partner or another close person has a memory loss recently installed and concern that is more than an occasional episode of forgetfulness. This may be an early sign of insanity.
Watchful waiting
Occasional Forgetfulness or memory loss may be a normal part of aging. But any new device or memory loss that worsens or problems encountered in daily life functioning should be reported to a doctor. It is well known to be the first ominous signs of dementia and consult a physician if any of these signs occurs in a family member.
These signs are:
- Increased difficulty in finding appropriate words during speech
- Error of looking for familiar places
- Or suspicious behavior more irritable than usual.
Doctors recommend
Following health professionals can evaluate symptoms of memory loss or confusion:
- GP
- Physician (specialist in internal medicine)
- Doctor Geriatrics
- Neurologist
- Psychiatrist.
Investigations
Doctors can diagnose dementia and identify because they possibly based on a medical history and physical examination, mental status examination and laboratory tests and imaging.
Tests can be used to determine whether that cause dementia can be treated. Even if dementias that can not be recovered, knowing the type of dementia that has the person may help the physician to prescribe medication or other treatment to improve mood and behavior of the person concerned, and on helping as other family members.
Medical History
Created during the medical history and physical examination, the doctor will ask the person affected and a close relative or spouse about recent illnesses or other life events happened recently, which could lead to memory loss or other symptoms such as behavioral disorders.
Although a person may have several conditions that could cause dementia sometimes symptoms can make the difference between one form or another. For example, the early installation of front temporal dementia the person may present a lack of social consciousness and may develop obsessions about food, none of these events does not occur early in other forms of dementia.
Mental status examination
The doctor will examine mental status. This test usually is various questions and activities such as: a person must say what day and what year are to repeat a series of words to draw a clock and count back from 7 100 in July.
Were made and other tests that may help in diagnosing dementia. Doctors can use such a test, such as Addenbrooke Cognitive Examination, to deferential Alzheimer's front temporal dementia. Orientation in Alzheimer's disease, attention and memory are more profoundly affected, while in frontotemporal dementia are more affected language skills and the ability to name objects.
Laboratory tests
Many medical conditions can cause alterations in mental function. While performing a physical examination, the doctor will look for signs of other medical conditions and will require a series of laboratory tests to see if that condition can be treated.
Routine tests are:
- Determination of thyroid hormones to identify a thyroid hypo activity
- Dosing vitamin B12 for identifying a vitamin deficiency
- Determination of folic acid for identifying a deficiency of this vitamin, which is part of the B vitamins
- Complete blood count (CBC) to find any infection
- Transaminases, i.e. ALT or AST, blood tests showing liver function
- Tests for syphilis
- Determination of blood levels of electrolytes and other tests that can provide data on kidney function
- Determination of glucose, to determine blood glucose levels.
Other laboratory tests that can be made are:
- Tests for HIV / AIDS
- Erythrocyte sedimentation rate (ESR), a blood test that identifies the presence of inflammation in the body
- Toxicological screening, including tests of samples taken from urine, blood or hair in order to search for drugs that may cause problems
- Antinuclear antibodies, a blood test used to diagnose autoimmune diseases
- Determination of heavy metals in the blood, such as lead.
Imaging tests
Many experts recommend that persons suspected of dementia assessed to make a test such as magnetic resonance imaging (MRI) or computed tomography (CT or CT). These tests may be useful to rule out brain tumors, stroke, normal pressure hydrocephalus or other conditions that might make symptoms of dementia.
MRI can show areas of atrophy in some parts of the brain changes that occur in some forms of dementia.
Also NMR - Site and CT - can show signs of your stroke when vascular dementias.
Two other imaging tests - CT scan with positron emitting (SPECT) and PET - are not routinely used for diagnosis of dementia. However, they can be useful if the symptoms are confusing or strange. These tests can be useful in identifying some forms of dementia, including vascular dementia and front temporal dementia.
In some cases, brain electrical activity can be measured with electroencephalogram (EEG). Doctors often use this test to diagnose dementia also EEG can be used to differentiate dementia from delirium and to identify abnormal brain activity of Creutzfeldt-Jakob disease, a rare form of dementia. Most often, EEG is used to see if symptoms seem to be due to dementia are not actually caused by epileptic seizures.
In rare cases, brain biopsy may be suspected when a cause of dementia can be treated.
After death, an autopsy may be performed to identify with certainty the cause of dementia. This information can be useful for family members who may be concerned about genetic causes.
Care of people with dementia is very stressful
Caregivers are advised to seek support from family members or friends. It is also advisable to look after their own health condition, occasionally taking a break for themselves. It can make counseling, support groups and settlements exist for adult day care or associations that may help caregivers so that they can go through periods of stress and strain can overcome mental episodes.
Treatment if the condition gets worse
As dementia progresses, memory decline occurs, thinking, reasoning and to make and to carry out plans (executive function). Depending on the type of dementia, the behavior may get out of control, the person may become angry, agitated or combative.
She may begin to roam and wander. These problems may make it difficult to provide care at home for the person with dementia by family members or by others. Therefore family members may be forced to opt for hospitalization person in a specialized center for treating dementia. Even with the best treatment, people with dementia tend to have a shorter life than other people the same age. Evolution depends on the condition causing dementia and whether there is comorbidity and other diseases such as diabetes or heart disease.
Outpatient treatment (at home)
For home treatment of a person with dementia requires a team work in which to engage healthcare professionals and caregivers who need to create a secure and comfortable environment and do so daily life activities to be as easy as possible.
Making a diagnosis of dementia can cause feelings of anger, fear or anxiety. A person in an early stage of the disease should seek emotional support from family members, friends and a person with experience in advising and treating people with dementia.
Professional counseling can help the person to accept the diagnosis and build strategies to cope with the situation.
If the condition is diagnosed early, people with a mild form of dementia may be involved with treating physician and caregivers, to develop future plans and organizing activities of domestic and everyday life . Dementia is a progressive rate varies from one person to another, such as the functioning of the person concerned may be stable for several months and even years. People with dementia may be able to stay active mentally and physically for a period of several years.
People with dementia and caregivers may need to face several dilemmas, such as:
- You can continue to drive a car. Take right to drive may decrease the feeling of independence and dependence may increase a person. But it is extremely important that that person not to drive if this could threaten the safety of their own or others. Individuals in a very early stage of dementia should be evaluated and checked to see if they can drive safely. Treating doctor should reassess their level of functioning every 6 months
- The legal and financial plans will be required. As soon as possible after the diagnosis of dementia, affected person should prepare a will and a document which empowers a lawyer for decisions regarding medical care. These documents will give assurance that the person's wishes regarding medical care, especially those related to treatment of life support will be met. Also, family members must ensure that all necessary financial and legal affairs are in order. These may include taxes, insurance policies and life health, pensions, trade stocks, mortgages, bank accounts, investments, etc. related information.
Other problems caregivers
Many people with dementia are cared for at home by partners or other living family members and friends. Care of people with dementia can be exhausting physically and emotionally, but the result of advice and other assistance can make everything easier.
- Is recommended to ensure a safe family environment. Rooms must be ordered, free horse. Knives, cleaners and other dangerous substances should be kept under lock and key locked. Carpets should be thrown on the floor and place mats must be larger to prevent slipping. It's best to install handrails in shower, borders around the bathtub and other auxiliary devices in the bathroom. It is good to ensure good lighting, to put lights in bedroom, bathrooms and hallways, which are lit at night
- Recommend maintaining a good nutritional status. It is advisable to be offered food more often, including healthy snacks at 11 am and afternoon. If the person can not be used as a spoon or a fork, you should be given food prepared so they can be served with your fingers. The dishes need to be given at a time that choice may cause confusion. If the person lose weight may be taken into account nutritional foods in liquid form
- Managing sleep disturbances. Indicated that the person with dementia to be kept awake and active during the day. Can be useful to offer a glass of warm milk or herbal tea, which do not contain substances stimulating the evening before going to sleep. A hot bath shortly before bedtime may be useful in obtaining relaxation
- Management of sphincter control problems (incontinence and fecal). Person should be encouraged to go to the toilet at regular times, such as every 2 hours. It's good to be clearly labeled with bath and toilet signs, drawings may be used when a person can not understand the words. Can also be used pampers for adults or absorbent linings or underwear. If incontinence is an emerging problem, it is good to see if it is not caused by another condition, such as urinary tract infection.
Caregivers must not forget to ask for support from other family members or friends. Relying on advice and temporary care centers can help in overcoming moments of overload or stressful periods.
Nursing services (care) at home
Even despite the best treatment, a person with progressive dementia will decline, perhaps to the point where the caregiver can no longer be capable of physically, emotionally or financially to provide them assistance. Person with dementia may begin to develop uncontrollable behavior problems or other conditions may need medical or therapeutic care which a person can not cope. There are certain ways to help, although many people with dementia require constant care (24 hours of 24) starting at some point. Decision regarding the appeal to a home nursing service is often very difficult, each family must consider the financial situation, emotional capacity and other variables. | 
