Ahmed Raza

Reviewed by Dr. Jessica DPN, RN, CEN, Dr. Jessica DPN, RN, CEN is a registered nurse and educator with 20 years of experience in critical care emergency nursing, specializing in patient care, education, and evidence-based practice. She holds multiple certifications and serves as a Patient Safety Coordinator.

Dementia is marked by a decline in cognitive abilities, affecting areas such as thinking, reasoning, and memory. Many individuals with dementia struggle to manage their emotions, which can significantly influence their daily lives, personalities, and activities.

In the early stages, dementia may impact a person’s functioning, while in the later stages, it can lead to complete dependency on others for daily tasks. Currently, around 55 million people globally are living with dementia, with nearly 10 million new cases identified each year. Alzheimer’s disease is the most prevalent form of dementia.

The likelihood of developing dementia increases with age, though it should not be viewed as a normal aspect of the aging process.

Signs and symptoms of dementia

Dementia impacts individuals in diverse ways, influenced by its underlying cause, any pre-existing health issues, and the person’s cognitive abilities. The signs and symptoms of dementia can be categorized into three progressive stages:

Early-stage dementia The early signs of dementia typically emerge gradually and may go unnoticed. Common symptoms during this stage can include:

• Losing track of time
• Difficulty remembering information
• Getting lost in familiar environments

Middle-stage dementia As dementia progresses to the middle stage, symptoms become more pronounced. Individuals may experience:

• Confusion
• Forgetting names or recent events
• Challenges in communication
• Dependence on assistance for personal care tasks
• Repetition of questions
• Changes in behavior

Late-stage dementia Late-stage dementia is marked by a complete or near-complete reliance on others for care. The physical symptoms are more evident, and memory issues worsen significantly. Symptoms of this stage may include:

• Inability to recognize time or place
• Difficulty recognizing friends and family
• Issues with walking
• Sudden changes in behavior, such as aggression.

Causes and risk factors of dementia

The causes of dementia can differ based on the changes taking place in the brain, with many cases remaining unexplained. However, specific brain alterations are associated with certain types of dementia. While genetic mutations can lead to dementia, such instances are quite rare.

Key risk factors

• Age: Increasing age is the most significant risk factor, with the majority of dementia cases occurring in individuals over 65.
• Family history: Individuals with parents or siblings who have dementia face a higher risk compared to those without such family histories.
• Research shows that Hispanics are 1.5 times more likely to develop dementia compared to whites, while African Americans face double the risk. Additionally, studies indicate that both African Americans and Hispanics are often diagnosed in the later stages of the disease, when they experience greater cognitive and physical impairment, making them in need of more medical care.
• Heart health: Conditions such as high cholesterol, hypertension, and smoking can elevate the risk of dementia if not adequately managed.
• Traumatic brain injury: Severe head injuries can also increase susceptibility to dementia later in life.

Types of dementia

While some forms of dementia can be reversed, many are chronic and have a lasting impact on families. The main irreversible types include:

Alzheimer’s disease Alzheimer’s is the most prevalent cause of dementia, accounting for 60% to 80% of cases. It stems from specific changes in the brain. The earliest and most notable symptom is memory loss, particularly of recent events, alongside challenges in recalling distant memories. Other signs may include changes in speech, movement, and personality. Genetic mutations can elevate the risk for Alzheimer’s, significantly if a first-degree relative is affected, which increases the risk by 10% to 30%.

Vascular dementia This form of dementia arises from strokes and disrupted blood flow to the brain’s oxygen-supplying vessels, potentially leading to more severe strokes. Contributing risk factors include diabetes, hypertension, and high cholesterol levels. The range and severity of symptoms depend on the brain areas affected, with the most common signs being difficulties in concentration, problem-solving, and slowed thinking.

Lewy body dementia

Associated with abnormal protein deposits known as alpha-synuclein, Lewy body dementia impacts brain chemistry. Individuals may experience movement difficulties, including trembling or stiffness, and changes in alertness, such as confusion or excessive daytime sleepiness. Other symptoms can include hallucinations, insomnia, mood swings, and impaired coordination.

Fronto-temporal dementia

This type involves behavior, language, and personality shifts due to changes in a specific brain area. Symptoms often manifest as significant behavioral issues, such as inappropriate remarks or neglecting responsibilities, alongside challenges in thinking and movement.

Mixed dementia

In individuals aged 80 and above, it’s not uncommon to see multiple forms of dementia coexist, such as both vascular dementia and Alzheimer’s. Diagnosing mixed dementia can be challenging since symptoms may overlap between the different types, and disease progression typically occurs at a faster rate.

Treatment

The approach to treating dementia depends on its underlying cause. While neurodegenerative forms like Alzheimer’s disease cannot be cured, medications are available to help protect the brain from further damage and to manage symptoms, including behavioral issues and anxiety. Ongoing research aims to enhance treatment options for dementia.

To help reduce the risk of developing dementia, consider the following strategies:

• Adopt a healthy diet
• Quit smoking
• Engage in regular physical activity
• Keep your blood pressure within a normal range
• Stay socially active
• Minimize the likelihood of chronic diseases

Early detection is essential. Seek medical attention promptly, as this can lead to early treatment options, including medications, therapies, and clinical trials, that may delay disease progression.

Works cited

• Centers for Disease Control and Prevention. “What is dementia?” Accessed September 27, 2022.
• Mayo Clinic. “Dementia: Symptoms and causes.” Accessed September 27, 2022.
• World Health Organization. “Dementia.” Accessed September 27, 2022.Dementia
• Fact Sheets. Alzimpact.org. March 2020.
• African Americans & Alzheimer’s Disease. (n.d) Mayo Clinic. https://dementiaoutreach.mayo.edu/learn/african-americans-ad/