What is Dementia?
What is Dementia?Dementia is a general term for symptoms of declining mental (cognitive) capacity of remembering, reasoning (thinking), communicating, and decision-making caused by brain disease.
Alzheimer’s disease is the most common type of dementia, and there are other types, including vascular dementia and Lewy body disease. Dementia affects older people, but not every older person has dementia.
What is the difference between dementia and Alzheimer’s disease?
Dementia is a decline in mental ability that affects daily function. Different diseases cause dementia and is not a specific disease. Alzheimer’s disease is a term for a specific disease, which is the most common cause of dementia, but not the only cause.
Types of Dementia
TypesThe most common types of dementia are:
- Alzheimer’s disease is the most common type of dementia affecting between 60 and 80 percent of all dementia cases. Symptoms of most people with Alzheimer’s disease typically increase with age. Memory loss is the most common symptom.
People with Alzheimer’s disease have plaques, sticky deposits of a beta-amyloid protein, and fibrous tangles of tau protein in their brains. Scientists suspect that these plaques and tangles damage the brain cells. A small percentage of cases are related to hereditary gene mutations and can pass from a parent to a child.
- Early-Onset Alzheimer’s disease is a subgroup of people with Alzheimer’s disease who have signs between the ages of 30 and their mid-60s.
- Vascular dementia is caused by damage to brain blood vessels. Damaged brain blood vessels can cause strokes and other problems that may lead to vascular dementia. Symptoms of vascular dementia depend on the size and area of the brain affected, including difficulties with problem-solving, thinking, and organization.
- Lewy body dementia. Abnormal protein deposits in neurons called Lewy bodies have also been found in the brains of people with Lewy body dementia. People with this type of dementia may have movement or balance problems, stiffness, or tremor trembling. Other symptoms include visual perceptions, hallucinations, and focus and attention problems. The major feature is the development of cognitive impairment within the same year as motor impairment.
- Fronto-temporal dementia. Those with this type of dementia have damaged nerve cells and their connections in their brains’ frontal and temporal lobes. Common symptoms include behavior, thinking, judgment, language, and movement changes.
- Mixed dementia may happen when a person may have more than one condition that causes dementia symptoms. For example, Alzheimer’s disease and vascular dementia result from a stroke.
Other conditions that cause dementia symptoms include:
- Parkinson’s disease. People with Parkinson’s disease often develop dementia symptoms as the disease progresses.
- Traumatic brain injury (TBI) is caused by repetitive head trauma. Boxers, football players, or soldiers might develop TBI. The symptoms are similar to dementia caused by a disease that can appear years after the brain trauma and include memory loss, impaired speech as well as depression, and changes in behavior.
- Creutzfeldt-Jakob disease is a rare brain disease. It’s known to be caused by prion protein.
- Huntington’s disease is a progressive inherited brain disease that causes changes in the central area of the brain and affects thinking and movement abilities.
- Temporary dementia symptoms and other causes. Dementia symptoms may be temporary when they are caused by medication side effects, vitamin deficiency, or infection.
Stages of Dementia
StagesAs opposed to cancer, there don’t seem to be formal stages of dementia progression. Instead the stages describe how dementia symptoms become more severe. Stages of dementia are:
- Early stage - mild symptoms. Patients in the early stage of dementia may have mild symptoms but are independent and can drive, work, and participate in social activities. However, there are small changes in behavior and gradual changes in thinking, planning, and remembering things. A doctor can recognize early dementia-like symptoms using specific diagnostic tools.
- Middle stage - moderate symptoms. Dementia symptoms of those in the middle stage are more noticeable, and as the symptoms become more severe, they will need more help with everyday tasks. Patients at this stage experience difficulty remembering friends’ names, carrying on a conversation, traveling, handling money, and other everyday activities.
- Late stage - severe symptoms. In the final stage of dementia, patients experience a severe cognitive decline. Individuals lose the ability to speak and walk, may not be aware of their surroundings, and may not recognize family members. At this stage, patients require around-the-clock assistance with daily personal care.
Signs & Symptoms of Dementia
SymptomsSymptoms of dementia can vary depending on the disease that causes dementia and can include difficulty remembering things that just happened, such as a conversation a few minutes earlier. Difficulty remembering more distant memories, difficulty walking or talking, and changes in behavior happen later as the disease progresses.
The symptoms and signs of dementia may include:
- Memory loss, repeating questions
- Difficulty understanding and speaking, losing and confusing words, inability to express a thought
- Difficulty reading and writing
- Confusion, poor judgment, and impulsive behavior
- Difficulty performing typical daily tasks of getting dressed or taking a bath
- Wandering and being lost in a familiar environment
- Trouble handling money
- Losing interest in normal daily activities or events
- Hallucinations, delusions, or paranoia
- Not caring about other people’s feelings
- Problems with movement-walking balance and stiffness
What Causes Dementia?
CausesThe term dementia describes symptoms linked to diseases, including Alzheimer’s disease, which causes a decline in brain function. These diseases are associated with an abnormal buildup of certain proteins in the brain. The protein buildups cause damage or changes that impair brain function. In most cases, the exact causes of dementia are unknown.
Risk Factors for Dementia
Risk FactorsSeveral risk factors increase the likelihood of developing dementia. Some of these factors, such as age, can’t be changed, while other risk factors can be changed, for example, smoking.
Risk factors for developing dementia include:
- Age
- Genetic factors are hereditary—family history of dementia in a close relative
- Cardiovascular conditions including high blood pressure, high cholesterol, and atherosclerosis
- Head injury
- Conditions such as obesity, diabetes
- Lifestyle factors can contribute to the development of dementia, including heavy alcohol use, poor diet, and lack of exercise
- Gender. According to reports from the U.S. and Europe, more women than men are diagnosed with dementia and Alzheimer’s disease. The reason may be that women tend to live longer than men, and the risk of developing dementia increases with age. More research is needed.
Can You Prevent Dementia?
PreventionsDementia cannot be prevented, but a healthy lifestyle can reduce risk factors and vascular contributions to dementia. The following steps may help reduce the risk of dementia onset and advancement:
- Avoiding or quitting smoking
- Maintaining a healthy weight
- Checking and maintaining healthy levels of blood pressure and cholesterol
- Exercising regularly
- Keeping a healthy diet
- Being socially active and engaged
- Getting enough quality sleep
Complications
ComplicationsDementia affects the body, brain, and general ability to function. Dementia can make everyday life more complicated for those with dementia and their caregivers.
Ways in which everyday life becomes more complicated include:
- Inadequate nutrition. Those with dementia often don’t eat enough and, as the disease progresses, may lose the ability to chew and swallow
- Inability to take care of oneself. Difficulty doing everyday activities, including bathing, dressing, using the toilet, and taking medications.
- Personal safety. Those with dementia tend to wander outside and may get confused and become lost. Other situations that put the person with dementia at risk include driving, living alone, cooking, and handling money.
- Changes in behavior and mental health including agitation, aggression, depression, and apathy
Trust NewYork-Presbyterian for Dementia Care
Our team at NewYork-Presbyterian Hospital understands the toll that Lewy body dementia, Alzheimer’s disease, and other neurological disorders and conditions can take on your quality of life and the lives of your family members. Learn more about Alzheimer’s Disease and how to identify dementia in seniors. Contact us to make an appointment for treatment.