Dementia symptoms: signs, diagnosis, risk factors
Dementia is a permanent decline in memory and thinking skills. There are many different neurological disorders that cause dementia. The most common and best known is Alzheimer’s disease. Dementia is usually gradual and progressive, leading to problems with executive function, which can include memory and self-care abilities.
This article describes the symptoms, diagnosis, causes, treatment, and prevention of dementia.
Symptoms of dementia can be subtle at first. Over time, the effects can progress to such a degree that many people with dementia may not be able to care for themselves independently.
Early signs of dementia can include cognitive symptoms, mood changes, behavioral changes, and personality changes.
Some early signs of dementia include:
- Forget where you put things
- Being irritable, anxious or sad
- Become withdrawn
- Forget recent events
For many people, these are normal personality traits and not signs of dementia. They can also be caused by being busy, distracted, not getting enough sleep, or having another illness. These signs may be indications of dementia praecox if they are abnormal, persistent and worsening.
Cognitive skills are thinking skills and include things like memory, planning, and organization. A decline in cognitive skills, the primary effect of dementia, can make normal functioning difficult.
As dementia progresses, common cognitive symptoms people may experience include:
- Excessive sleep or erratic sleep patterns
- Having difficulty with simple calculations
- To get lost
- Confabulationi.e. having false memories or saying false things to replace the missing memory
- Loss of appetite or increased appetite
- Not recognizing close friends, family members, or long-time co-workers
Sometimes people with dementia may notice these issues, which can be frustrating or embarrassing. Often, as dementia progresses, people no longer notice their own cognitive deficits.
Many behavioral and emotional problems can occur with dementia. These issues are unrelated to a person’s basic personality, and people with dementia may start to act very differently than before.
Psychological, psychiatric and behavioral symptoms of dementia include:
These symptoms may fluctuate and worsen temporarily during illnesses or infections or when adjusting to a new medication.
The psychological symptoms of dementia can be very difficult for caregivers to manage. It is important for caregivers to know that the behaviors are not deliberate. They occur due to changes in brain structure and function.
The diagnosis of dementia is based on clinical history and physical examination. Often other causes for the symptoms need to be ruled out, especially if the symptoms started and progressed abruptly or unexpectedly.
A physical exam, including a neurological exam, can help identify signs of other potential causes, such as infection, stroke (blockage of blood flow or bleeding in the brain), or brain tumor.
If necessary, blood tests, brain imaging tests, genetic tests, or other specific tests may be done to identify medical conditions that could be causing the signs and symptoms.
Dementia screening tests and cognitive tests can help with diagnosis and tracking changes over time.
Common tests used in the assessment of dementia include:
These tests examine certain executive functions. They are scored and compared to standard scores to help determine if there is an objectively measurable problem.
Cognitive tests and screenings alone are not used to diagnose any type of dementia. These are tools that are used along with a history of symptoms, a clinical examination and an overview of what happened.
Dementia is caused by degeneration or damage to areas of the brain involved in memory, thinking, planning and other executive functions.
Sometimes, as with Alzheimer’s disease, there is a concentration of degeneration in specific areas of the brain, such as the hippocampus.
Additionally, any condition that causes large areas of brain damage, such as multiple strokes, can also cause dementia due to a severe disruption of brain communication between different regions. Certain types of dementia are also characterized by an accumulation of proteins in the brain, in particular Lewy bodies and tau proteins.
Some of the conditions that cause dementia include:
- Alzheimer’s disease: A common type of dementia that leads to memory loss and depression, Alzheimer’s disease often causes people to be suspicious of others.
- Vascular dementia: Small or large strokes can cause damage throughout the brain, resulting in impaired thinking and memory.
- Frontotemporal dementia: This disease causes loss of brain tissue in the frontal and temporal lobes of the brain, leading to behavioral changes and memory loss.
- Pick’s disease: A rapidly worsening dementia, Pick’s disease causes personality changes and an inability to care for oneself.
- Dementia with Lewy bodies: This type of dementia causes memory problems and movement disorders, including tremors and stiffness.
- Multiple system atrophy: This rare disease causes dementia and movement problems due to degeneration of the brainstem, cerebellum and other areas of the brain.
- Parkinson’s dementia: Parkinson’s disease can cause dementia, usually at an advanced stage.
- Pseudobulbar palsy: This condition causes emotional instability, movement problems, and decreased memory and thinking skills.
- Huntington’s disease: This hereditary disease causes loss of motor control, spasms and symptoms of psychosis.
- Creutzfeldt-Jakob disease: This rare disease caused by brain damage leads to personality changes, dementia and loss of coordination.
Sometimes dementia can have mixed causes, or the specific disorder may not be defined.
Down syndrome and cerebral palsy are conditions present at birth that are associated with a higher than usual risk of Alzheimer’s disease and other types of dementia.
Smoking, high blood pressure, unhealthy cholesterol levels, uncontrolled diabetes, and heart disease can increase the risk of dementia.
Medications and cognitive therapy are the cornerstones of dementia treatment. There is no known cure for any type of dementia. Namenda (memantine), Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine) are drugs approved to treat certain types and stages of dementia. They can slow the progression of the disease in some people.
Cognitive training can be started in the early stages of dementia when a person is still able and willing to participate. This type of therapy may include activities aimed at maintaining organizational and memory skills.
Managing the effects of dementia can be beneficial. For example, many people with dementia lose interest in eating. Nutritional supplementation with high calorie drinkable supplements may be helpful, and in some situations a feeding tube may be necessary.
Other important interventions may include the prevention and treatment of pressure sores, muscle contractures and infections.
You can reduce the risk and impact of certain types of dementia. Vascular dementia can be disabling on its own and can contribute to the effects of other types of dementia.
Getting treatment for the health conditions that contribute to vascular dementia, such as unhealthy cholesterol levels and high blood pressure, can have a substantial effect in reducing risk.
Additionally, lifestyle habits like exercising regularly, avoiding smoking, limiting alcohol, and staying physically and mentally active are associated with a lower risk of vascular dementia, Alzheimer’s disease, and other types. of dementia.
Dementia is a progressive decline in cognitive functions, and its causes are multiple. Dementia is more common with age. Although there is no cure for dementia, certain medical treatments can slow the progression of the disease and help reduce symptoms.
People who develop dementia may be aware of the problem at first, but will not be concerned about the effects as the disease progresses and will need support from caregivers.
A word from Verywell
Dementia changes a person’s behavior and personality. It can be painful for loved ones to watch, and the day-to-day practical challenges can be overwhelming. Make sure you get the support and assistance you need for anyone in your life who is struggling with dementia.
Frequently Asked Questions
What are the first signs of dementia in a person?
Early signs of dementia can be subtle and may involve forgetfulness, forgetfulness, or mood swings. These symptoms can be part of normal life or can occur due to distraction, so they are not always signs of dementia praecox.
What is usually the most obvious early symptom of dementia?
The most obvious early symptoms are confusion and disorientation.
What is the average life expectancy with dementia?
Dementia can shorten a person’s life expectancy, but the impact varies depending on the type of dementia and other factors. Many people with dementia can survive for many years.
That said, the higher risk of death in dementia is often associated with problems such as malnutrition, blood clots, infections such as aspiration pneumonia or urinary tract infection, and falls.
Does a person with dementia know they have it?
It depends. Some people may be aware that they have early signs of dementia or even be aware of their diagnosis. Many people may be reluctant to admit they have dementia and may want to assert their independence and prove their abilities.
As dementia progresses, most people become somewhat dependent on loved ones or other caregivers and are generally not concerned about symptoms.