All of us know that there is nothing graceful about aging. Your skin starts wrinkling, vision blurring, hair falling, teeth missing, and although there are certainly ways to slow the process down, you will never be able to run from it. But all of those are probably nothing compared to the ugliness of forgetting.
Just like some of your grandparents and their grandparents before, one day you will probably forget the names of your beloved, of all the sweet things you had when you were young, and of simple activities, you do every day.
And there are reasons why you should worry about this. The WHO estimated that there are around 47,5 million people living with dementia around the world. Every year, around 7,7 million new dementia cases are diagnosed.
Almost half of the people who live past 85 have dementia, while 19% of people aged 75-84 also suffer from this brain disease.
So chances are, if you live long enough, you or some of the people you know are most likely going to be the next addition to the statistics.
Imagine that someday you wake up like all the demented people you know: not remembering the names of your grandchildren, or if you have eaten that day, or words you usually use to eloquently describe your feelings.
Fortunately, dementia doesn’t occur that way. There are subtle signs at the initial stages before the person who suffer from it completely turn like a different person because of the severity of the disease.
What is Dementia?
Dementia is a set of ongoing symptoms that include memory loss and other declines of cognitive functions which are not a part of normal aging.
It is actually a broad category of long-term and often gradual decline of brain functions.
People who suffer from dementia only display subtle signs of confusion or memory loss at the initial stages, which will progressively impair their abilities to remember, reason, judge, think, and finally even perform their activities of daily living.
Dementia mostly occurs to the elderly.
If you think all old people you’ve met are senile, this is what happens to them. However, although many elders display signs of the brain disease, it is not a normal part of aging.
It happens because of some impairment in the brain functions.
The term dementia is the condition which can be caused by a large number of different diseases. The majority of the cases – around 60%-70% of them – are caused by Alzheimer’s disease.
Besides Alzheimer’s, other common types of dementia are vascular dementia, Lewy body dementia, and frontotemporal dementia.
There are different ways to classify different kinds of dementia. The disorders can be categorized based on the brain parts that are affected or whether the dementia is primary or secondary.
A cortical dementia is when the disorder affects the cortex or outer layer of the brain and mostly causes memory, language, thinking, and behavioral problems. Subcortical dementia is when it affects the part underneath the cortex and also impair the patient’s emotional and mobility functions.
Primary dementia is the type which is not caused by any other diseases. The most common example is Alzheimer’s disease dementia. As oppose to that, secondary dementia results from injuries or physical diseases.
Symptoms of Primary Dementia
Primary degenerative dementia such as Alzheimer’s dementia has some stages with progressive decline of cognitive skills which will later also influence other behaviors.
Patients who suffer from dementia may experience some, but not all, of the symptoms. The signs can also be subtle or obvious. They can even go unnoticed until the patients enter the late stages which affect their functions to perform daily activities.
Primary dementia symptoms are usually categorized in seven stages. At the first few stages of cognitive decline, the doctors or medical professional will not give the patient a diagnosis of dementia.
The fourth to seventh stages are where patients are diagnosed with early, mid, and late stages of dementia.
Stage 1-3: No dementia
Stage 1 describes the condition of people with no dementia. If you can function normally with no memory loss and other cognitive problems, you are considered to be at this stage.
As you age, you will probably experience some forgetfulness, but still a normal part of aging. This is where a patient enters the second stage.
There is still no dementia diagnosed but the aging-related forgetfulness is displayed through subtle symptom such as difficulties to remember names or where an object is left.
The first signs of dementia may even be perceived as something normal that nobody around the elderly notices them.
The third stage is where somebody experiences a mild decline in their cognitive functions but still not diagnosed with dementia. In this stage, the forgetfulness becomes worse and concentrating becomes more difficult that slightly affects the person’s performance at work.
The person may also find difficulties in using vocabulary that were normally familiar to them. Traveling to new places may start becoming a demanding activity because of the difficulties in remembering directions. Besides, the problem-solving skills may also start to decline.
Some medical experts categorize people who are at this stage as sufferers of early stage dementia.
Stage 4: Early stage of dementia
In this stage, the person already displays moderate cognitive decline. A physician will diagnose the person with dementia. The early signs of dementia include:
- Vocabulary difficulty. The patient will find it hard to find the right words to use in conversations. To compensate it, the patient may choose to find synonyms of the words they intend to say. Alternatively, they may also decide to define the words.
- Increased forgetfulness in remembering names, appointments, activities, and objects. You will start hearing questions like, “Where is my key? “a lot or even “Have I had breakfast this morning?”
- Difficulty to complete familiar complex tasks. A person’s problem-solving skill in this stage is already impaired so managing personal finances, driving to a new place, or even cooking a meal become such troubling and demanding tasks. It will become even worse with the confusion, causing an overall decline of performance to complete routine tasks,
- Changes in personality and behavior. People who used to be sociable may start withdrawing from the social life they commonly partake in, even friends and family. They can even display paranoid behavior.
- Mood swings. Bursts of anger may come all out of sudden before the patients return to their normal moods.
- Poor judgment. The person may start making bad decisions or bad consideration. They will appear to recklessly do things such as knocking over objects while walking or putting something at awkward places.
Stage 5-6: Middle stage of dementia
The signs displayed in this stage are worse than the previous stage. While at an early stage of dementia a patient might still be able to compensate, it will be more difficult to cover it up at this stage.
The patients’ mental functions have significantly declined that it become very obvious. They will also start needing assistances. The patients may experience:
- Inability to carry out daily activities such as bathing, grooming, and preparing meals without assistance.
- Greater memory loss. A person in this stage displays much more prominent memory problems, such as difficulties to remember current date and day or inability to mention phone number and home address. They may also start forgetting the names of family members.
- Inability to learn new information. Memorizing recent events becomes something very difficult, almost impossible.
- Sleep problems. The patients may nap a lot but stay awake during the night. There seems to be no cause of the sleep problems but they won’t disappear. People who suffer from Alzheimer’s disease may also experience sundowning: they become agitated, afraid, or sad when the sun is down.
- Poor judgment and major confusion resulting in greater risks of accidents such as falling or dropping objects.
- Behavioral disorders and personality changes such as agitation, aggressiveness, paranoid delusions, compulsions (repeatedly do something in an abnormal way such as cleaning or making bed multiple times in a period) and even hallucinations. Extreme mood swing and psychological disorders like anxiety and depression are also common in this stage.
- Complete loss of interest in social life and the outside world.
- Confusion in familiar surroundings. A person with dementia in this stage may get lost even when walking in their own neighborhood.
- A decline in speaking ability and not only because of the inability to use the right vocabulary.
- The dementia patient in this stage may already forget a lot of details of their earlier life. As a result, they may make up some false information during conversations to fill the memory gaps.
- Lack of bladder and bowel movement control.
Final stage: Late stage of dementia
In this final stage, the symptoms of early and intermediate stages of dementia become a lot worse. The signs of end stage dementia may include:
- Total dependence on other people to complete the most common activities of daily living such as eating or using the toilet.
- Complete loss of memory, whether short or long term. Patients with late stage dementia may not even remember their closest family members.
- Losses of psychometric skills, such as the inability to walk, move, or sit on a chair or toilet. Other movements, like swallowing, may also become difficult so the patients’ risk of malnutrition increases.
- Inability to communicate or even speak at all.
Specific Symptoms of Other Types of Dementia
Besides Alzheimer’s disease, here are the symptoms of some other common types of dementia you should know.
This is the second most common type of dementia which attacks up to 20-30% of patients who display dementia symptoms.
Brain damage by cardiovascular or cerebrovascular problems like strokes, genetic disease, endocarditis, or amyloid angiopathy causes the disease. Symptoms may be similar to Alzheimer’s and post-stroke syndrome (like clumsiness, stiff facial expression, slowness) including wandering at night and depression.
However, personality changes are not common to find among patients with vascular dementia.
Lewy Body Dementia
Lewy Body Dementia or LBD affects 15% of the population who suffer from dementia. LBD is when cells in the brain’s cortex and substantia nigra die and form an abnormal structure.
This structure is called Lewy bodies and contains accumulating alpha-synuclein protein. Symptoms include memory impairment, confusion and poor judgment, visual hallucinations, sleep troubles, medication sensitivity, and other symptoms resembling Parkinson’s disease.
After diagnosed with this, people with LBD can live up to around 7 years.
To diagnose if a person has dementia and what type of dementia the person has can be a challenging task. To accomplish a dementia diagnosis, at least two core metal functions require being impaired enough that they affect daily living.
Those metal functions can be the memory, ability to focus, language skills, reasoning ability, and visual perception.
A thorough assessment is needed for the right treatment, therefore it is important that a specialist doctor conducts the diagnosis.
The doctor can be a mental health specialist such as a psychiatrist, a geriatrician, or a neurologist. The specialist will run a series of tests to find out the core problem as there is no single test to pinpoint dementia.
The tests may include evaluation of cognitive functions such as orientation, memory, judgment and reasoning.
A physical examination, for example, a blood test, will be conducted after reviewing the patient’s medical history.
Afterward, the specialist, along with a nurse or a non-specialist doctor, will test the patient’s mental abilities. Finally, a brain scan like a CT, MRI, or PET scan may also be needed to complete the diagnosis.
Dementia is not a normal part of aging, but it affects a lot of people in the demography that you should worry enough about it, for yourself or for the people you love.
Most people who have dementia are suffering from Alzheimer’s disease. The symptoms are shown little by little as the brain functions gradually decline.
It starts as a subtle stage of memory loss which often goes unnoticed but ends in a complete dependency to function in life.
Because severe dementia is a lot more than just forgetting simple life details, it is important to understand the disease and notice the symptoms so we can get our loved ones the necessary help when the disease affects them.