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Dementia is the loss of cognitive functioning to such an extent that it interferes with a person’s daily life, weakening their thinking, remembering, reasoning and ability to care for one’s self. Dementia is not a disease, but rather a set of symptoms.
An epidemic of dementia is here.
Here are just a few sobering facts from www.alzheimers.net about the rapidly increasing incidence of Alzheimer’s in the United States:
• Out of the 10 leading causes of death in the United States, Alzheimer’s is the only disease that cannot be cured, prevented, or slowed.
• Currently one in 10 Americans over the age of 65, approximately five million people, has Alzheimer’s.
• Between 2017 and 2025, every state is expected to see at least a 14% rise in the prevalence of Alzheimer’s.
• By 2050, it’s estimated there will be as many as 16 million Americans living with Alzheimer’s.
It has been my medical experience that a person with any form of dementia is at a much higher risk of injuries, hospitalization, placement in a long-term care facility and premature death. For people living alone, the early signs of dementia are often missed, and the diagnosis is made when the person is brought into the emergency room. For those fortunate enough to have a friend or family support system, changes may be detected earlier.
What are signs and symptoms of dementia?
The Alzheimer’s Association lists 10 common signs of Alzheimer’s disease, but they also pertain to other forms of dementia:
• Memory loss that disrupts daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks at home, at work, or at leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality
Cognitive problems are first recognized when the individual demonstrates a change in behavior. For caregivers, the most serious behaviors associated with dementias are aggression, anxiety and agitation, wandering and getting lost.
Aggression may be verbal (shouting or name calling) or physical (striking or pushing). There is often no clear trigger that causes this behavior.
For a person with dementia, anxiety and agitation can occur for many reasons. It is important for caregivers to try to identify triggers that will set off this behavior. These triggers may be found in the person’s surroundings, time of day, pain, hunger, need for sleep, or sudden changes in the environment.
Wandering and getting lost are the most distressing behaviors for a caregiver or family. It is also one of the most common behaviors for an Alzheimer’s/dementia individual. Six in 10 patients will wander and/or get lost at any stage of their illness. They may be trying to find their way home when they are already there, or trying to duplicate a familiar route they have taken in their life, such as going to work or school. The demented, wandering patient is at extremely high risk for injury, environmental exposure and death.
Does it make a difference to find the causes the dementia?
There has always been confusion on what to call these conditions. The term “dementia” has been around for more than a century. While Alzheimer’s disease is the most common form of dementia, accounting for an estimated 60 to 80 percent of cases (AARP), there are several other types. The second most common form is vascular dementia, caused by high blood pressure and mini-strokes. Other types of dementia include alcohol-related dementia, Parkinson’s dementia and frontal-temporal dementia; each has different causes as well. Additionally, it is important to separate dementia from other medical conditions that may be temporary or treatable. These conditions include the following:
• Side effects from medication
• Chronic alcoholism
• Some tumors and infections in the brain
• Vitamin B12 deficiency
• Low thyroid function
A correct diagnosis means the right medicines, remedies and support. For example, knowing that you have Alzheimer’s instead of another type of dementia might lead the doctor to prescribe a cognition-enhancing drug instead of an antidepressant or an anti-psychotic medication.
For individuals with early Alzheimer’s, cholinesterase inhibitors such as Donepezil (Aricept), Galantamine (Razadyne), or Rivastigmine (Exelon) are often tried. If your loved one has moderate to severe Alzheimer’s, his/her doctor may prescribe memantine (Namenda) for his or her symptoms. Memantine can help improve memory, attention, reasoning and language. This medication can help curb delusions, hallucinations, agitation, aggression and irritability. It can also help your loved one with disorientation, making daily activities easier.
What to expect in the future for managing dementias?
Research in the next decade will focus more on improving the early diagnosis of Alzheimer’s disease and other dementias, finding better ways to manage dementia when other chronic conditions are present, and understanding the influence of lifestyle factors on a person’s risk of cognitive decline and dementia. Currently, research is mostly focused on developing interventions to delay or prevent the onset of Alzheimer’s disease and other dementias.