Dementia - Types, Symptoms, Causes & Treatments

When sections of your brain that are required for memory, decision-making, understanding language, communicating, and learning gets damaged or diseased, it leads to neurocognitive disorder or dementia. This neurocognitive disorder is not any disease but rather a group of signs and symptoms caused due to other conditions.

The symptoms of this disorder might improve with proper treatment, but many diseases that lead to this disorder might not be curable. So let us get into the details of dementia and its treatment procedures.

A term that comprises a group of diseases affecting and declining your memory, reasoning, language, coordination, behaviour, and mood is dementia. It severely disrupts your daily life activities. According to study Almost 3% of adults aged between 70 to 74 years have some form of this disorder. Furthermore, it tends to increase, with 22% of adults between 80 to 85 years of age and 33% of adults aged 90 years and more having this disorder. The most common cause of dementia is Alzheimer’s disease.

Although this neurocognitive disorder involves loss of memory, memory loss can cause due to many other reasons too. However, memory loss is an early sign that you might be having this disorder.

Dementias can be categorised into three different groups. These common types of dementia are as follows:

Primary

This includes conditions where dementia is the major illness.

1. Alzheimer’s Disease

When two abnormal proteins, tau and amyloid, build up in your brain, they malfunction the coordination between nerve cells in the brain. Nerve cells then tend to die in one area and spread as more of these cells die in other sections. This is a most common neurocognitive disorder, including personality and behaviour changes, memory loss and confusion.

2. Vascular Dementia

Conditions such as atherosclerosis or strokes blocking the blood vessels in your brain can cause vascular dementia. The symptoms include issues in completing tasks, confusion and severe memory issues. They also come with risk factors such as diabetes, high cholesterol, and high blood pressure.

3. Lewy Body Dementia

Lewy body dementia involves building excessive proteins in your brain's nerve cells, known as Lewy bodies. They tend to damage nerve cells completely. Lewy body disorder comes with symptoms such as body balance problems, disruption in sleeping patterns, loss of memory, difficulty in judgement and solving problems, delusion and visual hallucinations.

4. Frontotemporal Dementia or FTD

When there is damage to the temporal and frontal lobes of the brain due to the building up of abnormal and excessive proteins, it leads to FTD. This causes personality changes, loss of communication in terms of speaking and understanding, and change in social behaviours.

5. Mixed Dementia

A blend of two or more forms of this disorder, mixed dementia is a combination of vascular disorder and Alzheimer's disease. It is often very tough to diagnose as the symptoms of both dementias overlap.

Secondary or Neurocognitive Disorder Due to Other Conditions

This happens when dementia happens due to any other condition or disease.

1. Parkinson’s Disease

Often you might notice dementia in the later stages of Parkinson's disease. The symptoms include hallucinations, delusions, trouble speaking, depression, and trouble thinking.

2. Huntington’s Disease

This disorder leads to breaking down in the nerve cells of your brain and is caused due to a single damaged gene. Hence, you might have trouble controlling body movement, thinking ability, gathering memories, decision-making, and noticing behavioural changes.

3. Creutzfeldt-Jakob Disorder

It is a very rare brain disorder and happens when the protein in the brain (prions) gather together, causing death to the brain's nerve cells. Symptoms include problems in decision-making, communication, and thinking, utter depression, and change in behavioural patterns.

4. Brain Injury

Sudden and repeated blows to the head or an accident can cause severe trauma and injury. This is often noticed in players, boxers and people who have met an accident. In addition, symptoms of dementia might occur several years later, leading to loss of memory, mood swings, improper speech and head pains.

5. Wernicke-Korsakoff Disorder

When there is acute Vitamin B1 deficiency in the brain, it causes bleeding in certain sections of the brain. Malnutrition and chronic infection are other causes of such a disorder. Symptoms include improper muscle coordination, double vision, loss of memory and change in behaviour.

Reversible or Causes of Dementia Due to Reversible Reasons:

Symptoms like dementia happen due to other illnesses.

1. Immune Disorder

Symptoms, mostly like dementia, might happen due to certain side effects in your body that happen to fight against infection. It can also happen due to extreme fever. Also, multiple sclerosis, which attacks your body's immune system of your body can cause this disorder.

2. Deficiency In Nutrition

Dehydration and Vitamin B1, B6 and B12 deficiency can cause dementia-like symptoms. It can also happen if you have a lack of copper and lack of Vitamin E. 

3. Abnormal Endocrine System

If you have hypoglycemia, thyroid issues, vitamin B12 deficiency, or excessive or less calcium and sodium, symptoms of the neurocognitive disorder can occur.

Other than all these mentioned above, brain tumours, subdural hematomas, normal pressure hydrocephalus, and side effects of medications can cause this disorder.

Dementia leads to cognitive and psychological changes. The potential symptoms of dementia are:

Cognitive symptoms:

• If someone notices that you cannot rethink or recollect memories from the past, meaning excessive memory loss, it might be an early symptom of this disorder. 

• A problem in finding adequate phrases and words during communication is another major symptom.

• Issues in problem-solving and reasoning, taking decisions and handling complex situations, handling tasks, planning, and organising.

• When you suddenly get lost somewhere else while driving or walking and cannot find the route.

• Disorientation, confusion, and improper body balance are other signs of this disorder.

• Repetition of questions and sentences over a short span.

• Placing items in unusual places or misplacing them and being unable to recollect them.

• Unable to recollect the dates, seasons, years and months.

Psychological Symptoms:

• Acute anxiety and depression causing loneliness can be another symptom.

• Hallucinations and delusions are other signs if you are developing this disorder.

• Changes in behaviour and personality and inappropriate behavioural patterns are major symptoms.

• Paranoia and agitation are related symptoms of this disorder.

• When you face challenges completing daily tasks such as brushing, making coffee or tea, bathing, cooking, etc.

Well, all these are very general and common symptoms of this disorder. Every person comes with different symptoms. However, you might notice special symptoms with specific neurocognitive disorders.

The risk factors of dementia are listed below:

• Chances of this disorder increase as you age, and in most cases, adults over 65 years have this disorder.
• If you have a family history where your parents or siblings have this disorder, you are likely to develop the same too.
• You can develop early stages of Alzheimer's disease by middle age if you have down-syndrome.
• In case you met with an accident or have had a blow in your head causing injury, you might develop symptoms of dementia.
• People with sleep apnea or related sleep disturbances might be at risk due to this disorder.
• High cholesterol, high blood pressure and atherosclerosis often risk your health condition and increase chances of strokes and lower blood flow. This can cause neurocognitive disorder later.

It is often difficult to diagnose this disorder as several diseases lead to it. However, your doctor will do the following to diagnose the disorder:

• The doctor will ask about the symptoms and your medical history, specific disease you have. Then they will review the medicines you are consuming presently. They will also ask if there is any family history of people carrying this disorder.
• Through laboratory tests, your doctor will rule out the other reasons as the cause of this disorder. 
• Then they will prescribe computed tomography or CT, magnetic resonance imaging or MRI, and X-rays to understand brain functions through images of your brain. These tests try to detect evidence of internal haemorrhage, stroke, fluid in the brain, or tumours. The FDG and PET scanning determine another special test that understands the cognitive decline of your brain.
• Your doctor then undergoes neurocognitive testing, where they detect your mental abilities through computerised and written exams.
• Your doctor will undergo a psychiatric evaluation to detect signs of depression, anxiety, other mental health problems and mood swings.

After a diagnosis of dementia, your doctor will understand the severity of the disorder and prescribe medication or therapy as required.

Although it is impossible to cure dementia, you can manage the symptoms. Here are the temporary treatments for dementia:

1. Medications

Donepezil, rivastigmine, galantamine and memantine are some cholinesterase inhibitors that work by boosting the chemical levels in your brain. Doctors also prescribe other medications that cure sleeping patterns and body movement. Although there are some side effects to these medications, they help in the temporary treatment of the disorder.

2. Therapies

Certain therapies, such as occupational therapy, teach coping patterns, reduce clutter and noise, and simplify tasks to reduce confusion if you have dementia. These therapies treat behavioural patterns effectively.

3. Home Remedies

Taking care of a person diagnosed with dementia is of utmost importance and can help reduce the symptoms. Enhanced communication, using a simple and short sentence to speak with that person, encouraging exercise, and helping the person to engage in activities can help a lot. Individual or family counselling and participating in a community where other people have similar traits will also help.

Apart from these, music therapies, watching videos, pet therapies, massage and aromatherapy and art therapy are effective treatments for dementia.

You can see the doctor if you notice the following signs in a patient diagnosed with dementia:

• You must consult a physician if you notice the patient has stopped or reduced eating, affecting their nutrient intake.
• As the patient finds it difficult to swallow, the risk of choking increases, leading to blocking breathing. This leads to pneumonia.
• With progress, the patient cannot perform self-care tasks such as brushing, bathing, dressing, using the toilet, consuming medicines, etc. 
• When there are safety issues while the patient is cooking, driving or living alone.

Taking utmost care of a person with this disorder and living a life focused on health reduces the risks of dementia. Here is how you can manage and prevent this disorder from risking the life of your loved one:

• Try to maintain healthy blood sugar and cholesterol levels to avoid unnecessarily building up cholesterol in blood vessels.
• Quit smoking and alcohol to improve your health status and enhance the quality of your life.
• Try to perform regular exercises that will control weight and boost energy levels.
• A Mediterranean diet is appropriate for a patient diagnosed with this disorder. This includes fruits, vegetables, fish, shellfish, nuts, beans, olive oil, limited red meat, and whole grains.
• Solving word games and puzzles and keeping the brain engaged in activities are effective ways to treat this disorder.
• Interacting with people, engaging your mind and heart, communicating with people with the same traits, and staying active socially are other ways to treat too.

So, now you have a clear idea about dementia and how you can treat this neurocognitive disorder. If you notice the situation deteriorating, consult your doctor immediately. Also, as the doctor prescribes, take your patient for regular check-ups.