Dementia is not a disease in itself but rather a group of symptoms which may accompany certain diseases or conditions. Symptoms may also include changes in personality, mood, and behavior. The causes and rate of progression of dementia vary. Some of the more well known diseases that produce dementia include Alzheimer's disease, multi-infarct dementia, Parkinson's disease, Creutzfeldt-Jakob disease (recently known as "mad cow disease"), amyotrophic lateral sclerosis (Lou Gehrig's disease), and multiple sclerosis. Other conditions which can cause dementia or mimic dementia include hydrocephalus, depression, thyroid disorders, nutritional deficiencies, infections (meningitis, syphilis, AIDS ), alcoholism, brain tumors, head injuries, stroke and drug reactions. Some of these conditions may be treatable or reversible.
Alzheimer's disease (AD) is a progressive, degenerative disease that attacks the brain and results in impaired memory and impairment of normal thinking and behavior. Briefly, AD usually has a gradual onset, not noticeable to family or friends. Problems remembering recent events and difficulty performing familiar tasks are early symptoms. In the later stages, the AD patient will also experience confusion, personality change, behavior change, difficulty finding words and finishing thoughts or following directions, disorientation in time and space, impairment of judgement, difficulty in learning, and loss of language. Communication becomes difficult as the person with Alzheimer's struggles to find words, finish thoughts, or follow directions. Some patients are unable to understand the spoken word. The brain can no longer process the information properly so words no longer have any meaning. Eventually, persons with Alzheimer's become totally unable to care for themselves. How quickly these changes occur will vary from person to person. Alzheimer's disease is the most common of the dementing disorders, affecting as many as 4 million Americans. As with all dementias, the rate of progression in Alzheimer's patients varies from case to case. From the onset of symptoms, the life span of an Alzheimer victim can range anywhere from 3 to 20+ years. It is important for a person suffering from any symptoms of dementia to undergo a thorough clinical examination. In fact, after such an evaluation, approximately 20% of suspected Alzheimer's cases prove to be a medical condition other than Alzheimer's, many times treatable. When German physician Alois Alzheimer first described the disease in 1907, it was considered rare. Today Alzheimer’s disease is the most common cause of dementia, affecting 10 percent of people 65 years old, and nearly 50 percent of those age 85 or older. In the past an absolute diagnosis could only be made upon examination of brain tissue, usually at autopsy, today there is a test, AD7C, which can help a physician determine the disease. Currently there is no treatment available to stop or reverse the mental deterioration but drugs such as Cognex or Aricept may be helpful in the early stages.
Multi-infarct dementia (MID), or vascular dementia, is mental deterioration caused by multiple strokes (infarcts) in the brain. The onset of MID may be relatively sudden as many strokes can occur before symptoms appear. These strokes may damage areas of the brain responsible for a specific function, such as calculations, and there may be more generalized symptoms, such as disorientation, confusion, and behavioral changes. As a result, MID may appear similar to Alzheimer's disease. In fact, MID and Alzheimer's disease co-exist in 15-25 percent of dementia patients. Brain scanning techniques (CAT, MRI) are used to identify strokes in the brain, MID progresses in downhill steps with periods of stability and possibly some slight improvement in between strokes.
Depression is a psychiatric disorder marked by sadness, inactivity, difficulty in thinking and concentration, feeling of hopelessness, and sometimes suicidal tendencies. Many severely depressed patients will have some mental deficits including poor concentration and attention. When dementia and depression are present together, intellectual deterioration may be exaggerated. Depression, whether present alone or in combination with dementia, can be reversed with proper treatment.
Individuals with Parkinson's disease (PD), such as Muhammed Ali, lack the substance dopamine, which is involved in control of muscle activity by the nervous system. Tremor, stiffness and slowness are characteristic features of PD. Speech may be slow. Movements may be difficult to initiate. Late in the course of the disease some patients develop dementia. Some Parkinson patients develop Alzheimer's disease and some Alzheimer's patients develop Parkinson symptoms. Parkinson drugs can improve the motor symptoms, but do not improve the mental changes that occur. In fact, Parkinson's disease serves as a model for drug research on Alzheimer's disease.
Huntington's disease (HD) is a hereditary disorder that usually begins in mid-life and is characterized by irregular involuntary movements of the limbs or facial muscles and intellectual decline. Personality changes are common, with depression and memory disturbances occurring in early stages. The pattern of memory impairment differs from that seen in Alzheimer's disease. As the disease progresses, movements become severe and uncontrollable; mental capacity may deteriorate to dementia. The family history of the disease, recognition of typical movement disorders and brain scanning provide the evidence for diagnosis of Huntington's disease. Recently researchers discovered a specific genetic defect in a gene on chromosome 4 as the cause of HD. The movement disorders and psychiatric symptoms seen in HD can be controlled by drugs; however, no treatment is available to stop the progression of the disease.
Creutzfeldt-Jakob disease (which recently became famous as "mad cow disease" (in England) is a rare fatal brain disease caused by a transmissible infectious agent, possibly a virus. Failing memory, changes in behavior and a lack of coordination are some of the symptoms observed in the early stages of the disease. The disease progresses rapidly, usually causing death within one year of diagnosis. Examination of brain tissue reveals distinct changes unlike those seen in Alzheimer's disease. No treatment is currently available to stop the progression of the disease.
Pick's disease is a rare brain disease which closely resembles Alzheimer's disease and is usually difficult to diagnose clinically. Disturbances in personality behavior and orientation may precede and initially be more severe than memory defects. Like Alzheimer's disease, a definitive diagnosis is usually obtained at autopsy.
Persons with dementia show symptoms of mental decline which require specialized care. How much assistance each patient needs will depend on the symptoms and the degree of impairment. It is important to help patients make the most of all remaining abilities.
Family members caring for a dementia patient may often find themselves overwhelmed by the patient's increasing care need. Please have patience and if needed, contact support groups for the families and friends of all dementia patients that exist across the United States.
Locally there is a support groups in our area, Bend Oregon, Easter Seals which has a meeting on the 3rd Monday of each month at 7 PM. At St. Charles Hospital there is a daycare program called 'Side by Side' which meets weekly from 12:30 to 4:30 PM. There is a $20 charge per session. This is an excellent way for you to be able to have have time to yourself. You can call Judy Rotondi for more information at 385-6358. Day care programs are very important for the family who cares for a dementia patient. Day care provides you the time you need to care of yourself. Don't try to do the job alone, ask for help from all sources.
When a dementia victim needs more care than the family is able to supply or is too much of a stress on the family unit, an Adult Foster Homes can provide a home like atmosphere where the dementia patient can feel comfortable, secure, well cared for with dignity and allowed to be themself without being judged.
Some of this information is from an Alzheimer’s Association. All Rights Reserved.
Research updated and compiled by Loreen Michel