What is dementia? More commonly, people hear about Alzheimer's disease, a disease that is closely related and often leads to dementia. Dementia is an umbrella term that refers to the loss of cognitive abilities and memory impairment, usually due to brain degeneration. It affects primary functions of the brain such as thinking, speaking, and making decisions. Moreover, it interferes with the ability to perform daily activities such as shopping, maintaining bank accounts, driving vehicle and keeping personal hygiene.
A person with dementia behaves differently from normal people. They usually wander anywhere and most of the time, become apathic and aggressive. There are two categories of dementia; reversible dementia and degenerative dementia. Unlike reversible dementia, degenerative dementia is irreversible. The most common examples of irreversible dementia are Alzheimer's disease as well as vascular, frontal lobe or lewy body dementias. Unlike other types, irreversible dementia can only be slowed down but cannot be cured.
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Dementia is not part of normal aging. It is a serious illness that affects four to five million people in the United States and more than 30 million people worldwide. Â Furthermore, dementia is expected to double over the next decade (Hale and Frank, 2005) due to the population of the baby boomers who will reach the age of increased risk. On the other hand, many people associate dementia with an older person. Although this disease is most likely to occur among elders, there are rare cases where people of thirty or forty years old can be impaired with dementia.
Overall, there are about seventy five to eighty types of dementia. However, this essay will only focus on the most common ones. Leading the list is the Alzheimer's disease, which accounts for approximately fifty to seventy percent of all cases of dementia (Robinson and Odle, 2007). Other common types of dementia are vascular dementia, Parkinson disease, and Lewy body dementia.
Alzheimer is a degenerative disease that usually occurs on people over 65 years old. Alzheimer is fatal and usually results from the complication of serious illness such as pneumonia. Anyone who has Alzheimer will suffer from three to twenty years but on the average, it is usually seven or eight years. Regardless of the time span, symptoms are usually the same for most cases. Initial symptoms include loss of memory and change of personality which can gradually lead to inability to control body functions
However, careful assessment must be done because these symptoms cannot be detected immediately during the earlier mild stage. In some cases, the patient just begins to experience memory lapses which include names, familiar places and people.
Patients who continuously suffer from Alzheimer will then start to be confused about everyday tasks and people. They will start to have a hard time when it comes to determining time and place and usually, poor judgment and apathy occur. In fact, among people who are in the early stage of the disease, more than forty percent show apathy about their life and condition. With the help of medical prescription, patients who are at the early stage of the disease can live for some time however; as the disease continues to worsen at mid-stage, it is no longer recommendable for a patient to live independently. This is because at this point, critical signs may already happen such as rapid loss of cognitive function and loss of memory about events and personal history. As a result of memory lapses, figuring out names and faces of familiar people as well as remembering their personal information such as their contact information seem to be difficult for these patients.
In addition, mid-stage Alzheimer patients undergo personality changes and are often reserved. Furthermore, they may experience hallucinations resulting to various paranoid behaviors. Due to this signs, they need to be more dependent and people who are taking care of them should assist them when eating, changing clothes, taking a bath and using the toilet.
As the late stage of Alzheimer occurs, patients start to lose control of their body function thus; they should be taken care of all the time. At this stage, they can no longer recognize other people, not even their own name. They are no longer capable of talking and moving thus, they always need assistance whenever they need to move or go somewhere. The worst part is, as the disease continues, it slowly shuts down the body of the patient leading to serious medical condition (i.e. pneumonia) and death.
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Unfortunately, scientists do not fully understand yet what causes AD, but it is clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include genetic, environmental, and lifestyle factors. (medicinenet.com)
Although Alzheimer's disease is fatal and not curable, a better quality of life for a longer period of time can still be experienced by the patient through prescription medications. Since the effects of AD mentioned earlier are extremely difficult for the patients and their families, it is important that counseling and support from a doctor and care team are present in order to overcome the pain and the difficulty.
Another type of dementia to be discussed is vascular dementia. Unlike Alzheimer's disease, the cause of vascular dementia is known. Vascular dementia is caused by chronic, reduced blood flow in the brain as a result of a stroke or series of strokes. It occurs when the blood that transports oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system. If blood supply is blocked for longer than a few seconds, brain cells can die, causing damage to the cortex of the brain-the area associated with learning, memory, and language. In many cases, the strokes are so small that the symptoms are barely noticeable. Commonly, these strokes are known as "silent strokes." However, as time passes by, the damage adds up, leading to memory loss, confusion, and other signs of dementia. (helpguide.org)
Vascular dementia is second to Alzheimer's disease and accounts for around ten to twenty percent of the population who suffer from dementia. In many cases, vascular dementia occurs with Alzheimer's disease at the same time. The symptoms of vascular dementia can come gradually or suddenly depending on the strength of the stroke. The most common symptoms are slowed thinking, forgetfulness, sudden mood and personality changes, confusion, and sometimes hallucination or delusions.
In general, a person with vascular dementia can experience difficulties in walking, maintaining balance or keeping control over their bladder or bowel. They might also have problems with speech, and language (i.e. difficulties to find the right words, laughing or crying inappropriately at the situation). Furthermore, the daily activities that used to come very easily before are now difficult to exercise or manage.
Currently, there is no cure for vascular dementia, so it is important for people with this mental decline to be honest about their difficulties with the team of doctors. In addition, high blood pressure, high cholesterol, diabetes and heart disease are health problems that are related to stroke and are taken as risk factors of vascular dementia. Therefore, it is important to take care of these patients and monitor their health regularly. Many strokes are caused by blood clots, so sometimes drugs that make blood less likely to clot, like aspirin, are given to some people who are at risk of developing clots. No treatment can reverse the damage already done by a stroke that is why treatments to prevent future strokes are very important. The cognitive effect of stroke can be devastating, but speech and occupational therapy as well as strong support network can help in this difficult time.
Another disorder that falls under dementia is Parkinson's disease. Parkinson's disease is a degeneration of the area in the brain responsible for muscle. This disease results in part, from the shortage of the brain chemical - dopamine. Dopamine stimulates receptors in the Basal Ganglia, part of the brain that controls motors functions and emotions. Normal brain stimulation results in good nerve function and normal movements. However, in people with Parkinson's disease, seventy percent or more of this dopamine cells have died, reducing the amount of dopamine in the system. As a result, movement becomes very difficult. Classic Parkinson's symptoms include shaking hand, tremors, difficulty in balancing, stiff limbs, and slower movements. Some patients experience decreased facial movements including trouble blinking and swallowing. Most individuals who develop Parkinson's disease are over 60 years of age. Parkinson's disease affects over one million people just in the United States alone, and about five million worldwide. (medicine.net)
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The cause of Parkinson's is unknown. Although scientists do suspect that both genetics and exposure to environmental toxins may play a role. In rare cases of head trauma, stroke or prescription of antipsychotic medication may contribute to the onset of symptoms. Even though Parkinson's disease is progressive, people could still live a normal and productive life. Although the disease is not curable, there are numbers of treatments that can help sufferers live healthy lives. Furthermore, there are many very good medications that can help on day-to-day basis.
The big problem in Parkinson's disease is that sooner or later, patients get side effects of therapy, and those can be worse than the disease itself. Unfortunately, these therapies don't really help patients anymore. There is a big emphasis on the disease, in addition to medications for exercise, dance or yoga. Anything that helps with movement and keeps patient active seems to be a benefit in this disease. This kind of exercise can be as important as the medications. The major focus in the Parkinson's disease is to find some way to stop or even reverse progression of the disease. (pdf.org)
The last type of dementia to be discussed in this paper is Lewy Body dementia or dementia with Lewy bodies. Lewy bodies are abnormal microscopic protein deposits in the brain that disrupt the brain's normal functioning causing it to slowly deteriorate. The effects include degradation of cognitive functioning, similar toÂ Alzheimer's disease, or a degradation of motor control, similar toÂ Parkinson's disease (helpguide.org).
More often, LBD is misdiagnosed with Alzheimer's or Parkinson's because of the similarity in symptoms. As in Alzheimer's disease, LBD symptoms can be loss of memory, confusion, difficulty to communicate and follow directions, behavioral changes and decreased judgment. Symptoms that common for a Parkinson's disease as well as LBD are tremors, muscle stiffness, difficulties with balance and walking, slow movements or stooped posture. People with LBD, besides mentioned symptoms, also may hallucinate and experience changes in attention and alertness. They can become drowsy, lethargic, depressed, confused and unresponsive to questions. Furthermore, they may have disorganized speech or they may stare into space for long periods of time.
LBD usually begins in people between fifty and eighty fife years old (nlm.nih.gov). As mentioned before, it is hard to diagnose LBD. Unfortunately, the Lewy bodies can be identified only by autopsy. An accurate diagnosis relies heavily on physician awareness of the defining characteristics. A brain scan can detect mental deterioration, but not the actual Lewy bodies. (helpguide.org)
Currently LBD is incurable and gets worse over time. Average survival after the time of diagnosis is similar to that in Alzheimer's disease, about 8 years, with progressively increasing disability. There are no known therapies to stop or slow the progression of the disease, although some medications are given to help the patient on day-to-day basis. Â Treatments are focused on controlling the cognitive, psychiatric, and motor symptoms of the disorder, although doctors often tend to avoid prescribing antipsychotics for hallucinatory symptoms of the disease because of the risk that neuroleptic sensitivity could worsen the motor symptoms.