Dementia is defined as Progressive decline in cognitive function of an individual usually in advanced age. The person affected by dementia technically “lose their mind” and everything they have learned throughout their lives, including memory of how to do some of the things like driving and even dressing themselves in severe cases. Currently there are no known causes of dementia but risk factors of developing Dementia have been identified, some of which are modifiable (can be changed) while others are not. Dementia negatively affect the person who suffers from it and those close to them, such as caregivers and family members. This is because they have to put a lot of effort in taking care of the affected person and at the same time live their own lives.
Causes of Dementia
There are different types of Dementia caused by different factors:
Vascular Dementia: it is caused by accumulation of many small strokes in the brain, this result it permanent death of certain parts of the brain and later development of Dementia.
Alzheimer’s disease: This is a progressive neuronal damage which leads to development of Dementia through loss of Memory and cognitive decline. The brain is damaged by accumulation of Beta-Amyloid Peptide bodies and deposit of Neurofibrillary tangles that impairs nerve conduction.
Other causes of Dementia and risk Factors include:
- Down Syndrome
- Traumatic Brain Injury
- Vitamin B3 Deficiency (Pellagra)
- Diabetes Mellitus
- Alcohol abuse
- Family History of Dementia
- Parkinson’s Disease
Signs and Symptoms of Dementia
Dementia is a disease that progress very slow over time. It is difficult to track when symptoms start exactly because they are mild and non-specific at first. The person may start by Forgetting where they placed things like keys, Cell phone, TV remote or money. This is very irritating and leads to mood swings. With time they find it difficult to retain new information that they learn and have short term memory loss (forgets recent events and names of new People).
As the disease progress affected person will find it difficult to do things he used to do with ease before such as driving, bathing and dressing up. Later the person will be disoriented to Time, Place and Person. In the Advanced stages of the disease, the person finds it difficult to speak because they run out of words, cannot walk or even swallow and eventually go into coma or Die of Infections like pneumonia.
How to Diagnose Dementia
The Diagnosis of Dementia requires careful History and detailed Mental state Examination, Neurologic exam as well as appropriate tests.
It should be differentiated from Delirium, which is more acute and reversible.
Blood tests to exclude reversible causes of Cognitive decline include: Full Blood Count (FBC), Kidney function, HIV test, Vitamins B12, B1, B9&B3 Levels and Syphilis tests.
Brain scans also assist identifying the type of Dementia through recognition of certain brain pattern and brain size. CT scan, PET, EEG, and MRI are some of the brain scans that are done when Dementia is strongly suspected.
Treatment Approach to Dementia
If you live with someone with Dementia, it is important to make sure that they get as much support as possible. This is simple because there is no medication or drug that is known to cure or reverse Dementia. The disease progression rate depends on the support the person is getting from family members.
- Ensure Safety: make sure that you remove dangerous objects such as Knives, unplug stoves after use, and hide car keys as they might not be aware that they cannot drive anymore.
- Keep them oriented: Put large calendars and clock on the wall to help them remember what day it is. Also always remind them whenever they forget where they are.
- Keep them active: People with dementia benefit from doing easy and fun activities, it help them relax and sleep better at night. Do not put them in unfamiliar environment
- Explain each Task: it is very important to explain what you are going to do next e.g. bathing or eating in advance so that they will not refuse or become aggressive.
- They must be kept in well lit room with a TV or Radio to have something to listen to. Avoid dark quiet places for People with Dementia.
Dementia can be prevented by lifestyle changes in the early years of life. The way we live our lives in the ages 20 to 49 determine how early Dementia is likely to develop. Sometimes it is unavoidable if genetically linked as it happens in the case of Down Syndrome and Alzheimer’s Disease. The following lifestyle changes can prevent early development of Dementia:
- Weight loss if you are Obese
- Do not abuse alcohol
- Minimize Psychological stress as much as possible
- Eat healthy and Exercise regularly
- Early screening for Alzheimer’s Disease: this is done by measuring level of Beta amyloid peptide level in the CSF many years before development of Dementia symptoms.
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