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As you age one of the latent concerns often is about dementia. What is it? What are the symptoms to look out for? What are the types of dementia? And more. The article below might help you understand dementia better as the author has compiled the symptoms associated with the different stages of dementia. And has also listed out the types of dementia and what it means. Team RetyrSmart
Understanding the Stages And Type of Dementia
One of the major causes of disability and dependency among older people, dementia affects around 50 million people worldwide, with nearly 10 million new cases every year. The syndrome causes cognitive decline, whereby the patient’s ability to process thought is decreased beyond what is expected from normal ageing. This leads to a host of issues and impairs memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement. Dementia is chronic, slow and progressive in nature, and the reduced cognitive function is often associated with a deterioration in emotional control, social behaviour and motivation.
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The symptoms of dementia can be divided into three stages. Explaining further, Dr Ashish Gosar, Consultant Neurologist, Masina Hospital, says, “The early stage of dementia is often overlooked as it may be difficult to consider these minor symptoms to be of organic origin. The symptoms are very slow and gradual and often considered to be due to low mood, decreased motivation, and part of normal ageing. Patients have mild forgetfulness in the form of misplacing things, forgetting names, losing track of time, and reduced ability in performing skilful work which could be done previously without any difficulty.” This does get worse, as he adds, “As the dementia progresses to middle stage, the disability and difficulty starts becoming more obvious for the family and caregivers. The patient starts becoming more forgetful of recent events and forgets familiar names and faces. Sometimes they may lose their way both inside and outside the home. There is increasing difficulty to perform complex tasks, and multiple errors are made without awareness. There may be increasing difficulty with communication, personal care and hygiene.”
According to Dr Gosar, the late stage of dementia is when the person becomes nearly totally dependent on the caregiver with minimum or no activity. He says, “The patient is unaware of time, place, and person, and completely disoriented. They have difficulty in recognising close friends and relatives and require assistance for almost every activity of day to day living. There is loss of control over bowel bladder habits without any social awareness, loss of balance and almost no ability to perform fined skilled works. Behavioural changes may be extreme and severely aggressive.”
Dr Gosar shares types of dementia depending on predominant symptoms and pathology.
First reported by Dr Alois Alzheimer in 1907, Alzheimer’s is the most common type of dementia, comprising 70 percent of all forms of the condition. It can be sporadic or familial; sporadic Alzheimer’s mostly occurs after the age of 65 and is the more common form of Alzheimer’s disease while familial Alzheimer’s is a rare genetic condition and affects people usually in their 40s or 50s.
The most common presenting symptom of Alzheimer’s disease is lapses in memory and words, where the patient finds difficulty in day-to-day conversation. As the disease progresses, there are frequent memory lapses, especially of recent events. There is loss of coordination in day-to-day conversation and loss of enthusiasm in previously well-performed activities. Forgetting familiar people’s name and faces is common and with time, there is progression of the disease, and patient may require assistance for daily activities and may become completely dependent.
The cause of this disease is an abnormal protein deposition (neuro fibrillary tangles) predominantly in the temporal lobes. The diagnosis is mainly clinical; there is no definite disease modifying treatment. Apart from this, symptomatic treatment is given and with time, the patient’s health continues to deteriorate gradually.
This is the second most common type of dementia after Alzheimer’s disease. Vascular dementia commonly occurs due to compromised circulation to the brain. This may happen due to secondary risk factors such as high blood pressure, smoking, diabetes, high cholesterol, cardiac issues, and vascular risk factors. Common symptoms include difficulty in walking, slowness and lethargy, emotional disturbance, loss of bladder control. Treatment involves management of risk factors and symptomatic treatment.
Lewy Body Dementia
Lewy body dementia may mimic Alzheimer’s disease. Patients commonly have difficulty in concentration and attention along with memory issues. The cardinal features include visual hallucinations and Parkinson’s symptoms such as tremors and stiffness. One other cardinal feature is inter and intra day fluctuations in mental state. Lewy body dementia progresses more rapidly in comparison to Alzheimer’s disease.
Other common dementias include Fronto Temporal dementia, which predominantly involves behavioural issues due to abnormal TAU protein deposition in the frontal and temporal lobe. Parkinson’s disease with dementia develops in patients with Parkinson’s disease; it has clinical features more or less similar to dementia with Lewy body disease. Currently, disease modifying treatment for various dementias are under clinical trial.