Dementia

Dementia is not normal aging and is not inevitable. Many people live into their 80s and beyond without any signs of the condition.

A dementia diagnosis can be frightening for patients, families, and caretakers. The term dementia refers to significant loss of cognitive functions such as thinking and memory, which affect functioning in daily life. It results from changes in the brain where healthy neurons stop working and die. Dementia ranges from mild to severe, with symptoms including problems with focus, language, and memory, changes in behavior and mood, and difficulty with daily activities.

Major Neurocognitive Disorder can also be used to label this constellation of cognitive and functional challenges. There are many brain conditions that can lead to Dementia / Major Neurocognitive Disorder. A few of the most common types of dementia will be discussed below.

  • Alzheimer's disease is the most common cause of dementia. It is a progressive brain disease that results in the decline of cognitive and functional abilities due to the buildup of abnormal beta-amyloid and tau proteins. This disease is not a normal part of aging and can lead to memory loss and a gradual decline in cognitive and functional abilities. Taking certain medicines can help slow down the progression of some symptoms, such as memory loss, for a time. The medicines can have side effects, however, and may not work for everyone.

  • Vascular dementia is a type of cognitive decline caused by inadequate blood flow to the brain, resulting in reduced memory, concentration, and other cognitive functions. Symptoms can range from mild to severe, and can be caused by a single stroke, a series of minor strokes, or generalized vascular changes. Vascular dementia has been linked to underlying medical conditions, such as diabetes, heart disease, and high blood pressure. Managing underlying conditions can improve outcomes and delay further decline. Medicines to slow cognitive decline may also help.

  • Lewy body dementia is a neurodegenerative disorder caused by the accumulation of abnormal alpha-synuclein proteins in the brain. This buildup leads to damage of brain cells, resulting in a wide range of symptoms. In addition to the more common symptoms of memory loss and other cognitive features, people with dementia with Lewy bodies may experience problems with movement and balance, fluctuations in their level of alertness, sleep disturbances, and visual hallucinations. Medications to slow cognitive decline are often considered.

  • Parkinson's disease is a progressive disorder that affects dopaminergic neurons in the substantia nigra, leading to a dopamine deficiency. Symptoms such as tremors, stiffness, and balance problems develop slowly and progress differently in each individual. Treatment involves medication to increase or substitute dopamine. Deep brain stimulation surgery may also be considered. Parkinson’s disease can also cause cognitive changes, sleep disturbances, changes in mood, such as depression and anxiety, which may require separate treatment.

  • FTD refers to a set of disorders characterized by changes in language and/or behavior, which are caused by progressive brain cell loss in the frontal or temporal lobes. Changes in frontal lobe function can lead to alterations in personality and social behavior, sometimes resulting in unexpected changes from the person's normal behavior. When the brain cell damage primarily affects the temporal lobes, communication difficulties tend to be the most prominent symptom. Treatment for these conditions is usually symptomatic in nature.