Dementia: Signs of a ‘decaying’ brain

Just a quick note, my blog is primarily based on personal views and experience, sometimes referring to research and some background information, with the aim of helping anyone who may be suffering, or know of anyone suffering from a mental health illness. I would welcome any advice and feedback on my blogs, or your personal thoughts on the topic. My post today is about Dementia.

Dementia is a term used to describe cognitive (or a mental) decline in abilities such as memory, language, understanding, reasoning, planning, and more. Some cognitive decline is to be expected as one ages, but dementia involves a level of cognitive decline that can lead to complete loss of the ability to carry out daily activities. The likelihood of developing dementia increases with age, with the most common age of onset being around 65. Dementia is also a progressive illness (meaning that it gradually gets worse over time).

There are many symptoms associated with dementia. All symptoms are usually gradual and worsen over time. The most common symptoms are:

  • Frequent and progressive memory loss
  • Difficulties with language and communication
  • Lack of concentration
  • Disorientation/general confusion
  • Forgetfulness
  • Inability to recognise objects (and people)
  • Lack of interest
  • Agitation
  • Sudden mood swings
  • Lack of visuospatial skills (problems judging distances, on stairs etc.)
  • Depression
  • Paranoia (in some cases)
  • Difficulties with eating (poor appetite)
  • Change in sleeping patters
  • Lack of initiative/motivation
  • Lack of empathy
  • Visual hallucinations (in some cases)
  • Delusions (in some cases)

Dementia is an umbrella term, that is used to describe a set of symptoms that are caused when an individual’s brain is affected by a specific cause. There are many types of dementia, but Alzheimer’s Disease and Vascular Dementia are thought to be the most common types of dementia. Symptoms for all of the different types of dementia are essentially the same. However, the majority are named according to their cause.

Alzheimer’s Disease:

The most common cause of dementia is Alzheimer’s Disease. With alzheimer’s, proteins build up in the brain to form ‘tangles’ and ‘plaques’. Individuals with alzheimer’s also usually have a shortage of important chemicals in the brain. This all leads to a loss of connections in the brain. Sometimes symptoms of alzheimer’s may develop with other illnesses that exhibit similar symptoms. Memory loss in alzheimer’s is also usually very subtle in the early stages and can be confused with normal ageing.

Common symptoms of Alzheimer’s include:
– Problems with communication.
– Difficulties with visuospatial skills.
– Lack of concentration.
– Confusion.
– Difficulties with recent memories.
These symptoms are the most common for alzheimer’s, but symptoms vary between individuals (and more symptoms are listed above).

Vascular Dementia:

Vascular dementia is thought to be the second most common type of dementia. Symptoms here occur because of a lack of blood supply to the brain. Blood is usually supplied to the brain through a network of vessels referred to as the vascular system. In vascular dementia, these blood vessels are broken or blocked. There are a few different types of vascular dementia:
Stroke related: during a stroke, blood supply to the brain is cut off. The most common reason is due to a blood vessel being blocked by a clot. This can lead to vascular dementia. Strokes vary in severity depending on the block in the vessel, and the type of damage.
Post-stroke: not everyone who has a stroke will develop dementia, but a small percentage can develop a post-stroke dementia. An individual who has a stroke is at risk of suffering from another stroke, which increases their risk of developing dementia.
Subcortical dementia: believed to be the most common form of vascular dementia, it is caused by damage to the small vessels in the brain that lead to reduced blood flow to the brain.
Mixed dementia: is a combination of both alzheimer’s disease and vascular dementia, where symptoms are usually a combination of both.

Common symptoms of Vascular Dementia include:
– Difficulties with problem solving.
– Delay in ability to process information.
– Lack of concentration.
– Confusion.
– Difficulties communicating.
These symptoms are the most common for vascular dementia, but symptoms vary between individuals (and more symptoms are listed above).

Diagnosis of dementia is usually quite difficult at first because symptoms are usually confused with normal ageing. Symptoms are usually first witnessed by family and friends, who would notice an observable difference in behaviour. The first step would be to visit a GP if you think you or someone you know has any change in behaviour that is quite significant, or peculiar. The GP would then carry out a physical assessment to ensure that any physical illnesses can be ruled out. If necessary, they will then refer you to a professional who will carry out an in depth assessment to determine a diagnosis. Several medical professionals may also be involved in your diagnosis and treatment plan.

There are several different types of dementia (as discussed above), and your diagnosis will be based on your symptoms, and the severity of your particular symptoms. A diagnosis is usually given following an observation, some brief tests, and interviews with those who know you (i.e. family, friends, carers, etc.)

Dementia cannot be cured, but is usually managed by medication, or a combination of both medication and psychological intervention. There are many different types of medication available, but the one prescribed will be based on type of dementia, symptoms exhibit, and the severity of the symptoms.

For Alzheimer’s disease, the usual type of medication prescribed is acetylcholinesterase inhibitors. They work by increasing the amount of the neurotransmitter (chemical) called acetylcholine, that individuals with alzheimer’s usually have a lack of. The drug is used to reduce the severity of symptoms, and has been found to be particularly effective in treating hallucinations. However, there are some side effects including nausea, vomiting, loss of appetite. These side effects usually clear up after a few weeks of taking the medication. An alternative of acetylcholinesterase inhibitors (if they don’t work) is memantine. Memantine works by blocking the effects of a chemical called glutamate. People with alzheimer’s usually have unusually high levels of glutamate in the brain. It has been found to be effective in reducing the severity of symptoms. There have also been found to be some side effects, such as headaches, lethargy, and dizziness. These usually wear off after some time taking the medication. As for Vascular dementia, the GP will usually prescribe a medication that will treat the underlying condition (i.e. stroke). Antipsychotics may also be prescribed if the individual exhibits challenging or disruptive behaviours. It should be noted that there are side effects to each of the types of medication described here, and these would usually be discussed with your prescribing GP.

A form of therapy may also be offered to help determine some effective coping mechanisms to deal with symptoms. Cognitive Behavioural Therapy (CBT) is a form of talking therapy that is found to be most effective, and has no side effects. The therapy aims to look at how an individual thinks, and how this affects their behaviour. Psychological therapy can be effective in developing coping mechanisms to deal with the symptoms experienced; to help with any stress; and to help with any depressive or anxiety related feelings experienced.

There are also support groups, counselling services, activity groups, etc. that can all be extremely supportive and helpful for those with dementia (and family, friends, carers, etc.). These can be accessed through your GP, and more information can be found on the internet about the particular services available in your area.

I have written this particular blog simply to inform people about Dementia, what it is, and the forms of treatment available. I hope that this blog has been informative, and that people understand the disorder better. Help can be found from your GP; and further information about the condition can be found through these well-informed websites listed below:

http://www.dementia.com/index.html

https://www.alzheimers.org.uk/site/scripts/documents.php?categoryID=200360

Please feel free to comment with topics that you would like to read about.

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