Dementia

What Is Dementia?

Dementia is a broad term that describes loss of memory, language, and thinking abilities. It often affects older adults.

It's more than forgetfulness. It's severe enough to interfere with daily life.

Dementia is not a single disease. It is an umbrella term for several specific disorders.

Alzheimer's disease is one type of dementia. It's by far the most common type, affecting nearly 6.2 million people in the U.S. age 65 and over.

Types of dementia

Alzheimer's disease. This disease accounts for 60% to 80% of all dementia cases. People with Alzheimer's may have memory decline, confusion, and delusions.
Vascular dementia. About 10% of dementia cases happen after a stroke or other disruption to blood flow to the brain. Diabetes can cause harm to blood vessels and may also increase the risk for this type.
Lewy body dementia. This form of dementia may cause movement and balance problems, daytime sleepiness, and confusion.
Frontotemporal dementia. This type of dementia affects one part of the brain and can cause personality and behavioral changes.
Mixed dementia. More than one type of dementia may be present, especially in people over 80. Sometimes symptoms overlap.

Overview
Symptoms & Diagnosis
Treatment

Dementia causes

Damage to brain cells is the root cause of dementia. When the brain cells can't "talk" to each other, it affects a person's ability to communicate, reason, and remember.

Although dementia happens mostly in older adults, it's not a normal part of aging.

Researchers believe that dementia is likely to develop from many factors, including lifestyle, family history, and environment.

Dementia risk factors and complications

There are risk factors that make it more likely you'll suffer some form of dementia.

They include:

Age. The older you are, the greater your chances of getting dementia.
Family history. If your parents or sibling had dementia, you're more likely to get it.
Chronic health conditions. Diabetes, high blood pressure, or high cholesterol are common in people with dementia.
Smoking. Smokers are more likely to develop many diseases, including dementia.
Being African American or Hispanic. These ethnic groups have a higher likelihood of dementia.
Traumatic brain injury. Even a single head injury, from sports or other trauma, increases the likelihood that you'll get dementia later in life. The more head injuries you have, the greater your risk.

Complications of dementia include:

Loss of ability to communicate.
Loss of ability to care for oneself.
Memory loss.
Inability to recognize loved ones.
Increased mobility issues.
Increased risk of infections.
Decreased lifespan.

How to prevent dementia

At the present, there's no cure for dementia. But there are lifestyle changes you can make to delay or even prevent the onset of it.

To help keep your brain sharp and healthy, you should:

Maintain a healthy weight.
Quit smoking.
Keep your blood pressure under control.
Stay (or become) physically active.
Form good sleep habits.
Manage your diabetes.
Develop a good social network.

Dementia Symptoms and Diagnosis

It's normal to slow down a little as you age. Misplacing your keys or not being able to remember the name of a new acquaintance is not cause for alarm.

But the symptoms of dementia are more severe than the occasional forgetful moment. They can vary widely, depending on the type of dementia.

But most people with dementia have:

Memory loss.
Trouble paying attention.
Problems communicating.
A hard time with reasoning and problem-solving.
Unexplained personality changes.

What are the first signs of dementia?

The early signs of dementia may include:

Getting lost in a familiar neighborhood.
Forgetting names of people, places, or objects.
Not being able to complete simple tasks (like cooking a favorite meal).
Forgetting to pay bills or go to appointments.

If you suspect a loved one has a problem beyond mere forgetfulness, it's time to contact the doctor.

Diagnosing dementia

To help diagnose dementia, doctors will:

Take a detailed medical history.
Do a complete physical exam.
Run blood tests.
Give tests that measure your thinking ability.
Order imaging tests (CT, MRI, and PET scans) to look for problems.

No one test will tell if someone has dementia. It can be challenging to diagnose the exact type someone may have. Symptoms of different dementias can overlap.

If your PCP suspects dementia, they may refer you or a loved one to a:

Neurologist
Psychiatrist
Psychologist
Geriatrician

Dementia Treatment

There's no cure for dementia. But the care team at UPMC may be able to slow the progress of the disease or manage the symptoms.

Medicine to treat dementia

Your doctor may prescribe:

Drugs to slow down dementia. There's a new FDA-approved drug (Aducanumab) that targets plaque in the brain. Removing the plaque may slow mental decline in people with Alzheimer's disease. This drug isn't a cure and will not reverse the damage that has already occurred.
Drugs that treat cognitive symptoms of dementia. Cholinesterase inhibitors are drugs that help nerve cells in the brain talk to each other. They help manage the symptoms of dementia but don't stop its progression.
Drugs that help manage other symptoms of dementia. People with dementia often get agitated easily or have anxiety and sleep problems. Doctors may prescribe medications to treat these symptoms.

Tips for caregivers of people with dementia

Someone with dementia may not be able to express themselves well.

The following techniques can help caregivers at home.

See to their personal comfort. Someone with dementia may communicate an unmet need in a physical way like pacing or getting aggressive. An unmet need could include being hungry, being too warm or cold, or having a full bladder.
Don't argue that their memories aren't correct.
Keep a calm environment.
Set up (and stick to) a daily routine.
Try to redirect their attention instead of arguing.
Be patient.

Dementia prognosis and survival rate

It's hard to pinpoint life expectancy after a dementia diagnosis because of the many types and factors involved.

A person with Alzheimer's disease, for instance, lives on average 4 to 8 years after diagnosis. But they can live as long as 20 years.

Talk to your doctor about your loved one's specific case.