Understanding Dementia is the first step in learning how to address its challenges.

Dementia is a term used to describe a group of symptoms that affect memory, thinking, and social skills severely enough to interfere with your daily life.

It is not a specific disease, but various diseases can cause dementia. Memory loss does not mean one has dementia, although it is often one of the first signs of the condition. Alzheimer's disease is the most common cause of progressive dementia in older adults, but there are several other causes.

Causes of Dementia

The causes of dementia vary by type. For example, vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells; whilst Alzheimer’s is caused the abnormal build-up of 2 proteins called amyloid and tau.

Depending on the area of the brain that's damaged, dementia can affect people differently and cause varying symptoms. 

Some other causes of dementia include: 

  • Alcohol or substance use disorder  

  • Subdural hematomas, blood clots beneath the outer covering of the brain  

  • Normal-pressure hydrocephalus, a build-up of fluid in the brain  

  • Metabolic disorders such as a vitamin B12 deficiency  

  • Low levels of thyroid hormones, called hypothyroidism  

  • Low blood sugar, called hypoglycaemia  

  • HIV-associated neurocognitive disorders (HAND)  

Symptoms   

Symptoms of dementia vary depending on the cause, but common signs and symptoms include: 

  • Memory loss that is usually noticed by someone else. 

  • Difficulty communicating or finding words.   

  • Difficulties with visual and spatial skills, such as getting lost while driving.   

  • Difficulty arguing, reasoning or problem-solving.   

  • Difficulty handling complex tasks, planning and organising.   

  • Difficulty with coordination and motor functions.   

  • Confusion and disorientation.  

  • Psychological and/or personality changes.  

  • Depression and/or Anxiety.  

  • Inappropriate behaviour.  

  • Hallucination, Paranoia, Agitation.  

Types of Dementia  

There are multiple types of dementia, as this is not a particular disease but rather a group of symptoms that occur when the brain cells are affected and stop working properly. It is possible to have more than one type of dementia at the same time.

Alzheimer’s is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called ‘mixed dementia’.  

Degenerative neurological diseases: these diseases get worse over time and include:  

  • Alzheimer's disease;

  • Parkinson's disease;

  • Huntington's disease; and

  • Some types of multiple sclerosis.  

 Vascular disorders: these conditions affect the blood circulation in your brain.    

  • Traumatic brain injuries caused by car accidents, falls, concussions, etc;

  • Infections of the central nervous system. These include meningitis, HIV, and Creutzfeldt-Jakob disease;

  • Long-time alcohol or drug use; and

  • Certain types of hydrocephalus, a build-up of fluid in the brain  

Some types of dementia that are progressive and not reversible include:   

Alzheimer's disease

This is the most common cause of dementia. Although not all causes of Alzheimer's disease are known, scientists believe that this disease is caused by the abnormal build-up of two proteins, amyloid, and tau, in the brain. These proteins form plaques and tangles that affect the brain cells. It is also known that the genes you inherit from your parents can contribute to the risk of developing Alzheimer's. 

Vascular dementia

It is the second most common type of dementia, and it is caused by reduced blood flow to the brain. This can be caused by damage to the vessels that supply blood to the brain. Blood vessel problems can also cause strokes which can increase the risk of developing dementia. The most common signs of vascular dementia are trouble solving problems, slow thinking, and loss of concentration and organization. These are usually more noticeable than memory loss. 

Dementia with Lewy bodies

This is one of the most common types of progressive dementia. It is caused by the damage inflicted to the brain cells by the build-up of Lewy bodies, which are clumps of alpha-synuclein protein. Common signs and symptoms include acting out dreams while you sleep, seeing things that are not there (visual hallucinations), and having trouble concentrating and paying attention. Other signs include slow or uncoordinated movements, tremors, and stiffness (parkinsonism). 

Frontotemporal dementia

Frontotemporal dementia is one of the rarer types of dementia. However, it can affect younger people, typically 45-65 years old. This kind of dementia affects the front and sides of the brain, areas that control our personality, emotions, speech and behaviour. Which is why signs and symptoms include personality and behaviour changes, like acting inappropriately or impulsively; language problems, like struggling to make the right sounds or getting the words in the wrong order; problems with mental abilities, like struggling with planning and organisation.  

There are some rarer conditions that can lead to dementia like Creutzfeldt-Jakob disease, Huntington’s disease, Chronic traumatic encephalopathy (CTE), Corticobasal syndrome (CBS), and Progressive supranuclear Palsy (PSP). 

Conclusion

Unfortunately, there is no cure for dementia, but there are many research efforts into the various diseases that can cause it. There are also some medicines that can help by making day-to-day life a little easier.

Since there is no cure for dementia, as the symptoms advance, many people need support in a professional environment, such as a care home. This can be a challenging decision to make for loved ones, and often requires a lot of thinking and soul searching. There are a few ways to help one make this decision: seeking support from GP, talking to dementia charities and discussing with friends and family who may have had similar experiences. 

One important aspect of your decision making is to understand that even if you move your loved one to a care home, you are still involved in their care through establishment of person-centred care plans. These are provided in every good care home must be prepared with your input. Please seek a discussion with the managers of your short-listed homes in this regard.  

Thanks to the Care Act (2014), in England, your local council must carry out an assessment of anyone with care needs. You can request this from the Adult Social Services Team at local council by phone, in writing or online. 

In Scotland, Wales you can contact your local council's Social Services office to request an assessment and in Northern Ireland, you should contact your local Health and Social Care Trust. Your GP or local hospital doctor can also arrange an assessment for you. 

For more information:  

https://www.ageuk.org.uk/  

https://www.alzheimersresearchuk.org/dementia-information/quick-guide-dementia/ 

https://www.nhs.uk/conditions/dementia/  

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