Dementia is a general term for a decline in mental ability severe enough to interfere with daily life.
It’s an umbrella term that describes a collection of symptoms that are caused by abnormal brain changes that influence memory, reasoning and other thinking skills, and affect behavior, feelings, and relationships. I want to point out that we’ve come to understand that dementia is not a normal part of aging – it is caused by damage to brain cells that affects the cells’ ability to communicate.
There are several types of dementia and different types of brain changes associated with each – it has to do with where in the brain the changes are occurring – and there can be more than one type occurring at the same time if multiple parts of the brain are experiencing damage. Alzheimer's disease is the most common cause of dementia, so common, in fact, that people often refer to any type of cognitive decline as “Alzheimer’s,” even though there are other types like Vascular dementia, Parkinson’s Disease Dementia, and more.
There are no cures for dementia, but there are medications and non-drug treatments that may slow the worsening of symptoms or address symptoms related to memory loss, sleep changes, depression, or behavior changes, all to improve quality of life.
The Alzheimer's Association describes brain cells like tiny factories, receiving supplies, generating energy, processing information, communicating with other cells, getting rid of waste, and so on, and while it may be unclear just where a problem starts, it’s like any other factory in that a breakdown in one area causes problems in other areas. There is also no single cause or risk factor for Alzheimer's or other dementias, and genetics, lifestyle, and environment may all be factors.
The most common early symptom of Alzheimer's is difficulty remembering newly learned information. In fact, memory loss that disrupts daily life is common across all dementia types. Alzheimer's disease and other dementias progress in stages and biological changes can be occurring in the brain for years before someone exhibits changes in memory.
Other early signs include:
· Difficulty completing familiar tasks like organizing grocery lists or paying bills, and getting lost going to familiar locations
· Confusion with time or place, days of week, someone may not remember where they are or how they got there
· Vision changes that affect balance, reading, judging distance, colors/contrast
· Trouble with conversation and communication, repeating words, struggling to name familiar objects
· Losing things and losing the ability to retrace steps to find them
· Loss of judgement or using poor judgement when dealing with money or making decisions, paying less attention to personal hygiene or grooming
· Withdrawal from hobbies, activities, and socializing
· Changes in mood or personality – new confusion, depression, fear, anxiety, less tolerance for being out of their comfort zone
The Alzheimer’s Association and other websites have descriptions of what can be expected during normal aging – because our brains do change with age, and age is the greatest known risk factor for Alzheimer's and other dementias, but, again, these are diseases that involve damage to brain cells and progress in severity, and are not just “normal” aging.
What are risk factors for Alzheimer's and other dementias? While specific causes are not yet well-understood, genetics, lifestyle, and environment may all be factors.
· Head injuries are one of the most important, preventable risk factors for dementia, and studies are showing that increased numbers of head injuries are associated with greater risk for dementia.
· Family history is a strong risk factor and the closer the relationship the more likely someone is to also develop dementia (parent, sibling). Risk is also higher if more than one member of the family has dementia. When diseases run in families, genetics and environment could be involved.
· There is strong evidence that links heart health and brain health – every heartbeat, 20-25% of the blood your arteries carry goes to the brain where ~20% of the oxygen and fuel carried in the blood is used – up to 50% when you’re thinking hard!(https://www.alz.org/alzheimers-dementia/what-is-alzheimers/brain_tour) So, adequate blood flow is vital for the brain to function at its best, and even minor strokes or other conditions that affect small blood vessels can lead to widespread damage – termed “vascular dementia,” or “vascular cognitive impairment.”
· Hearing loss has been linked with a greater risk of developing dementia.
How can we reduce our risk?
· Practice head safety like wearing seatbelts and helmets during activities.
· Families may have more than just genes in common, so look at things like diet and exercise habits, smoking, and if there are other chronic diseases that are shared and look at making changes now.
· Monitor conditions like blood pressure, cholesterol, diabetes, and try to maintain as heart-healthy a lifestyle as possible.
· Protect your ears from loud sounds, get your hearing checked, and address hearing loss with appropriate hearing aids.
· Strategies for overall healthy aging may help reduce the risk of developing Alzheimer’s or other dementias – eat a healthy diet, stay physically active especially in ways that increase your heart rate, get enough good sleep, and stay socially engaged.
· Keep exercising the brain like you do the body! Mental stimulation can be found in reading, playing games, learning a new skill, craft or language, or volunteering. Jigsaw puzzles have even been studied as a potential protective factor for cognitive decline. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174231/)
Another condition to be aware of is Mild Cognitive Impairment (MCI) which is memory or thinking problems that do not affect the person’s ability to carry out daily activities.
· It may be an early stage of neurodegenerative disease progression or may not progress at all, and not everyone with MCI will develop dementia.
· Mild cognitive impairment may primarily affect memory, or may affect other thinking skills including judgement, and visual perception.
· MCI is diagnosed by a doctor completing a medical history, doing an assessment of independent functions and daily activities, asking input from someone close to the patient and using tests of memory, planning, understanding visual information, neurological examination, evaluation for depression, lab tests, and/or PET scans.
Like other dementias, the causes of Mild Cognitive Impairment are not fully understood but risk factors are similar as are protective factors.
If someone is noticing in themselves or a loved one more frequent lapses in memory, having trouble doing daily tasks, losing things and not being able to retrace their steps, it is vital to talk to a healthcare provider. Some memory and thinking problems may be caused by medications or conditions that are treatable! And if that is not the case, there is much more that can be done when dementia is caught early. People will have:
· Access to treatment options that reduce progression and impact of symptoms, resulting in longer time until the disease is debilitating
· Opportunities to participate in clinical trials, early diagnosis means wider variety of trials
· Time to prioritize your health, make lifestyle changes that may help preserve cognitive function longer
· Allows time for you to maximize the time with family and friends and make your own decisions about legal, financial, and end-of-life wishes, that eventually you may not be able to make
· Cost savings related to medical and long-term care
The brain is highly complex and not necessarily well understood but much progress is being made in recognizing, managing, and treating dementia. It is no longer necessary for people to just live with cognitive impairments and suffer the decline without being able to do anything about it. There is more support for people with dementia and for caregivers. If you want to explore more about Alzheimer's and other dementias, the Alzheimer's Association website is packed with great information, as is the National Institute on Aging website, and Alzheimers.gov.
If you are experiencing a form of dementia, or caring for someone who is, there is support from various resources. The CSU Engagement Center in Sterling hosts a monthly Parkinson's Support Group on the third Thursday of the month at 2:00 p.m. which can be attended virtually. Please call Bob Blach for more information: 970-580-9771. Other support group information can also be found at these websites: