1. What is Dementia?
Dementia is a chronic syndrome in which people have memory and other cognitive impairment that affects their daily function. People with dementia may forget:
- Dates, appointments, names and places
- To pay bills or be unable to manage their finances
- How to cook or to turn off the stove
- To take their medications or that they have already taken their pills leading to drug toxicity
- To clean and organize their house
- Directions in the community and how to drive a car
- To attend to their personal hygiene or to change their clothing
People with Dementia may have a change in personality. The most common changes are irritability, anxiety and depression. Agitation, aggression,delusions, hallucinations and other behaviour disturbances are much less common, affecting less than 20% of people with dementia.
2. How common is Dementia?
Dementia is rare before the age of 65. It affects approximately 8-12% of people over the age of 65 in Western Countries. The prevalence increases with advanced age so that approximately 1/3rd of people over 85 may be affected by this condition
3. What causes Dementia?
There are many causes of dementia and often people have more than one cause.:
- Alzheimer’s Disease – is a slowly progressive degenerative condition in the brain. People get plaques and other debris building up in the brain which affects the normal function and causes cell death. This will gradually lead to memory and other cognitive impairment and ultimately to dependency in daily function
- Vascular Dementia- is caused by problems with the circulation in the brain. People may have chronic poor blood flow, small and large strokes which affects cognitive function. Vascular Dementia may cause a more abrupt onset of problems and is often associated with other neurological problems such as gait disturbances
- Parkinson’s Disease and Parkinson-Like Syndromes may lead to dementia
- Lewy Body Disease – is a degenerative neurological disease characterized by features of Parkinson’s Disease (eg shuffling gait), sensory problems and hallucinations and fluctuating levels of consciousness
- Frontal Temporal Dementia- is a degenerative neurological disease characterized by dementia and significant changes in personality, loss of initiative and self-regulation
- Normal pressure Hydrocephalus – causes blockage of flow of the normal spinal fluid throughout the brain leading to swelling in the brain. It is characterized by dementia, urinary incontinence and a typical magnetic, shuffling gait
- There are other rare causes of dementia
4. What can my doctor do for Dementia?
Your doctor will get collateral history from family members or other caregivers and administer standardized cogntive tests such as the MMSE. A physical exam and blood tests may be ordered to rule out less common causes of dementia or exacerbating conditions. A CT scan or MRI may be ordered, or a referral may be made to a specialist if the presentation is unusual. the physician may refer you to the local home care agency to ensure that you have adequate supports. The doctor may prescribe drugs available for dementia which have been shown to have a small benefit on cognitive function. Similarly, he or she may prescribe drugs for mood or significant behavioural problems.
5. What can I do for Dementia?
Dementia is a chronic condition that can last for many years. It is important that the person afflicted with dementia stay physically fit through regular excercise and healthy diet. Mental stimulation may help maintain cognitive function. Caregivers need to ensure that they have enough support and balance in their lives. You should contact your local chapter of the Alzheimer’s Society which has excellent information and resources for people and caregivers. http://www.alzheimerbc.org/In-My-Community/Vancouver-Island.aspx