A condition that is characterised by a generalised deterioration in the brains functioning abilities. Dementia most commonly affects the elderly; 1 in 5 people over the age over 80 have the disorder and 1 in 20 people over the age of 65.
Causes and types
Dementia is often caused by damage to the brain tissue. It is often due to Alzheimer’s disease, which in turn causes changes in the chemistry and structure of the brain. The next most common form is multi-infarct dementia. In this condition, blocked or narrowed arteries in the brain deprive the tissue of oxygen and blood; repeated small strokes (episodes of tissue damage due to lack of blood) arise, causing deterioration that develops gradually in stages. Other, uncommon forms of dementia include Lewy body dementia (in which small, spherical structures called Lewy bodies form in the brain tissue); AIDS-related dementia; and deterioration that occurs as a result of progressive brain disorders, for example Parkinson’s disease.
In a minor proportion of cases ( mostly in people younger than 65), dementia is caused by a treatable cause such as a brain tumour, head injury, encephalitis, alcohol dependence, hormone or vitamin deficiency, or a side effect of some medications.
The key symptoms of dementia are confusion, disorientation and progressive memory loss. The affected person cannot remember recent events, can become confused over days and dates or get lost in an area that is familiar to them. These symptoms can slowly come on and can be hard to notice at first; also the person affected may cover up any problems by confabulation (making up explanations in order to fill the gaps in her or his memory).
Unexpected outbursts or embarrassing behaviour can also be the first obvious signs of dementia. Unattractive personality traits can become magnified; families and friends of those affected may have to endure unreasonable demands, accusations or even assault. Depression, paranoia and delusions can occur as the disease progresses and worsens. Anxiety or irritability gives way to indifference towards all events and feelings. Hygiene and personal care are neglected, and speech becomes disjointed. Ultimately affected people can need total nursing care.
The uncommon cases of dementia due to a treatable underlying cause may be cured or significantly improved by appropriate treatment of the cause. However, majority of types of dementia don’t fall into this category and treatment is based on the management of symptoms. In these particular cases, the afflicted person should be kept well nourished, clean, in comfortable surroundings and with quality nursing care. These actions can at least help ease distress for both the family and the patient. In certain cases, encouraging the affected person to stay as mentally active as possible can be beneficial.
For some persons with mild to moderate Alzheimer’s disease, drug treatment with acetylcholinesterase inhibitors such as donepezil can help improve behavioural symptoms and can also slow down the deterioration in mental function. However, regardless of treatment Alzheimer’s disease is progressive.