By Chia-Fen Tsai, M.D
Dementia is a collective name for progressive degenerative brain syndromes which affect memory, thinking, behaviors and emotions. Symptoms of dementia may include:
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Memory loss
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Difficulty performing familiar tasks
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Problems with language
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Disorientation to time and place
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Poor or impaired judgement
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Problems with keeping track of things
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Misplacing things
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Changes in mood or behavior
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Changes in personality
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Loss of initiative
Dementia has no social, economic, ethnic or geographical boundaries. Although each person will experience different symptoms in their dementia course, eventually those affected are unable to care for themselves and need help with all aspects of daily life. There is currently no cure for most types of dementia, but treatments, advice, and support are available.
Types of Dementia
There are a lot of conditions which may cause the symptoms of dementia, as a result of changes that happen in the brain and the ultimate loss of nerve cells (neurons). The most common causes are:
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Alzheimer's disease
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Vascular dementia
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Dementia with Lewy bodies
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Fronto-temporal dementia (including Pick's disease)
Risk factors
Currently, there are many factors have been suggested to be linked to the development of dementia. Some are risk factors, whilst others appear to be protective.
Age and a strong family history of dementia are risk factors with a strong link to dementia. Excessive alcohol consumption, head injury, and risk factors for heart disease such as high blood pressure, diabetes, smoking and being overweight also seem to increase the risk of getting dementia.
It seems that people who keep their brains active may be at less risk of developing dementia. Reading, engaging in a hobby such as playing bridge or chess, or doing crosswords and word puzzles may help to reduce risk.
Diagnosis
A reasonably accurate diagnosis of dementia can be made by taking a careful history of the person's problem from a family member or close friend, together with an examination of the person's physical and mental status. There is no simple test to make a definite diagnosis and dementia can only be confirmed with certainty by examining the brain after death. When making a diagnosis, it is important to exclude other treatable conditions that cause memory loss such as depression, infectious diseases, vitamin deficiency and brain tumor.
The impact of a dementia diagnosis depends greatly on how it is made and imparted. Evidence suggests that when people with dementia and their families are well prepared and supported, initial feelings of shock, anger and grief are balanced by a sense of reassurance and empowerment.
An early diagnosis is helpful, because it:
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enables carers and people with dementia to be better prepared to cope with the disease progression
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provides people with dementia with an opportunity to make decisions about their financial and legal affairs earlier while they still have the capacity to do so
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gives people with dementia a better chance to benefit from available drug and non-drug therapies that may improve their cognition and enhance their quality of life.
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