Dementia, also known as dementia, which is defined as a disorder of memory, thinking and mental abilities that affects daily life activities, is most common in the elderly. Dementia, which points to a disease group in which forgetfulness is at the forefront, is often confused with Alzheimer’s disease. However, Alzheimer’s is defined as only one type of dementia. Alzheimer’s dementia accounts for approximately 60-80 percent of all dementia pictures. Early diagnosis and correct treatment approaches play an important role in dementia, which can be slowed down with various methods. Memorial Health Group Neurology Department experts gave information about dementia.
WHAT İS DEMENTİA?
Dementia, or dementia, is the impairment of cognitive functions. For the diagnosis of dementia, more than one cognitive area must be affected. Cognitive impairment prevents daily living activities. If there is a significant deterioration in activities such as decreased professional performance, use of ordinary devices, hobbies, housework or self-care, a diagnosis of dementia should be considered. Cognitive changes may also occur due to aging. As a person ages, his / her learning may slow down, his thoughts may change, his memory may not be as good as before. However, daily living activities are not affected by aging. Dementia is a condition that progresses over time.
WHAT ARE THE SYMPTOMS OF DEMENTİA?
The most important symptom of dementia is memory impairment. Since people have memory problems, not remembering their conversations, repeating or asking the same things all the time may be a sign of dementia. Newly learned names, phone numbers can be forgotten. When dementia progresses, old knowledge is forgotten as well as what has just been learned. Difficulty finding words, replacing these words with meaningless different words is a typical problem in dementia. Patients lost their ability to judge, abstraction, and cause and effect. Inability to do daily activities such as combing hair and brushing teeth is also a symptom of dementia. Recognition of sensory stimuli, losing the way in places that the person knows well, and prominent impairments in public and occupational functions are also symptoms of dementia. Personality changes,
WHAT ARE THE CAUSES OF DEMENTİA?
There are many diseases that cause dementia. The most common disease that causes dementia in the society is Alzheimer’s Disease. However, apart from Alzheimer’s Disease, dementia may occur due to many neurological diseases such as vascular diseases (vascular dementia), Parkinson’s disease, normal pressure hydrocephalus, and some systemic conditions. Dementia can also be seen due to substance, alcohol use, tumor or the combination of all these. Dementia is caused by damage to brain cells for a reason, and this damage causes cognitive impairment.
HOW İS DEMENTİA DİAGNOSED?
Mini Mental Test is applied to patients for dementia diagnosis. If the suspicion of dementia arises as a result of this frequently used screening test, patients are taken into a more detailed neurological and psychometric evaluation. The patient undergoes a comprehensive physical examination. Detailed information about the person’s background is obtained from him and also from one of his relatives. After the Mini Mental Test, biochemical tests, neuroimaging methods (MR, CT), neuropsychological tests and, if necessary, EEG, waist fluid removal procedures can also be applied. In the light of these examinations, a differential diagnosis of dementia can be made. The diagnosis of the disease that causes dementia plays a big role in terms of course and treatment.
HOW İS DEMENTİA TREATED?
Dementia treatment and response to this treatment differ depending on the type of dementia. Most types of progressive dementia cannot be cured with certainty. But signs and symptoms can be managed with supportive treatments. With drugs such as cholinesterase inhibitors and memantine, a temporary improvement in the symptoms can be achieved by aiming to stop the course of the disease. In addition, a neurologist may prescribe different medications to relieve and treat symptoms such as depression, sleep disorder, and agitation. In addition, apart from medical treatments, it is necessary to make the environment where the patient is located safe with environmental regulations. Important duties fall on the relatives of the patients in order to prevent accidents such as falls and crashes. Reducing noise helps dementia patients focus. Items that threaten security, such as knives and car keys, may need to be hidden.
In dementias that occur due to causes such as B12 deficiency and thyroid hormone disorder, which are among the treatable dementias, the symptoms completely improve with the treatment of the underlying cause.
Regular follow-up of patients with dementia by neurology and psychiatry physicians is important in terms of controlling the symptoms, course and severity of the disease.
FREQUENTLY ASKED QUESTİONS ABOUT DEMENTİA
What are the types of dementia?
The most common dementia is Alzheimer’s disease. There are types called vascular dementia, dementia with Lewy bodies and frontotemporal dementia.
Which diseases are included in the differential diagnosis of dementia?
Depression that causes pseudo-dementia should definitely be included in the differential diagnosis. Toxic causes such as B12, B1, B6 deficiencies, lead and mercury poisoning, endocrine causes such as hypothyroidism, vasculopathies, subdural hematoma, normal pressure hydrocephalus, slow-growing tumors, central system infections should be reviewed in differential diagnosis.
What are the stages of dementia?
Dementia can be classified as early, middle and late stages according to the findings. In the early stage, forgetfulness, not being able to follow the time, getting lost in familiar places are seen. In the middle stages, recent events and human names can be forgotten. Problems such as getting lost in the house, having communication problems, not being able to take personal care can be seen. In the late stage, the person is unaware of the time and place, does not recognize his close acquaintances, cannot take personal care, may have difficulty in walking, and may show aggressive behavior.
Does dementia progress fast?
There are some diseases included in the differential diagnosis that can lead to rapidly progressive dementia. In addition to these diseases, dementia may progress faster in conditions such as eating habits, additional chronic diseases, use of some medications, frequent infections or previous surgical operations in the course of Alzheimer’s disease-related or other dementia-related diseases.
Does the patient with dementia hallucinate?
A common occurrence in dementia is hallucination. It is generally seen in the middle and late stages. In dementia, there are situations such as stealing property, infidelity, not accepting that the house is their own, and the patient refusing to accept his wife as his own.
Can dementia be prevented?
Although there is no sure way to prevent dementia, lifestyle changes and control of risk factors can contribute to preserving brain reserve and slowing the progression of dementia. It may be useful to play mentally stimulating games such as sudoku to keep one’s mind active. Exercise must be done as physical activity can delay the onset of dementia. Smoking should not be allowed. Because smoking can increase the risk. It is necessary to have a diet rich in vitamins, minerals and antioxidants. It will be beneficial to reduce salt and sugar intake in the diet. It is beneficial to manage cardiovascular risks, prevent diabetes, high blood pressure and cholesterol, lose weight. Quality sleep and improvement of other health conditions are important.
What are dementia tests?
After the Mini Mental Test, neuroimaging (MR, CT) and neuropsychological tests provide information about dementia. Neuropsychological tests are applied by specialist psychiatrists and psychologists. Functions of the patient such as attention, memory, planning, and perception are evaluated in these tests. With these tests, the depression status of the patients is also checked. The results obtained from this test help the neurology physician to determine which type of dementia profile the patient has. These tests include Wechler Memory Test, Stroop Test, Wisconsin Card Sorting Test, Semantic Fluency and Letter Fluency Tests, Öktem Verbal Memory Processes Test.
What is the difference between Alzheimer’s and dementia?
Dementia (dementia) signs and symptoms occur due to many diseases. Alzheimer’s disease symptoms are the same as dementia findings, so Alzheimer’s disease is a disease that causes dementia. The first 2-4 years of Alzheimer’s disease are known as mild and early stages. The earliest finding is forgetting new things or events. Difficulties may arise in writing, using the device. The next 4-10 years can be considered as the middle stage. Here, difficulties in coping with problems, inability to establish a cause and effect relationship, loss, and sleep disturbance may occur. People need help with their daily activities. Confusion becomes evident at these stages. In the advanced stage, relatives are not recognized, falls, swallowing problems, urinary-fecal incontinence occur. As a risk factor in Alzheimer’s disease, it is stated that factors that are bad for heart health are also negative for brain health. Prevention of vascular risk factors, smoking cessation, sleep patterns, social activities, exercise, hobbies for cognitive activity are important in reducing the risk of Alzheimer’s Disease.
Does exercise prevent dementia?
The biggest risk factor in dementia is aging. The majority of dementia cases occur over the age of 65. Modifiable risk factors for dementia include physical inactivity and obesity. The cognitive manifestations of dementia begin many years after neuronal damage. For this reason, it is important to control risk at a young age. Modifiable risk factors are important in delaying dementia. The World Health Organization recommends at least 150 minutes of moderate physical activity per week. In addition, the World Health Organization recommends stretching exercises twice a week. He gives balance activities to elderly people to reduce falls.
Does dementia happen at any age?
Dementia is a problem with aging, but it can rarely be seen in young people.
Is dementia fatal?
Dementia-related deaths are increasing all over the world, and according to research, dementia is among the leading causes of death among the elderly. In advanced dementia, patients spend most of their time in bed. The tendency to urinary tract infection, bed wound infection increases. Infections can recur frequently.
What is the life expectancy of dementia patients?
How long do dementia patients live? It is one of the frequently asked questions on this subject. However, life expectancy in dementia varies according to the person. Correct treatment planning and appropriate patient care increase the quality and duration of life.
What is frontotemporal dementia?
It is called the disorder due to progressive loss of nerve cells in the frontal area of the brain, in the areas behind the forehead, or in the temporal area, in the areas behind the ears. There are also types of frontotemporal dementia. Behavioral variant frontotemporal dementia, primary progressive aphasia, motor impairment function are among them. Frontotemporal dementia patients often experience noticeable changes in relationships, personality, and behavior. Language skills, speaking, writing are affected. Individuals may not be able to understand spoken sentences. Changes occur in muscle or motor functions. There may be muscle weakness, difficulty walking. Frontotemporal dementia treatment is a wonder. However, there is no method yet to stop the course of this disease. Good care, activities, diet, sleep patterns, stress management can be positive for this disease.
What is dementia with Lewy bodies?
It is the second most common type of dementia after Alzheimer’s disease. Dementia with Lewy bodies develops as a result of an abnormal protein accumulation that prevents normal cell communication and disrupts neural regeneration. Its symptoms may overlap with Parkinson’s. Hallucinations are common. The rapid development of symptoms is one of the indicators of this problem. Blood tests, vitamin B12, thyroid functions should be checked. It should be investigated by neuroimaging methods. The cause of this problem is not yet known.
What is vascular dementia?
Vascular dementia caused by damage to the vessels that supply blood flow to the brain, cerebral hemorrhage or strokes due to vascular occlusion may occur due to amyloid accumulation in the vascular wall (Amyloid Angiopathy). Sometimes complaints can appear suddenly after a stroke and tend to progress over time.