Dementia: The memory loss gone wrong

What is the definition of dementia? (This is the understanding - as per www.dementia.com) "Dementia is a decline in mental abilities or cognitive functions such as memory, language, reasoning, planning, recognising, or identifying people or objects. This decline is beyond what might be expected from normal aging". Dementia is marked by a gradual impoverishment of thought and other mental activities that eventually affect almost every aspect of mental life. The goal of a diagnosis is to eliminate any other possible condition (reversible or irreversible) that could be creating dementia-like symptoms. For instance, it is important to make a distinction between dementia and depression.

"I ’ve taken four tests for dementia. I suck at drawing clocks and I have a horrible memory.Part of my brain continues to work. Doctors tell stories and I remember them. My brain is working sort of…. so doctors have scheduled more tests for me. I’m convinced that people diagnosed with dementia should keep fighting. my dementia is getting worse but this demon is moving really slowly. Maybe I have more to say. I listen to my body and respond. I work out. I fall down. I have no idea the name of people I should know their name. I sleep a lot and then climb back into the ring called life. I may get my ass beat but it will be a long fight".

Dementia is a symptom characterized by deterioration in memory, orientation, judgment and other intellectual functions. Dementia is very common in elderly people. However, even young person may suffer from dementia due to various reasons. Thus, addressing it becomes very important. Dementia is memory loss that occurs in the hippocampus and frontal cortex. 

The brain damage is from plaques accumulating in critical parts of the brain. Medication is introduced to "eat" those plaques (mostly tau and amyloid plaques) which are then excreted in urine. Over time, the plaques continue to accumulate first destroying STM and finally LTM until the damage is significant enough to begin to shut down homeostasis.

What is important to understand is the negative behaviors are not "on purpose". No, they are not doing it to aggravate you. Arguing with a person with dementia is like talking to a brick wall and only results in escalation. Walk away, get everyone out of their sight (at this point they do not have peripheral vision) so is easy to keep an eye on them. Wait 5 minutes, without stimulation, they will forget. Re-enter the situation and smile at them and they have already forgotten being upset. There are multiple types of dementia with the most prominent being Alzheimer's and Lewy Body and vascular dementias. Even children can get dementia typically due to infections and rarely live until adulthood. There is no age limit. Be kind to those who struggle with dementia of any kind. Get help from others.

"In my father's case, dementia was an exacerbation of his personality. He couldn't remember things he never did remember, was obsessive but always had been, asked the same questions many times but was always soothed by repetition. I read a NYT article about analysis done on Reagan's speeches to determine when his dementia began. I wonder if behind a fragile layer of social grace we are born demented. I wonder if it's part of our composition instead of something that arrives. Maybe it's incurable because you can't cure who you are". 

Dementia is not a disease in itself. The word dementia is used to describe a group of symptoms including problems with: Memory loss, Communication & language, Planning & problem solving, Ability to focus, Reasoning & judgment, Visual perception, A decline in judgment and understanding, Confusion, Mood changes. For a person to be diagnosed with dementia, these symptoms must have become severe enough to affect daily life. As people become older they experience some cognitive changes known as ‘normal age related cognitive decline’, however these changes are barely noticeable. Some people experience greater changes which are noticeable to themselves and other but do not have a significant impact on their daily lives, this is known as ‘mild cognitive impairment’

What causes dementia? There are many diseases which cause the symptoms of dementia and each type affects different parts of the brain. This means that in the earlier stages, the symptoms a person experiences will depend on the type of dementia they have. Although the symptoms of dementia are often different in the early stages they become more similar in the later stages. This is because most types of dementia are progressive, which means that the structure and chemistry of the brain become increasingly damaged over time, affecting more areas in the brain. The person’s ability to remember, understand, communicate and reason gradually declines.

Although most types of dementia are caused by progressive diseases i.e. they are irreversible and will get worse over time, the symptoms of dementia can also be caused by reversible conditions which don’t inevitably get worse over time and where recovery is possible, such as a B12 deficiency or brain tumour. How many types of dementia are there? There are a number of diseases which cause dementia, including: Alzheimer’s disease is the most common cause of dementia. Vascular dementia. Mixed dementia. Dementia with Lewy bodies. Frontotemporal dementia . Many other rarer forms of dementia. It is possible to have more than one type of dementia at the same time. Is Alzheimer’s and dementia the same?

Alzheimer’s is one type of disease which causes the symptoms of dementia but there are many others. So one person’s dementia symptoms may be caused by Alzheimer’s but another person’s dementia may be caused by another disease such as dementia with Lewy bodies. Dementia is a symptom of a disease process. We've started using it as a diagnosis, but that doesn't make it any less a symptom of some disease process. The same way 'fever' is a symptom of influenza, 'dementia' is a symptom of a disease process. Dementia is a sustained and continuing cognitive loss. A stroke can cause cognitive loss, but possibly not dementia, because dementia is a sustained and continuing cognitive loss. Then again, if appropriate circulation is not restored, the stroke can cause dementia- continuing cognitive loss.

Unlike the symptom 'fever', there are many different types of dementia with varying causes and damage. Many people believe all dementias are "Alzheimer's", but that isn't true. There's classic Alzheimer's, Alzheimer's type, vascular, mixed, Lewy Body, Jakob-Kruetzfeld, frontal lobe, alcohol-induced, hypoxia-induced-- there's many different types and causes. The hallmark symptom is that the cognitive loss is sustained and continuing.