Facts About Dementia, a Neurodegenerative Syndrome
I have been learning about dementia more and more the last couple of years as it has really affected my family. My father is currently struggling with it, at an age that really surprises me. He seems way too young to be struggling with this the way he is, and it has really affected his whole life drastically. We hear so much about Alzheimers, and the word dementia can mean a lot of different things to different people. I think the more that we know about such syndromes or diseases, the more we can work through them and help to even cure them for future generations. My father lived a fairly healthy life, and to look at him just a couple years ago he looked to be the picture of health. He was very active and stayed in shape though he didn't always steer clear of alcohol and tobacco. Can alcohol and tobacco have an effect on your brain to this degree, or is it just genetics? From what I know, no one else in the family has suffered from dementia. So you can imagine my questions on this. (Update 12/10, My father has been diagnosed with Alzheimer's Disease, and Frontal Lobe Atrophe Component.)
Alzheimer's disease is the most common form of dementia (at this time, things can change as more studies are done), and may account for up to two thirds of the cases of dementia. By no means is it the only reason a person can get dementia. The good news with my dad, is that he seems at peace for the most part and happy. He doesn't seem to be fully aware of all that is even happening to him. I am thankful that it is not worse than it is.
Find out more about Dementia
Dementia is a Syndrome
As stated previously, there are many other causes of dementia though Alzheimer's is the one we most often associate with it and for good reason. Dementia refers more to a clinical syndrome that has observable patterns and features. It is not a disease itself, but a manifestation (or partial) or associated with many other underlying diseases. For example, we may experience a stomach ache, or headache which can be more of a symptom of any number of other things going on inside our bodies. If you were to "fix" the other cause, then the other aches wouldn't be present. So the more we learn about what the things are that cause dementia, the better it can be treated. I find myself saying that I just can't believe there isn't more research that has been done for these neurodegenerative disorders that are killing people. I guess we all have grown accustomed to hearing about a big problem, such as heart disease, or cancer, then proceeding with a course of treatment. So it seemed hard to hear about this dementia with my father, but even worse to hear is that there really isn't much that can be done to save a person's life from it. You can medicate them for all the symptoms, but there isn't really a cure or course of treatment. This really surprised me. I know that in time however, this will likely change and much is already being done to try to learn more.
A side note or observation on my part, is that we see so many people campaigning or going on walks or having drives for things like breast cancer or heart disease and many other things. We also see these things have the most research done for them! So it makes sense to say that those efforts are invaluable in regards to saving lives over time. I hope people realize how much money has gone into the research and that has really helped very likely. Money fuels so much, and this is no exception. I hope our communities never stop trying to find cures for the things that are taking life right now.
So, now we know dementia is more of a syndrome and not a disease and I am just as guilty of referring to it as a disease or saying something like, "He has dementia." Technically, it isn't an adequate diagnosis, and we need to try to determine the cause and investigate things appropriately. As a syndrome, there is marked impairment of brain function with dementia. It can be more localized at first, then become more widespread in the brain as the syndrome progresses. There are many different combinations of impairments and can include many or any of the following: memory for events, and memory for understanding of facts, reasoning, language, thinking and the general perception of the world. Understanding a patient's combination of cognitive impairment is very critical and was especially helpful before the days of good imaging say with MRI's and CT's. It was (and still is) critical to understand if the problem in the brain was more localized or widespread. So in that area of imaging we have come very far and thank you to all the researchers and inventors out there that help to make all of these things possible!
As we know, particular parts of our brains control specific things in our lives. Remembering day to day things or events, for example, is very dependent on our hippocampus. This is found on the inside of our temporal lobes. A different area such as the cerebellum helps us to keep balanced so that we can do things like stand, then walk, run and move our arms. We see impairment come on and we can fairly conclude which parts of the brain are being affected. This is the heartbreaking part of watching a loved one struggle with these things.
A woman shares some initial symptoms of dementia
More information about Dementia
Dementia occurs in people between the ages of 40 and 70 years old, so it can include some fairly young people. It affects both the frontal and temporal lobes of the brain. There is a loss of nerve cells when one has dementia. There are no amyloid plaques, and the tau protein "tangles" can be seen but are different from Alzheimer's tangles. You can observe varying personality changes from apathy to hyperactivity. You may observe a loss of empathy towards others in the person with dementia and maybe even lack of proper social conduct. There is sometimes difficulties with language, and there may be compulsive eating or other oral fixations. Repetitive actions are not uncommon in a person with dementia. Keeping them active, and paying attention to what they enjoy and allowing more time for those things are good. My dad loves to read a lot, and will read anything that is laying around. I think this is good to have plenty of reading materials, including coffee table books with both information and lots of great pictures. When I took my dad to the bookstore, he was very interested in one Italian cookbook which I bought for him. He loves to be with the family whenever he can.
What we see now, and what is on the horizon?
In patient it can be determined whether a tumor, or a stroke or something like Alzheimer's disease is to blame, by noting how quickly the onset of the problems are arising. Add to this the observations of how widespread the problems are. We have all heard about how a person with a stroke can lose their speech as if overnight, for instance. These things and the imaging that can be done help us so much to narrow down the exact area of damage. A person with Alzheimer's disease will have more widespread damage over the brain, usually. It is a good thing that definition of dementia has been made more precise over time.
More than one cognitive domain in the brain needs to be involved for it to be dementia. However, in particular, memory and remembering day to day events (or episodic memory) needs to be affected for dementia to be the "thing" that is happening. As dementia progresses, you will see the problems worsen. As of right now, there are some medicines out there that sometimes claim to help "slow down" what can be fairly rapid progression of dementia. The goal of the future is to have earlier diagnosis of dementia which seems kind of hard because a lot of us have day to day forgetfulness and other things going on which can be affected by things like lack of sleep or hormones, etc. So we simply, usually just brush such things off and probably rightly so.
Some specialists are suggesting we move away from the term "dementia" (which can mean so many different things) and try to focus more on specific cognitive impairments and their relationships to possible underlying diseases. I am looking forward to finding out more about all of these things, and I hope the research steadily increases so that we can help people not have to have decreased quality and length of life. If you are interested in researching more on all of this, i would suggest also looking into Frontotemporal Dementia, or FTD. There has been some great things written on this kind of dementia in particular that I know of. This can be especially helpful to the caregivers of a person struggling with dementia.
A short film on Dementia (this made me cry)
© 2010 Paula
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