What is dementia?
(Excerpted my book, "Who Stole My Mother? An insider's view of dementia")
The word ‘dementia’ comes from a Latin root word of ‘mens’ which means the mind. The term mens was used in describing a persons thinking and mental ability. The Romans used the term in referring to a person’s thinking. Someone’s thinking would be considered either ‘sound’ or sanus or unsound which is insanus. The terms referring to the soundness of the thinking were added to the term mens. So a person who was thinking soundly was described as ‘mens sanus’. The word ‘dementia’ is composed of de + mens literally means the ‘not working mind’. The addition of the prefix de also conveys a deteriorating type of not working. This same prefix is used in destruction, decompose and defile which are words that convey the idea of stopping but also have the additional tearing down aspect of taking away, breaking down and making worse. So it is not just that brain stops working, it is growing worse.
In the 19th century the term was used in combination with the major symptom experienced. Terms like “dementia paranoides”, “dementia praecox” and “pre-senile dementia” were used. The diagnosis of dementia was given to conditions that were deemed incurable and deteriorating. Physicians also made a distinction between dementia and amentia (feeblemindedness). Dementias were often associated with senility which were seen as part of old age.
The term is now used in describing a group of disorders that share the common feature of thinking and memory problems. Although several types of disorders are put in the ‘dementia’ group, they share in common difficulties with thinking and memory. What this means is that word ‘dementia’ is used in categorizing many different disorders.
With dementias, the initial diagnosis is often made based on symptoms presented. Obtaining specific diagnoses is often not possible until a thorough examination of the brain and all its tissues can occur. Alzheimer’s, severe head trauma, Parkinson’s disease, Pick’s disease, Creutzfeldt-Jakob disease, strokes, and Huntington’s disease are all considered types of dementia. There are also dementias related to drug use, advanced HIV infection, and heavy metal poisoning. Many of the disorders currently classified under dementias are considered treatable. The medications focus on dealing with the symptoms of the disorder. Medications are available to slow down the effects and symptoms associated with dementia. Since some of the medications are expensive, there are often debates over which medications are the treatment of choice for dementia patients in nursing facilities.
Each of the dementia disorders may show different symptoms, depending on which part of the mental functioning is affected. One of the key symptoms is memory impairment. Memory impairment is not simply forgetting things or people. To be considered a memory impairment, the person has difficulty learning new material, forget where they are, important dates, the identity of family members, previously learned material or leave stoves on.
Since many factors can influence memory, it is important that when there is a question about the possibility of a dementia being present, that a professional be consulted. Sometimes family members are over zealous is thinking that any kind of memory impairment is automatically dementia. Since memory loses may be due to many factors, there are many things to consider. Health care professionals who are experienced in this area know what to look for in telling the difference between age-associated memory impairment and dementia.
In addition to memory problems, dementia also contains deficits in other areas. Some of these include, aphasia (difficulty producing the names of people or objects), apraxia (difficulty executing motor skills, which they had previously mastered), agnosia (difficulty recognizing or identifying objects), and impaired executive functioning. (Executive functioning refers to a person’s ability to think, plan, sequence, and initiate behaviors).
Once the healthcare professional assesses a person with dementia, the difficulties are not over. With many families, once a family member receives the diagnosis of dementia, effort is made to shift the responsibility of care to a facility. The diagnosis of dementia is often taken to mean, “they will need extra care, which we are not able to provide”.
In cases where the family is willing to care for the person with dementia, there are many challenges. The next challenge is assessing what the dementia is due to. Knowing what caused the problem is key in treating the situation. Knowing the areas of mental functioning that are effected is also important in finding care for the person. It amounts to the question, “I know we are dealing with a dementia, now what?” The ‘what’ is important in knowing which kind of treatment is needed to meet the needs of the patient.
The prevalence of dementia depends on its etiology (origin). It most often occurs later in life, with the highest occurance being 85+ years. It is an organic disease characterized by progressive deterioration of mental functioning.
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