Is Your Loved One Suffering From Dementia?
Learn about the various types of dementia, how doctors diagnose it, and how to get help if you suspect your loved one is suffering from dementia.
Dementia is not a fun topic. In fact, you may not even want to talk or hear about it. It may bring on unsettling feelings of sadness and concern. However, as people live longer and longer, it is a grave reality for many. In fact, as the large population of baby boomers starts to age, we will likely encounter more dementia in our loved ones than ever before.
About a fifth of the population currently suffers from dementia, with most of them experiencing Alzheimer’s dementia, specifically. It is the 6th leading cause of death in the U.S, requiring a good deal of resources and coordination of care and time from loved ones, family members, and health care teams.
If you suspect a family member may be suffering from this potentially debilitating medical condition, make sure to read or listen on.
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What Is Dementia?
When screening patients for dementia, it’s usually an issue that is first brought to my attention by a family member because most patients with dementia don’t even realize there’s a problem.
Dementia is a progressive disorder; that means that it gets worse with time. It is a deterioration in overall intellectual ability that also interferes with the person’s ability to function in social and occupational roles. It’s really uncommon to find dementia at age 60, comprising only about 1% of the population. But by age 85, it can reach a high of 30% to 40% prevalence.
Symptoms of Dementia
Here are some areas of intellectual ability that patients with dementia can have trouble with:
- Learning/retaining new info: Repeating things, trouble remembering recent events, frequently misplaces objects.
- Handling complex tasks: Trouble following a complex train of thought or performing tasks that require many steps (such as managing their finances or cooking a meal).
- Reasoning ability: Unable to respond with a reasonable plan to problems at work or at home (for example, knowing what to do if the bathroom is flooded).
- Spatial ability and orientation: Trouble driving, organizing objects around the house, finding their way around familiar places.
- Language: Increasing difficulty finding words to express what they want to say.
- Behavior: Appears more passive, less responsive. More irritable, more suspicious.
- Miscellaneous: Fails to arrive at the right date or time for doctor appointments; has difficulty discussing current events in their area of interest; sharp changes in behavior or dress.
Initially, most patients begin to show signs of dementia by having difficulty with more complex tasks, such as handling finances. They may have difficulties paying the bills on time or balancing their checkbook. Short term memory is often affected in early dementia as well – they may not be able to recall a recent event or conversation, but older memories from the past are crisp and clear.
Later in the progression…
…patients have difficulty handling basic activities of daily living, such as getting dressed and eating, and eventually difficulties with toileting. They also eventually develop difficulty remembering people, even important ones in their lives. This more than anything leads to the greatest amount of heartbreak for family members, as you can imagine.
Various Types of Dementia
Alzheimer’s is by far the most common type of dementia and does have a hereditary component. However, there are a few other types of dementia we see in patients:
- Vascular Dementia: Comprises about 10% to 20% of dementia cases and is caused by plaque build-up in the vessels of the brain. This is more common in those with a history of heart disease or stroke.
- Lewy Body Dementia: Specific protein deposits in the brain called “Lewy Bodies” are found. They’re the key defining feature of this type of dementia. Visual hallucinations are more common than in Alzheimer’s.
- Parkinson’s Dementia: Occurs in those with a history of Parkinson’s disease. It often progresses more rapidly than Alzheimer’s.
- Alcoholic Dementia: More prevalent in patients with a history of heavy alcohol intake and/or alcoholism.
- Frontal Lobe Dementia: Imaging studies may show most changes in the frontal lobe of the brain, where personality is most affected.
How to Diagnose Dementia
It’s also important to rule out other potential medical conditions that can mimic dementia.
There are various ways to screen for dementia, however, most doctors use something called a “Mini-Mental State Examinationopens PDF file ,” which comprises of 30 questions and can be found on the internet to administer to your family members if you choose to. The major issue with this test is education level – those who have a lower education level may score lower than they otherwise would, and those with higher education levels can score higher than they really should.
There is also a special “clock drawing test” that assesses organization and planning and can also be found online. Experts don’t agree on how to score it, however. Therefore, it’s either often considered “normal” when drawn exactly or “abnormal” if not.
It’s also important to rule out other potential medical conditions that can mimic dementia, such as thyroid disorder, vitamin B12 deficiencies, HIV, syphilis, stroke, depression, alcoholism, and infection. Your doctor may also order a blood test and possibly a CT scan of the brain as part of the testing, although the CT is a low-yield test for most patients.
Where to Go for More Information
Obviously, your first source of information should be your primary care doctor. Be prepared to give exact examples of your loved one’s behavior changes when first discussing this topic with your doctor. Consider these questions:
- Are they able to balance their checkbook?
- Do they ask the same questions repeatedly?
- Are they getting lost driving to places they’ve been to numerous times?
- Are they having trouble with complex activities they used to enjoy, such as cooking or knitting?
- Are they leaving the stove on?
- Are they using a shoe as a telephone?
- Are they forgetting where they live? The date? Familiar names?
- Are they hallucinating or hearing voices?
- Are they depressed?
- Are their symptoms sudden in onset, or gradual over time?
If your primary care doctor suspects a problem, they can refer you to see a neurologist. There are medications that may slow the disease’s progression, however, nothing can reverse it, unfortunately.
Resources
https://www.nlm.nih.gov/medlineplus/alzheimersdisease.html
https://www.nlm.nih.gov/medlineplus/ency/article/000739.htm
www.cdc.gov/Features/Alzheimers
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Don’t forget image courtesy of Shutterstock.
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About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
