Dementia

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Introduction

According to WHO, dementia is a syndrome associated with memory deterioration and thinking. This will ultimately affect your daily productivity. When your cognitive abilities are at a decline at a greater pace and you can’t keep a sincere follow up then you are suffering from dementia. But it was just an easy explanation to give you a better insight. It is associated with forgetfulness and is a symptomatic condition revealing underlying diseases and brain disorders. 

About 47.5 million people suffer from dementia at the existing time according to the research. This is not a singular disease but is associated with several symptoms relatable with memory, communication, and thinking. Alzheimer's disease contributes most to dementia making about 60-70% of patients total. Dementia is not just an own-hold disease. It affects others as a whole and has a significant social and economic impact. 

As in a syndrome, it progresses gradually and leaves the patient to its worst. There is profound cognitive deterioration leading to an inability to process thought procedures. It affects memory, thinking, orientation, calculation, and comprehension. A person doesn't lose consciousness but gets unorganized and impaired by deteriorating key figurative timelines. 

Dementia is always accompanied by a lack of awareness, knowledge, and understanding and such patients demand special care and attention. It results from a variety of diseases like brain injury, Alzheimer's disease, and stroke. 

Stages of Dementia

The effect of dementia on every individual is significantly different. It depends on disease severity and the person’s personality before he gets ill. The associated signs and symptoms are better to understand when classified into stages. 

Early Stage 

These stages are rather taken non-seriously gradually converting to mild and severe forms of dementia. Treatment at an early stage is rather easy than monitoring it at the late ones. The symptoms associated with this stage are the elementary ones as stated: 

  • Easy to forget things and won't be able to remember things that took place in the earliest day. 
  • Inability to manage time slots and always missing it. 
  • Shows unfamiliarity with the known places and faces as well. 

Mild Stage

As dementia progresses it starts showing some deliberate symptoms. This is demarcating the basic progress has now changed into something severe than the earlier one. The key symptoms include: 

  • Unfamiliarity with the recently taken events and known faces. It causes a great amount of social distancing between the patient suffering from dementia and society. 
  • The person feels lost at home. 
  •  A communication gap is created. 
  • They need extensive help with their personal care. 
  • This may even cause them to be nostalgic bringing changes in their behavior. 

Late Stage 

It's merely the abrupt situation leading to complete dependence and the immense shattering of thought processes. There are serious disturbances associated with this plan and show severity and versatility with the associated signs and symptoms. These symptoms include:

  • They always feel they are in short of time leading them towards an inability to carry out the prior task effectively.
  • They always show unfamiliarity with time and place. 
  •  They need large amounts of self-care. 
  • Behavioral changes are now more pronounced and can be felt extensively. 
  • Inability to recognize close family members and relatives
  • Experience ataxia and gait movement. 

Causes of Dementia

There are innumerable causes associated with progressive dementia. These are hypothyroidism and vitamin B12 deficiency the most. Lyme’s disease and neurosyphilis can also lead to dementia which is caused by the microbes. Alzheimer's disease is mainly associated with word distorted leaving a loss chain of thoughts impeding the critical formation of the brain’s part. Vascular dementia accounts for 20% of the cases associated with dementia. It may also be associated with Parkinsonism which is associated with tremors. 

Signs and Symptoms

As discussed, there are innumerable symptoms associated with dementia, and understanding each one of them is necessary to understand and to make a distinct clinical diagnosis of the case. 

  • Memory loss - the patient and the patient’s caretaker are going to bring the physician's notice to the fact that the person inquires about the same thing frequently. 
  • Problem communicating - the patients are always short of words and don't know what to speak out creating a great barrier. 
  • Difficulty in completing familiar tasks - The patient suffering from dementia is usually not able to recognize familiar faces and places leading to more difficulty. 
  • Disorientation - The oriented tasks are rather compromised. Forget the order usually and get lost in something that happened earlier. 
  • Problems with abstract thinking - they are having problems dealing with money. 
  • Mood changes - sudden changes happen with the mood which is unexplanatory. 
  • Personality shift - Such clinical conditions can cause personality shifts.  

Different Types of Dementia 

Neurodegenerative disorders can lead to dementia which is the progressive and irreversible loss of neurons. There is no definitive cure for these disorders. The relatable disorders are called: 

  • Alzheimer’s disease - is a progressive disorder associated with tangling and accumulation of certain proteins leading to deteriorated cognitive abilities. 
  • Frontotemporal disorders - It is collective damage to frontal and temporal lobes of the brain that leads to brain atrophy due to neuron death. 
  • Lewy body dementia - it is associated with abnormal protein deposition namely alpha-synuclein and Lewy bodies. It's the commonest dementia interfering with the production of brain signaling molecules. 
  • Vascular cognitive dementia - VCID arises from stroke and vascular injuries of the brain that affect memory and thinking. Cognitive function affected is directly proportional to the amount of damage taken place. 
  • Mixed dementia - It's a combined effect of dementia adjoining two different types like people can have both Alzheimer's disease and vascular dementia at the same time. It's the most common form of dementia in elderly people. 

There are certain medications and cerebral accumulations that can lead to dementia. Other problems include excessive use of antihypnotic and sedative medications affecting the brain adversely. Depression and stress can also lead to neuronal degeneration at a greater front. Certain vitamin deficiencies are associated with such causations. Moreover, too much alcohol intake can cause similar damage. Hypoactive, Hyperactive, and mixed delirium which is a state of immense confusion and perplexity can lead to such neurodegenerative disorders. 

Conditions that have Dementia like Symptoms 

Few of the disease shows similar symptoms as of the patients of dementia. These notable conditions include 

  • Argyrophilic grain disease 
  • Creutzfeldt-Jakob disease 
  • Huntington's disease 
  • Chronic Traumatic Encephalopathy
  • HIV associated dementia 

Diagnosis of Dementia 

There are just a few tests to make a definitive diagnosis of dementia. The diagnosis is overall symptomatic, and physicians diagnose this by taking a precise medical history, physical examination, laboratory tests, and day to day behavioral changes. The specific diagnosis is made by neurologists. 

To diagnose this condition, neurologists assess normal thyroid function, normal hydrocephalus pressure, and vitamin B12 deficiency that induce cognitive difficulties. A diagnosis of dementia needs to take some key steps: 

  • Medical History: A person’s medical history is to be taken. This includes taking genetic profiles of a family history of dementia. It too includes symptom assessment and its changes and certain medications that worsen with time. 
  • Physical examination: It's about measuring blood pressures and other vitalities that may lead to a definitive diagnosis of dementia. 
  • Neurological tests: It's about assessing balance and sensory response. Certain reflexes are also checked. It too includes an assessment of cognitive functions. 

Risk Factors associated with Dementia 

Many factors are closely associated with dementia. These factors are: 

  • Age: it can be a greater risk factor once someone crosses their 50s. Dementia is not solely associated with aging as it can even occur with younger patients. 
  • Family history: Genetic inputs are causing and putting in the elementary risk that a person could develop. Certain genetic mutations can lead to major degenerative changes. 
  • Down Syndrome: People with such DNA diseases are also diagnosed with early Alzheimer's diseases. 
  • Diet and exercise: People with a healthy lifestyle and those who exercise regularly account for the health of the blood vessels. This won't impede the blood flow and will not lead to vascular dementia. A Mediterranean rich diet including whole grains and rice are known to reduce the incidence of the disease. 
  • Depression: Dementia is when a person is unable to feel small life happiness associated with him and his loved ones. Constant integration will eventually lead to dementia in the long run. 
  • Alcoholic intake: Large amounts of alcohol is merely a greater inductive point in many neurological conditions. 
  • CVS risk factors: Hypertension and cholesterol can adversely affect the vessels depositing lipids in the vessel walls. This can lead to atherosclerosis and choking of the vessel's mouth leading to abrupt blood supply interfering with the memory stores. 
  • Diabetes: Uncontrolled diabetic patients of both type I and II can get associated with these diseases. 
  • Smoking: The carcinogenic and nicotinic constituents are known to create profound effects on mental health creating far more insights for the same disease. 
  • Sleep apnea: It is also known to have a close association with dementia. 
  • Vitamin B12 Deficiency: Low vitamin D, B-6 and B-12 increases the risk of the same disease. 

Tests for Definitive Diagnosis of Dementia 

The following tests are made for definitive diagnosis of dementia: 

  • Cognitive tests: Assessing memory through different tests. Check for problem-solving and language skills. Certain personality tests are made like the Myers Brigg Type Indicator. 
  • Laboratory Tests: Test for different levels of hormones in the person’s body. These especially include the concentration of thyroid hormones and Vitamin B12. 
  • Brain Scans: These are assessments of other clinical conditions like stroke and tumors. These are ascertained through CT scan which is X-ray imaging of the brain and related organs, MRI which is getting the detailed imaging of the brain structures and its tissues and PET which gives precise detail of brain activity. 
  • Psychiatric evaluation: It will determine depression and other mental health conditions taking part in the unprogressive mental health condition of the patient suffering from dementia. 
  • Genetic Tests: These are detrimental diagnoses of defective genes existing within the person’s genome. 

Importance of Diagnosis

Early diagnosis is closely related to slowing the progress of the disease. This will reduce the problems the patient will encounter. Though there is no certain treatment option slowing this gradual process can help your patient escape from drastic situations he might encounter in the later part of life. 

The right treatment at the right time is such a support system for these patients on Earth. This will even let people form a precise future evaluation at an early stage. 

Treatment of Dementia 

There is no such cure for dementia. Donepezil, cholinesterase inhibitors are beneficial in mild to moderate diseases. A nice caretaker can help improve the condition to a greater deal with strategic influence. Cognitive and behavioral interventions are taken at a greater front. Memory inclination is narrowed down by showing them the earlier photographs and memory products to help the patient recognize the memories associated with it. Daily activities are rather organized to bring about a greater change. Behavioral distortion is treated with antipsychotics. This class will help fight depression and stress at the same time. 

Prevention from Dementia 

Certain factors fasten up the rate of dementia. Monitoring these closely can notably slow down the disease progression.  Early education about dementia and its associated risk will alert people at a greater front and even instigate them to see a doctor if they find some hidden symptoms associated within. Certain conditions like hypertension and diabetes should be treated to prevent accustomed conditions underlying with it. The risk can be reduced by adopting a healthy lifestyle. 

To improve the diagnostic condition computerized cognitive training may be carried out to improve memory with time. This acts as supplementary treatment not particularly referring to the elimination of the disease. A strict gluten-free diet can aid better management of the disease. 

Keeping the mind active through proper integration and keeping oneself socially and physically active helps prevent the disease a lot. 

Associated Complications 

It's not associated with memory stance but may show key adverse effects on other parts of the body as well. These include a wide array of functional abnormalities that may arise by a gradual progression of the disease. People may stop eating or they may even forget the taste associated with the food. This will prevent them from getting a wholesome balanced diet affecting them.

Moreover, this will eventually diminish their power of swallowing leading to tracheal choking and then to progressive pneumonia. Adding on, these patients are not capable of carrying out their basic self-relatable tasks like their basic cleaning tasks and their regular chores. Even, they may face day to day challenges with their safety issues. They may run into fire beyond acknowledging its health effect.

They may even jump into a swimming pool without getting themselves to the point that they cannot swim. Such conditions can eventually make their lives harder and will lead to coma and death in later stages. Prompt and early treatment can be a common life-saving hack for individuals. 

Summary

Dementia is a memory disorder associated with a progressive decline in a person’s memory. It is usually seen in old age. 

The symptoms of the disease are divided into three stages; early, middle and late stage. As the disease progresses from one stage to the other, the symptoms worsen, and the patient becomes more forgetful. He often forgets daily life things and is unable to keep a record of daily activities. The quality of life is severely affected. 

Dementia can be caused by several factors. It can occur in some brain disorders like Alzheimer’s disease of Lyme’s diseases. Deficiency of certain nutrients can also cause dementia for example Vit. B12 deficiency etc. 

Major symptoms that are seen in this disorder are memory loss, disorientation, problems in communication, and abstract thinking as well as mood changes. 

Dementia can be divided into different types based on its root cause. 

Some other diseases like Huntington’s disease also have dementia-like symptoms. 

The diagnosis of dementia is based on medical as well as personal history. The history of neurological development in childhood is also important for diagnosis. Different cognitive tests, as well as brain scans, are also
performed for diagnostic purposes. Early diagnosis can slow down the progression of the disease. 

Dementia is associated with different risk factors like age, family history, diet, Down’s syndrome, etc. 

Management of dementia involves providing better care to the patients. Cognitive and behavioral therapies can improve the quality of life of individuals.certain drugs can also be used for the management of such patients. 

Some complicated problems are also seen with dementia as mentioned in the article. 

 References

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