Dementia
Dementia
Dementia
Dementia is a syndrome characterized by gradually worsening, usually permanent, unlimited cognitive losses — emotional, intellectual, mental, and subjective —due to the gradual breakdown of brain cells. Dementia can show up in many different forms and impact a wide range of normal life activities, including simple, everyday tasks like paying bills, driving a car, shopping, doing laundry, or taking medication.
Dementia is not one solitary condition or disease but an umbrella term that covers multiple conditions like Alzheimer’s, etc. It is diagnosed in a specialist setting, usually by an older-age psychiatrist.
Delirium vs Dementia
People often confuse delirium with dementia. People with dementia can also develop delirium — they can get temporary episodes of acute brain failure. This presents challenges since the two conditions can be somewhat difficult to tell apart when looking at symptoms.
| DELIRIUM | DEMENTIA |
|---|---|
| Delirium can be thought of as acute brain failure (sudden). | Dementia can be thought of as chronic brain failure (lifelong). |
| Delirium follows a fluctuating course and is reversible. The symptoms fluctuate enough to be noticeable | Dementia keeps progressing and is irreversible. People may experience better or worse times throughout the day, but their cognitive skills and memory recall generally don’t noticeably fluctuate |
| The onset of delirium occurs in a very short timeframe, and with noticeable symptoms | Dementia starts out with symptoms that are not as easily noticed at first, and then they get worse slowly. |
| Delirium presents significantly greater challenges in relation to maintaining attention or staying focused. | Someone just beginning to experience symptoms of dementia would generally still be considered to be alert and able to focus |
Dementia is a syndrome characterized by gradually worsening, usually permanent, unlimited cognitive losses — emotional, intellectual, mental, and subjective —due to the gradual breakdown of brain cells. Dementia can show up in many different forms and impact a wide range of normal life activities, including simple, everyday tasks like paying bills, driving a car, shopping, doing laundry, or taking medication.
Dementia is not one solitary condition or disease but an umbrella term that covers multiple conditions like Alzheimer’s, etc. It is diagnosed in a specialist setting, usually by an older-age psychiatrist.
Delirium vs Dementia
People often confuse delirium with dementia. People with dementia can also develop delirium — they can get temporary episodes of acute brain failure. This presents challenges since the two conditions can be somewhat difficult to tell apart when looking at symptoms.
DELIRIUM
DEMENTIA
Symptoms of Dementia:
The clinical features of dementia include:
The symptoms of dementia may present as cognitive or psychological, and the range of symptoms and the potential severity of impact to the individual is far-reaching.
Overall, the clinical features of dementia include:
Progression of Dementia
The progression seen with dementia is not linear, and the rate of cognitive malfunction, or the severity of the symptoms, may not map to a commonly understood course. Some patients switch between the different stages. Sometimes a behavior like walking off on one’s own may appear in an early stage and later stop or reverse, but something like the impact to one’s memory will likely only worsen.
In loose terms, dementia is a general term for a mild, moderate, or severe decline in cognitive function because of abnormal changes to the brain.
EARLY OR MILD DEMENTIA
Early signs of dementia can easily be dismissed or disregarded as something else deemed less serious. Typically, the signs can be seen as what people think is normal for older people or for those who experience the loss of a loved one or are stressed or anxious. Dementia generally starts with minimal changes in behavior or capabilities, and sometimes the individual’s loved ones don’t want to believe the symptoms could be indicating, but it is progressive and in many cases irreversible.
MILD OR MODERATE DEMENTIA
In this stage, the elements mentioned in the early or mild stage have progressed and have become a greater source of impact and frustration to the individual.
In this stage, it is not uncommon to see some of the following:
Depending on the person’s age, severity of their symptoms, how close their immediate family lives, and the extent to which they are willing to provide care, it may be necessary for some to enter a facility to help give the right level of care needed on a daily basis.
LATE OR SEVERE DEMENTIA
In this phase, the impact of dementia has become extremely debilitating for the individual, and their reliance on family members or professionals has increased dramatically.
This phase can often be hallmarked by a complete loss of memory for both recent events as well as of most or all family members, and most details about their life, including their identity. The individual will often retreat into their own world and glaze over as they increasingly experience their inability to communicate, understand anything that is happening around them, or recognize anyone, including those they see all day every day.
Other symptoms of this phase include:
Diagnosis of Dementia:
Because of the range of possible manifestations, a doctor will work to identify any pattern in the reduction of cognitive skills and/or motor skills, as well as identify what skills remain intact. Additional assessments can be made through more recent advances with biomarkers — found in the cerebrospinal fluid.
For a complete assessment of the person, the doctor will combine the findings of the person’s medical history, current symptoms, and current physical exam, and (where possible) interview those closest to the patient regarding their observations of the symptoms.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for a dementia diagnosis requires:
Neurological, cognitive, psychiatric, and neuropsychological tests and evaluations will be made in conjunction with lab tests and brain scans to make a determination regarding how the individual measures against these criteria.
Dementia is then either diagnosed as irreversible / pseudo-dementia, or reversible / pseudo-dementia.
Irreversible progressive dementia
Irreversible progressive dementia includes:
The impact from irreversible dementia can be seen in permanent or fluctuating changes in personality and behavior.
Causes of Dementia:
Reversible or pseudo-dementia
Reversible or pseudo-dementia can be caused by neurosurgery, neurological infections and inflammations, or metabolic imbalances.
Of these, depression is the leading cause of reversible dementia, followed by extreme side effects of medication followed by drug or alcohol abuse. With the right treatment, some of the causes of reversible dementia or dementia-like symptoms can be controlled or reversed.
Risk factors for Dementia:
In addition to the aforementioned causes of reversible or pseudo-dementia, there are multiple factors that can increase an individual’s risk of developing dementia.
These include:
Dementia Complications:
The potential reach for dementia to impact a person’s quality of life and capacity to function normally is significant due to the potential complications from the cognitive and psychological changes they could experience. The impact of dementia can be very frustrating both for the individual and for their family members, and it can cause serious personal safety outcomes.
Some of the ways the complications can affect a person include:
Treatment of Dementia:
A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.
Functional support – from caregivers is crucial so as to maximize mobility and to encourage independence with, for example, washing, toileting, and feeding.
Therapy is an important additional non-drug treatment option for people who may exhibit behavioral issues and symptoms.
Possible therapies include:
A person’s doctor could also prescribe other medications to address hallucinations, depression, or other conditions.
Provide care for the caregiver
Being a caregiver for someone with delirium can be very tiring, and for some a potential source of anxiety. In order to look after yourself, and to remain able to give the best care, it is important to take care of yourself as well. Consider the following:
Symptoms of Dementia:
The clinical features of dementia include:
The symptoms of dementia may present as cognitive or psychological, and the range of symptoms and the potential severity of impact to the individual is far-reaching.
Overall, the clinical features of dementia include:
Progression of Dementia
The progression seen with dementia is not linear, and the rate of cognitive malfunction, or the severity of the symptoms, may not map to a commonly understood course. Some patients switch between the different stages. Sometimes a behavior like walking off on one’s own may appear in an early stage and later stop or reverse, but something like the impact to one’s memory will likely only worsen.
In loose terms, dementia is a general term for a mild, moderate, or severe decline in cognitive function because of abnormal changes to the brain.
EARLY OR MILD DEMENTIA
Early signs of dementia can easily be dismissed or disregarded as something else deemed less serious. Typically, the signs can be seen as what people think is normal for older people or for those who experience the loss of a loved one or are stressed or anxious. Dementia generally starts with minimal changes in behavior or capabilities, and sometimes the individual’s loved ones don’t want to believe the symptoms could be indicating, but it is progressive and in many cases irreversible.
MILD OR MODERATE DEMENTIA
In this stage, the elements mentioned in the early or mild stage have progressed and have become a greater source of impact and frustration to the individual.
In this stage, it is not uncommon to see some of the following:
Depending on the person’s age, severity of their symptoms, how close their immediate family lives, and the extent to which they are willing to provide care, it may be necessary for some to enter a facility to help give the right level of care needed on a daily basis.
LATE OR SEVERE DEMENTIA
In this phase, the impact of dementia has become extremely debilitating for the individual, and their reliance on family members or professionals has increased dramatically.
This phase can often be hallmarked by a complete loss of memory for both recent events as well as of most or all family members, and most details about their life, including their identity. The individual will often retreat into their own world and glaze over as they increasingly experience their inability to communicate, understand anything that is happening around them, or recognize anyone, including those they see all day every day.
Other symptoms of this phase include:
Diagnosis of Dementia:
Because of the range of possible manifestations, a doctor will work to identify any pattern in the reduction of cognitive skills and/or motor skills, as well as identify what skills remain intact. Additional assessments can be made through more recent advances with biomarkers — found in the cerebrospinal fluid.
For a complete assessment of the person, the doctor will combine the findings of the person’s medical history, current symptoms, and current physical exam, and (where possible) interview those closest to the patient regarding their observations of the symptoms.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for a dementia diagnosis requires:
Neurological, cognitive, psychiatric, and neuropsychological tests and evaluations will be made in conjunction with lab tests and brain scans to make a determination regarding how the individual measures against these criteria.
Dementia is then either diagnosed as irreversible / pseudo-dementia, or reversible / pseudo-dementia.
Irreversible progressive dementia
Irreversible progressive dementia includes:
The impact from irreversible dementia can be seen in permanent or fluctuating changes in personality and behavior.
Causes of Dementia:
Reversible or pseudo-dementia
Reversible or pseudo-dementia can be caused by neurosurgery, neurological infections and inflammations, or metabolic imbalances.
Of these, depression is the leading cause of reversible dementia, followed by extreme side effects of medication followed by drug or alcohol abuse. With the right treatment, some of the causes of reversible dementia or dementia-like symptoms can be controlled or reversed.
Risk factors for Dementia:
In addition to the aforementioned causes of reversible or pseudo-dementia, there are multiple factors that can increase an individual’s risk of developing dementia.
These include:
Dementia Complications:
The potential reach for dementia to impact a person’s quality of life and capacity to function normally is significant due to the potential complications from the cognitive and psychological changes they could experience. The impact of dementia can be very frustrating both for the individual and for their family members, and it can cause serious personal safety outcomes.
Some of the ways the complications can affect a person include:
Treatment of Dementia:
A multidisciplinary team comprised of a psychiatrist, family doctor, speech and language therapist, occupational therapist, and psychologist provide a holistic approach in the management of dementia.
Functional support – from caregivers is crucial so as to maximize mobility and to encourage independence with, for example, washing, toileting, and feeding.
Therapy is an important additional non-drug treatment option for people who may exhibit behavioral issues and symptoms.
Possible therapies include:
A person’s doctor could also prescribe other medications to address hallucinations, depression, or other conditions.
Provide care for the caregiver
Being a caregiver for someone with delirium can be very tiring, and for some a potential source of anxiety. In order to look after yourself, and to remain able to give the best care, it is important to take care of yourself as well. Consider the following: