Dementia; describes a group of symptoms that affect memory, thinking, and social skills. Dementia is not a single disease. On the contrary, there are many types. Alzheimer's dementia, the most common type, is responsible for approximately 60% to 80% of all dementias. Vascular dementia resulting from a stroke is the second most common type of dementia.
The word dementia is derived from the Latin word mens, meaning mind. Dementia means loss of mind. However, dementias, especially Alzheimer's dementia, do not occur suddenly, the symptoms appear gradually and are progressive. Some dementias occur due to a deficiency of a substance in the body or as a side effect of a substance or drug. This type of dementia is not usually progressive and is reversible.
Why does dementia occur?
The brain has many different regions, each responsible for different functions (for example, memory, judgment, and movement). When cells in a particular area are damaged, that area cannot perform its normal functions.
Dementia is caused by damage to brain cells. This damage inhibits the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and emotions can be affected.
Different types of dementia are associated with certain types of brain cell damage in specific areas of the brain. For example, in Alzheimer's disease, high levels of certain proteins inside and outside of brain cells make it difficult for brain cells to stay healthy and communicate with each other. The brain area called the hippocampus is the center of learning and memory in the brain, and brain cells in this area are often the first to be damaged in Alzheimer's disease. That's why memory loss is often one of the first symptoms of Alzheimer's.
What are the types of dementia?
Progressive (progressive) dementias can be listed as follows:
- Alzheimer's Disease: Although not all causes of Alzheimer's disease are known, experts know that a small percentage are associated with mutations of three genes that can be passed on from parents to children. While several different genes are likely involved in Alzheimer's disease, one important gene that increases the risk is apolipoprotein E4 (APOE). In patients with Alzheimer's disease, protein clumps called beta amyloid plaques and fibrous structures made up of tau protein accumulate in their brains. These clumps are thought to damage healthy neurons and the fibers that connect them.
- Vascular Dementia: This second most common type of dementia is caused by damage to the vessels that supply blood to your brain. The most common symptoms of vascular dementia include difficulties with problem solving, slow thinking, focus, and organization. These tend to be more pronounced than memory loss.
- Lewy Body Dementia: Lewy bodies are abnormal balloon-shaped clumps of protein found in the brain. Common signs and symptoms include; moving while dreaming during sleep, seeing things that do not exist (visual hallucinations), problems with focus and attention.
- Frontotemporal Dementia: This disease is a group of diseases caused by the breakdown (degeneration) of nerve cells in the frontal and temporal lobes of the brain, which generally includes areas related to personality, behavior and language. Common symptoms are behavioral and personality changes, impaired thinking, judgment, language, and movement.
- Mixed dementia: Autopsy studies of brains aged 80 and over with dementia show that many factors can coexist, including Alzheimer's disease, vascular dementia, and Lewy body dementia. Studies are ongoing to determine how the complexity of dementia affects symptoms and treatments.
What is the frequency of dementia?
According to the World Health Organization (WHO) data; There are around 50 million people with dementia worldwide, 60% of whom live in low- and middle-income countries. About 10 million new cases of dementia occur each year. It is estimated that the total number of dementia patients will reach 2030 million in 82 and 2050 million in 152 with the aging of society.
What are the symptoms of dementia?
The most obvious symptom of dementia is forgetting newly received information. Additionally, for a person to be considered demented, at least two of the following functions must be impaired:
- Memory,
- communication and language,
- Ability to focus and pay attention
- reasoning and judgment,
- Visual perception.
If you or someone close to you have memory problems or impaired thinking skills, you should see a specialist as soon as possible to determine the cause. Although the symptoms indicate an irreversible dementia; Early diagnosis allows a person to get the most out of available treatments. It also gives you time to plan for the future.
What are the symptoms of dementia by stage?
Symptoms of dementia can be classified as early stage, intermediate stage and late (final) stage.
Early stage: The early stage of dementia is often overlooked because it progresses so slowly. Common symptoms are as follows:
- forgetfulness,
- unable to keep track of time
- getting lost in familiar places.
middle stage: As dementia progresses to the middle stage, signs and symptoms become more pronounced and limiting. These symptoms
- forgetting recent events and people's names,
- getting lost at home
- encounter increasing difficulties in communication,
- needing help with personal care,
- It can be listed as experiencing behavioral changes, including wandering and repetitive questioning.
late stage: The late stage of dementia is close to total dependence and inactivity. Memory disorders are severe and physical signs and symptoms become more pronounced. Symptoms include:
- being unaware of time and place,
- Difficulty recognizing relatives and friends
- inability to do without assistance in personal care,
- difficulty walking,
- experiencing behavioral changes that can increase aggression.
How is dementia diagnosed?
There is no specific test to diagnose dementia. After a detailed clinical examination, your physician may administer a test with questions to you. If he suspects other diseases, he may order blood tests or brain imaging tests.
Is there a cure for dementia?
Most types of progressive dementia are incurable, but there are a number of ways to manage signs and symptoms.
MEDICINES
The following are used to temporarily improve dementia symptoms.
- Cholinesterase inhibitors: Some medications, such as donepezil, rivastigmine or galantamine, work by increasing the levels of certain chemical messengers that are active in memory and decision making. Although primarily used to treat Alzheimer's disease, these drugs can also be given to other dementias such as vascular dementia, Parkinson's disease dementia, and Lewy body dementia. Side effects can include nausea, vomiting and diarrhea. Other possible side effects include slow heartbeat, fainting, and sleep disturbances.
- Memantine: It works by regulating the activity of glutamate, another chemical messenger involved in brain functions such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.
- Other drugs: Your doctor may prescribe medications to treat other symptoms or conditions, such as depression, sleep disorders, hallucinations, parkinsonism, or agitation.
THERAPIES AND NON-MEDICATION TREATMENTS
- You can seek help from an expert to learn how to make your home safer and cope with changing behavior. The goal is to prevent accidents such as falls, manage behavior, and prepare you for the progression of dementia.
- Landscaping: Reducing clutter and noise makes it easier for people with dementia to focus and work. Objects that could threaten security, such as knives and car keys, may need to be hidden.
- Simplifying tasks: You need to break down tasks into easier steps and focus on success, not failure.
Can dementia be prevented?
There is no sure way to prevent dementia, but some changes in living standards can delay the onset of dementia or slow its progression.
- Keep your mind active: Mentally stimulating activities such as reading, solving puzzles, and playing word games can delay the onset of dementia and lessen its effects.
- Be physically and socially active: Physical activity and social interaction can delay the onset of dementia and reduce its symptoms. Move more and aim for 150 minutes of exercise per week.
- Stop smoking: Some studies have shown that smoking in middle age and older may increase your risk of dementia and blood vessel (vascular) diseases. Quitting smoking can reduce these risks.
- Get enough vitamins: Some research shows that people with low levels of vitamin D in their blood are more likely to develop Alzheimer's disease and other types of dementia. Vitamin D can be obtained through certain foods, supplements, and sun exposure. Although there are not enough studies on this subject, making sure you get enough vitamin D is a good choice for other health reasons. Taking a daily B complex and vitamin C can also be beneficial.
- Manage cardiovascular risk factors: Controlling factors such as high blood pressure, high cholesterol, diabetes, and a high body mass index (BMI) is important for lowering some dementia risks.
- Get your other health conditions treated: If you have hearing loss, depression or anxiety, consult a doctor for treatment of these problems.
- Get a healthy eating habit: A healthy diet is important for many reasons, but the Mediterranean diet – nutrients such as fruits, vegetables, whole grains, and omega-3 fatty acids commonly found in some fish and nuts – improves your health and reduces the risk of developing dementia. Try to eat fatty fish like salmon three times a week and a handful of nuts, almonds and walnuts each day.
- Get quality sleep: Quality sleep is important for preventing many diseases and improving the quality of life. See a specialist if you have sleep apnea or snore loudly.
If you have any doubts about dementia, do not forget to have your check-ups.
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