Buzz
It is truly heartbreaking to witness a loved one fall victim to Alzheimer's disease or other forms of dementia. Dementia refers to a collection of symptoms that negatively impact memory, thinking ability, and various social functions. Nearly 11% of dementia cases are considered reversible, particularly among individuals under 65 years of age. Depression, hypothyroidism, and vitamin B12 deficiencies are common causes of dementia. While there is no cure for this condition, certain measures can help mitigate the symptoms. Early recognition of dementia signs is crucial, as it allows you to plan ways to support the patient in managing the disease's effects.
Steps
Monitor Dementia Symptoms
Assess for signs of dementia. It's normal for anyone to forget things occasionally, but people with dementia struggle to remember recent events, familiar names, or even well-known routes.
- Everyone's memory is different, and sometimes forgetfulness is common among many people. Only family members and close friends can accurately notice behavioral changes in someone with dementia.
- However, denial may occur. Sometimes, people deliberately avoid confronting the significant issues their loved ones are facing by normalizing abnormal behaviors or downplaying the situation.
- Conversely, some may become overly sensitive to dementia and react excessively to minor forgetfulness. For example, if Mrs. Nga forgets to take her medication on time, the solution may be for the doctor to adjust the medication schedule to make it easier to remember, rather than placing her in a nursing home due to dementia.
- Differentiate between normal forgetfulness and abnormal dementia. As people age, memory issues become more common. After many years of activity, the elderly brain cannot function as efficiently as it did when they were younger. However, when memory loss begins to interfere with daily life, intervention is necessary. The initial signs of dementia vary for each individual, but the most common signs include:
- Inability to care for oneself: skipping meals, overeating, neglecting personal hygiene, wearing inappropriate clothing, staying indoors, wandering behaviors.
- Inability to complete household chores: dirty dishes, unemptied trash, accidents while cooking, unkempt home, wearing dirty clothes.
- Other unusual behaviors: calling family members at 3 a.m. and hanging up, neighbors reporting abnormal behavior, sudden outbursts of anger over trivial matters.
- Forgetting your daughter's high school graduation day is one thing, but forgetting her name is an entirely different matter.
- It's fine if you can't remember which countries border Vietnam, but if you can't recall whether Vietnam is a country, that is a serious concern.
- If the dementia becomes severe enough to affect daily life, you should take them to a doctor for a more accurate assessment.
Watch for tasks they used to perform easily but now struggle with. Individuals with dementia may forget meals they've just prepared or mistakenly believe they haven’t cooked at all. Additionally, patients often face difficulties with daily activities such as dressing. In general, you should observe a noticeable decline in personal hygiene and grooming habits. If the person increasingly finds it hard to perform simple daily tasks, it’s time to consult a doctor.
Note difficulties with language. While we all sometimes need time to find the right word, dementia patients often become confused when they can't find the right words. This can lead to frustration and anger, both for the patient and the person they’re talking to.
- Language difficulties start with an inability to recall specific words or expressions.
- As the condition progresses, the individual may struggle to understand the language used by others.
- Eventually, communication becomes limited to facial expressions and body gestures, as verbal communication becomes nearly impossible.
Pay attention to signs of confusion. Dementia can cause individuals to become disoriented in terms of space, time, and context. This is not just simple forgetfulness or 'senior moments'—the confusion surrounding time and place may lead the person to not recognize where they are in the present moment.
Do not underestimate the issue of misplaced items.- Spatial confusion makes them lose their sense of direction, for example, confusing north with south or east with west, or believing they have entered their home through a different path. They may wander off and forget how they got there, unable to find their way back.
- Time disorientation shows up as actions occurring at the wrong times, ranging from minor changes in eating and sleeping patterns to more severe cases like having breakfast at midnight and preparing for bed during the day.
- Place disorientation causes the patient to confuse their location, leading to inappropriate behaviors. For instance, they may think a library is their living room and become upset, thinking someone has broken into their house.
- The person may also find it difficult to perform everyday tasks outside due to their loss of spatial orientation. This is particularly dangerous as the patient may become lost when leaving the house.
Observe their ability to think and reason abstractly. A typical person might occasionally make errors when keeping records, but someone with dementia may forget even the concept of numbers. They might also fail to recognize when a kettle is boiling, allowing the water to evaporate completely.
Monitor changes in mood and personality. While it’s common for people to experience mood swings from time to time, individuals with this condition can undergo rapid and dramatic shifts in temperament. They may go from being extremely happy to becoming enraged within moments, or shift to irritability or delusional thoughts. Often, they are aware that something is wrong, which leads to frustration. This can result in sudden outbursts, delusions, or other similar states.
- It’s important not to escalate the situation further, as getting angry will only make things worse for both parties.
Look for signs of withdrawal. The patient may lose interest in places they usually visit, activities they once enjoyed, or people they frequently interacted with. As everyday tasks become more difficult, many individuals begin to retreat. Over time, they may sink into depression and lose all motivation to do anything, whether at home or outside.
- Observe if they spend long hours sitting in one spot, staring blankly into space, or watching TV without engaging.
- Look for signs of physical decline, poor hygiene, and difficulty with daily tasks.
Compare their current behavior to what you know about them. Dementia manifests as a series of irregular behaviors and noticeable decline that cannot be diagnosed by any single indicator. Simply being forgetful doesn’t mean someone has dementia; you need to look for a combination of symptoms. The more you know about their usual habits, the easier it is to spot changes in their behavior.
Identify the Signs
Learn about various types of dementia. Dementia varies greatly in its presentation, with each patient showing unique symptoms. Generally, you can predict the disease's progression by considering the underlying cause of the dementia.
- Alzheimer's disease: A slowly progressing form of dementia over several years. The exact cause is still unclear, but amyloid plaques and tangled nerve fibers are found in the brains of those affected by Alzheimer's.
- Lewy body dementia: Abnormal protein deposits called Lewy bodies develop inside nerve cells in the brain, impairing cognitive function, memory, and motor skills. Hallucinations can also occur, leading to behaviors such as speaking to someone who isn’t there.
- Multi-infarct dementia: This occurs after multiple strokes, causing blockages in brain arteries. Symptoms may remain stable for a while, but worsen when subsequent strokes occur.
- Temporal lobe dementia: Shrinkage in parts of the temporal and frontal lobes leads to personality changes or language difficulties. This type typically develops between the ages of 40 and 75.
- Normal pressure hydrocephalus: Fluid accumulation causes pressure on the brain, leading to dementia that may develop slowly or suddenly, depending on the rate of pressure increase. MRI or ACT tests can diagnose this form of dementia.
- Creutzfeldt-Jakob disease: A rare and fatal brain disorder caused by an abnormal protein known as a prion. Prions can remain in the body for a long time before symptoms appear, but once they do, the condition progresses quickly. A brain biopsy can detect prions as the cause of Creutzfeldt-Jakob disease.
Take the patient to a doctor. If you observe a series of behavioral changes and symptoms as mentioned, it’s best to consult a specialist. In some cases, a general practitioner can diagnose dementia. However, patients typically need to see a specialist in neurology or geriatrics.
Provide a medical history. Include details on the onset and progression of the symptoms. Based on this information, the doctor will conduct tests such as blood cell counts, blood sugar levels, or thyroid hormone tests. These tests are specific to the type of dementia the doctor is trying to diagnose.
Inform the doctor about any medications being taken. Certain medications, when combined, can either trigger or worsen dementia-like symptoms. Sometimes, medications that seem unrelated can cause confusion and memory issues when taken together. This is particularly common among older adults, so it’s important to provide a full list of all medications being used.
- Common drug groups that may contribute to symptoms include: benzodiazepine sedatives, beta-blockers, selective serotonin reuptake inhibitors, tranquilizers, and diphenhydramine (among others).
Prepare for a comprehensive health check-up. A full health examination can uncover other conditions that may be contributing to dementia. Sometimes, this helps rule out dementia entirely. Conditions such as heart disease, stroke, malnutrition, or kidney failure can all play a role in cognitive decline. Identifying these factors can help pinpoint the type of dementia requiring treatment.
- The doctor may conduct a mental health assessment to rule out depression as the cause of the symptoms.
Allow the doctor to assess cognitive abilities. This process includes tests for memory, mathematics, and language skills, including writing, drawing, naming objects, and following instructions. These assessments evaluate both cognitive function and motor skills.
Consent to a neurological examination. This evaluation checks balance, reflexes, sensory perception, and other functions, with the goal of ruling out other conditions and identifying treatable symptoms. The doctor may request brain imaging to uncover underlying causes, such as a stroke or tumor. Common imaging methods used include MRI and CT scans.
Some cases are treatable, others are not. Dementia may be caused by certain treatable conditions that can be addressed with medical care, but many forms of dementia are progressive and irreversible. It is important to understand whether the patient is in a treatable situation to make future plans accordingly.
- Reversible causes of dementia include: hypothyroidism, neurosyphilis, vitamin B12/folic acid/thiamine deficiencies, depression, and subdural hematomas.
- Irreversible causes include Alzheimer’s disease, multi-infarct dementia, and HIV-related dementia.
Warning
- Some patients with dementia may refuse to acknowledge their symptoms, and their family members may exhibit the same denial.
