Dementia

What is dementia?

Dementia is a progressive condition that gradually affects the functioning of your brain, causing a decline in memory, thinking and understanding. It’s a term used to describe many different neurological disorders.

Types of dementia

There are over 200 different types of dementia. The most common types are:

• Alzheimer’s disease

• Vascular dementia

• Dementia with Lewy bodies

• Frontotemporal dementia

• Mixed dementia – When you have a combination of different types of dementia

What causes dementia?

In healthy brains, billions of nerve cells connect with one another by sending messages. If you have dementia, some of the nerve cells in your brain become damaged, and connections become lost. Dementia can affect you in different ways, depending on which area of your brain is affected.

Who gets dementia?

Factors that put you at greater risk of developing dementia include:

• Age – Dementia isn’t a normal part of ageing, but people aged 65 and over are more likely to develop it

• Family history – If someone else in your immediate family has dementia, you’re more likely to develop it, but many people with a family history of the condition don’t get it themselves

• Lifestyles factors – Factors like diet and exercise, how much alcohol you drink and smoking are all thought to increase your risk of dementia

• Cardiovascular factors – Including high blood pressure (hypertension), high cholesterol, and obesity

• Down syndrome

• Diabetes

• Head and brain injury

Dementia symptoms

Dementia is different for everyone, and the symptoms vary depending on the area of your brain that’s affected and the type of dementia you have.

Symptoms often start with mild memory loss, which can begin some time before dementia is diagnosed. At this stage, it’s often called ‘mild cognitive impairment’ (MCI).

Common symptoms of MCI include:

• Memory loss

• Lack of concentration

• Feeling confused

• Mood changes

• Losing the thread of conversations and difficulty finding the right words when you’re talking

Not everyone with MCI develops dementia, but for some people, these problems can worsen over time. Other symptoms that can develop are:

• Difficulty doing daily activities or losing interest in doing them

• Finding social situations difficult or losing interest in engaging in them

• Difficulty managing moods and emotions

• Seeing or hearing things that aren’t there (hallucinations)

• Communication problems with speech and language

• Sleeping problems

Dementia symptoms gradually become worse over time. The later stages can be distressing for people with the disease and their carers and relatives. At this stage, symptoms become more severe. Full-time care is usually needed to help with moving, eating and other daily activities, and communication skills may be entirely lost.

When to see a doctor about dementia

If you or someone you know is experiencing memory loss, it’s essential to see a doctor straight away. There are many possible causes of memory loss, but if it is dementia, an early diagnosis can help you get the proper treatment and support. In some cases, an early diagnosis and treatment can also help slow down the progress of symptoms.

Dementia diagnosis

There are many other causes of mild memory loss – including stress, anxiety and depression, certain medication and other health conditions. The GP will go through some simple procedures to rule these out first.

These procedures might include:

• Mental ability tests looking at your memory and thinking skills

• Blood tests

• Asking about your symptoms and medical history

• Talking to someone close to you about your symptoms

It’s a good idea to take a close friend or relative along to the appointment – the doctor will ask questions about how your symptoms affect your daily life, and their input can be helpful.

If the GP is unsure whether you have dementia, they’ll refer you to a specialist. This might be a geriatrician (a physician who specialises in elderly care) or a specialised memory clinic.

There’s no single test to diagnose dementia, but the specialists will carry out cognitive assessments, which are more in-depth mental ability tests. They may also recommend brain imaging like CT scans or MRI scans.

It can take several months to get a confirmed diagnosis, and this can be a stressful time if you’re having tests or supporting someone else having them. The GP can recommend information and support through organisations like Dementia UK to help you through the process and come to terms with the diagnosis.

Dementia treatment

There’s no cure for dementia, but there is a range of treatments that can help to reduce symptoms. The treatment plan will depend on the type of dementia, what stage it’s at, the signs and how severe they are.

The main types of treatment for dementia are:

• Medication – Acetylcholinesterase (AChE) inhibitors are prescribed by specialists and help brain cells communicate with each other. Other medicines that the doctor may recommend include antipsychotics to help treat challenging behaviour and antidepressants to treat depression and anxiety.

• Cognitive therapy – This can be very effective to improve memory and cognitive skills and may involve group activities and exercises or one-to-one help with everyday tasks.

• Reminiscence therapy - Involves talking about your past and life story using meaningful objects and pictures as prompts. It can be a great way to help boost your moods and emotional wellbeing.