Dementia: Definition, Conditions In Patients, Treatment
“Dementia is a condition characterized by a progressive, irreversible decline in mental ability, accompanied by changes in behavior, personality, and, in the late stage, motor functions.” (Swartout-Corbeil, Davidson, and Atkins 430-438). Besides memory loss, most commonly the skills we use on a day to day basis are severely compromised. Dementia is a horrifying, and to some people an inescapable disease. Intellectual functioning declines overall with Dementia. This can include simple math, abstract reasoning, motor skills, difficulties with speech/language, planning and judgment, alongside memory loss. There are more than 70 distinct types of dementia, but Alzheimer’s disease (AD) is thought to be the form that is behind majority of complications. “Approximately 60 percent of dementia among the elderly in the United States and worldwide in industrialized nations is thought to be secondary to AD (US General Accounting Office 1998)” (Post 823-831).
It is important to understand the distinction between dementia, delirium, and age-associated memory impairment, due to the fact that dementia can coexist with these other conditions. Delirium is more common in elderly patients and typically a side effect of medications, dehydration, surgery, and infectious illnesses. It is a temporary state of confusion, disturbed consciousness, hallucinations, restlessness, and inability to focus. You can distinguish the two because delirium generally happens abruptly, in a few hours or days, varies in severity, and usually is worse at night. While age-associated memory impairment is a mild case of memory loss, inability to learn new information, taking longer than usual to recall certain facts, but their memory impairment isn’t as severe as someone who has dementia, and it won’t progress. The current Diagnostic and Statistical Manual of Mental Disorders specifies for an individual to be diagnosed with Dementia, they must meet a certain criterion. “One criterion is significant weakening of the individual’s memory with regard to learning new information as well as recalling previously learned information.” (Swartout-Corbeil, Davidson, and Atkins 430-438). The patient must also be diagnosed with any one or more of these conditions: aphasia, apraxia, agnosia, or complications concerning abstract thinking. These specific disturbances must also be so severe that they complicate the patients day to day life.
These conditions combined complement each other when diagnosing dementia. Aphasia can get to the point where the person no longer speaks. They may use vague descriptive words because they cannot remember something specific or repeat certain words or phrases they hear. Apraxia is slightly more complicated, a person will lack intentional movements and become incapable of doing certain things, even though they know what they want to do, even though they are not paralyzed. Agnosia is the inability to remember people or objects, even your own face in a mirror. And finally, abstract thinking, “This criterion refers to the loss of the ability to make plans, carry out the steps of a task in the proper order, make appropriate decisions, evaluate situations, show good judgment, etc.” (Swartout-Corbeil, Davidson, and Atkins 430-438).
“There are no medications or surgical techniques that can cure AD, the frontal lobe dementias, multi-infarct dementia, or dementia with Lewy bodies. There are also no treatments that reverse or stop the progression of these dementias.” (Swartout-Corbeil, Davidson, and Atkins 430-438). Although this is true, there are somethings that can be done to reduce side effects. Behavioral treatments approach problems like socially inappropriate conduct or aggression. Treatments can be made by identifying trigger situations and getting them under control by any means necessary. Home modification can assist this, you would essentially be baby proofing the house which increases safety and comfort. Covering or camouflaging doors can lessen the impulse to wonder. Long-term institutional care can be mandatory for people with dementia, as deep cognitive losses generally predate death by a generous amount of years.
How to reduce your risk of having dementia? The answer is simple, live a healthy lifestyle. Proper nutrition may prevent dementia related to nutrient deficiencies. “The diet associated with lower rates of AD was roughly the Mediterranean diet (leafy vegetables, nuts, tomatoes, fish, and fruit with little or no red meat, butter, or high-fat dairy products).” (Post 830). This information is in the least bit surprising, but once you have dementia it will only go downhill from there, so the key is to start prevention as soon as possible. Smoking and alcoholism should also be excluded from your healthy lifestyle, while incorporating more physical fitness. Dementia related to alcohol abuse can be blocked by refraining from unreasonable alcohol consumption or minimized by receiving early treatment for alcoholism. Dementia provoked by reciprocated blows to the brain/skull can be stopped by refraining from sports where head trauma is common. Unfortunately, most forms of dementia cannot be prevented.
