The Dirty “D” Word- Dementia

Everyone hates that word, especially if it is being used to describe yourself or a loved one. But the reality in the US is that 5% of adults over age 65 have some form of dementia. That number doubles every 5 years after age 65 resulting in 50% of adults over age 80 having this disease. There are many different kinds of dementia but we will focus on the most common ones in this article. Some of the common types are Alzheimer’s, Lewy Body Dementia, Vascular, Frontotemporal dementia and Parkinson’s dementia. All types affect 3 areas of the brain; language, memory, and decision making. 

Alzheimer’s Dementia is the most common type accounting for 60-80% of all kinds. About 5% are adults ages 40-50. AD is characterized by brain cell death and the accumulation of amyloid plaques. It causes memory loss, confusion, mood changes, and will result in the person being unable to perform any task including swallowing, using the bathroom,walking and talking. Alzheimer’s dementia patients tend to wander and are at highest risk for getting lost outside the home. 

Lewy Body Dementia is caused by protein deposits in the nerve cells called “Lewy bodies”. The deposits interrupt the chemical messages in the brain causing memory loss, disorientation, tremors, sleep disturbances, visual and auditory hallucinations. Hallucinations tend to be hearing music or seeing animals and children. Adults ages 50 and older are at highest risk and one of the early symptoms are difficulty with movement. 

Vascular Dementia is the second most common accounting for 15-20%. It can be caused by a multitude of issues like strokes or hardening of the arteries. The brain is receiving a decreased amount of blood flow into the outer cortex. This results in confusion, trouble completing tasks, concentrating, and can include visual problems and hallucinations depending on which parts of the brain are affected. Patients with vascular dementia will function better with blood pressure on the high normal side due to the increased blood flow into the brain. 

Frontotemporal Dementia includes several types, all involving the front and sides of the brain which control language and behavior. It can occur in patients as young as 40 and may present as a loss of inhibitions, motivation, and compulsive behavior. There is no known cause and can be familial. 

Patients with Parkinson’s Disease can also develop dementia with paranoia, speech difficulty, depression, problems reasoning and frightening visual hallucinations and delusions. They can be very challenging patients to treat and some of the drugs for PD can actually make the hallucinations worse. 

Many people are not open to discussing early symptoms with their doctors and this is a big mistake. There are multiple medications to treat and manage dementia but they are most effective when started early. If you are having symptoms don’t be afraid to speak to your doctor about it. Any of the precious memories our brains hold are worth it.