This time around, we'll be discussing the 5 most common forms of dementia.
Remember that dementia is an umbrella term for over 100+ diseases.
The 5most common forms of dementia are:
1. Alzheimer's Disease (62%)
2. Vascular Dementia (15%)
3. Frontotemporal dementia (10%)
4. Lewy Body Dementia (5%)
5. Alcohol Related Dementia (Korsakoff's Syndrome 2%)
So what causes these forms of dementia and what are the symptoms to look out for.
Alzheimer's Disease
Alzheimer's is the most common form of dementia in the UK and is caused by changes to the chemistry and structure of the brain, leading to the death of brain cells. Problems with short term memory loss are usually the first signs of the disease at work but this can easily be mistaken at first with natural memory loss in old age, but as time and the disease progresses the gaps become more noticeable. If you can imagine the click and save function on your computer being faulty, then this should give you an idea as to how the disease operates. New memories are unable to be formed so the person with Alzheimer's relies more on long term memories to communicate.
The disease usually takes between 7-8 years from the start of diagnosis to be fully formed and as it progresses it begins to affect areas of the brain that control speech, motor skills and cognitive ability. This means that things such as getting dressed, toileting, operating a remote control and holding a conversation become more and more difficult. There can sometimes be a loss of appetite and difficulty with using cutlery that can cause eating problems, leading to weight loss and other health issues.
Due to the degenerative nature of Alzheimer's, this can cause people with this form of dementia to become depressed and withdrawn.
For more information on this visit this link www.alzheimersresearchuk.org/about-dementia/types-of-dementia/alzheimers-disease/symptoms/
Vascular Dementia
Vascular dementia is the second most common form of dementia and is caused when the oxygen supply to the brain fails due to vascular disease. This causes brain cells to die. These symptoms can occur suddenly, following a stroke, or over time through a series of small strokes.
Things to look out for are problems with planning or organising, making decisions or solving problems, difficulties following a series of steps (such as cooking a meal), slower speed of thought and problems concentrating, including short periods of sudden confusion. A person in the early stages of the disease may have problems with language, eg. speech becoming less fluent, memory, eg. problems recalling events (often mild) and visuospatial skills such as problems perceiving things in three dimensions.
Stroke related vascular dementia tends to progress in a stepped way where the person with vascular dementia will function at a certain level for a period of time before declining suddenly to the next plateau. This will be a sudden steep decline usually and then the person will function at that level for a period of time before stepping down to the next plateau.
Unlike Alzheimer's Disease, vascular dementia can start anywhere in the brain, which sometimes means it can be mistaken for other forms of dementia due to this.
As vascular dementia progresses it can cause uncharacteristic behaviour from the person with vascular dementia such as irritability and agitation. It can also disrupt the sleep pattern.
In the latter stages those living with vascular dementia can become unaware of what is going on around them and may need assistance with eating, dressing and bathing.
For more information on this visit this link https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=161
Frontotemporal Dementia
Sometimes known as Picks Disease this is a rarer form of dementia that is caused by damage to the front part of the brain. Nerve cells die and the brain shrinks. Symptoms tend to be personality and behavioural changes.
Personality changes may include the way that people express their feelings towards others or a lack of understanding of other people's feelings. They may also show a lack of interest or concern, become disinhibited or behave inappropriately.
There can also be a lack of personal awareness, that is people may fail to maintain their normal level of personal hygiene and grooming. There may also be a lack of social awareness, for instance making inappropriate jokes, or showing a lack of tact. There may be a change in eating patterns resulting in either over-eating or under-eating.
Behavioural changes may include changes to humour or sexual behaviour. People may become more aggressive, develop unusual beliefs, interests or obsessions. Some people may become more obsessive or easily distracted. They may also have difficulty making simple plans or decisions. There may also be a lack of awareness on the person's part that they have changed in any way.
There can also be a decline in language abilities. This might include difficulty in getting words out or understanding them. The person might develop repetitive speech patterns and forget the meaning of certain words.
There may also be issues with recognising people or knowing what objects are for.
One in eight people will develop mobility issues or some form of motor neurone impairment. This can be anything from muscle weakness to difficulty with swallowing. Some people will experience Parkinson's like symptoms. Although the speed of the disease differs, the average development can take up to 15 years.
For more information follow this link http://www.alzheimersresearchuk.org/about-dementia/types-of-dementia/frontotemporal-dementia/symptoms/?gclid=CjwKEAjwm_K_BRDx5o-sxq6ouXASJAC7TsFLapXdJNW3vLy8h84crz9TFfYiFy1sN6eP0XxmOPwfxhoCYG_w_wcB
Lewy Body Dementia
This is usually caused by abnormal proteins found in the nerve cells that die. This usually starts in the cerebral cortex or occipital lobe. Dependent on where Lewy Body's forms in the brain will depend on the symptoms.
If Lewy Body forms at the base of the brain then this will tend to lead to motor neurone deficiencies that have all the features of Parkinson's disease. This will seriously affect the person's mobility, leading to a rigidity of the limbs and slow movement, usually accompanied by a blank facial expression. As the DLB (Dementia with Lewy Body) progresses, their posture might become stooped and the walk turn into more of a shuffle. They may also have difficulty with their balance and their limbs may start to tremble Around a third of people diagnosed with Parkinson's disease will eventually develop dementia.
If Lewy Body forms in the outer layer of the brain then this will tend to impair mental abilities, especially around cognitive skills. In the early stages of this, the condition may present as being bad and then better. Someone with DLB will often stare into space if there speech is disorganised.
Visual hallucinations (seeing things that are not there) occur frequently in people with DLB, often in the early stage of the condition. This tends to be people or animals and appears completely real to the person with the dementia. This can last for several minutes and can be highly distressing. Some people with DLB can have visual misperceptions, such as mistaking a shadow for or a coat on a hanger for a person. Auditory hallucinations, such as hearing a knocking sound or footsteps can occur, but tends to be less common.
These hallucinations and misperceptions tends to explain why people with DLB have delusions. Some common delusions are that someone is out to get them or that their partner has been replaced by an identical stranger. This can be incredibly traumatic for carers and loved ones.
Sleep disturbance is quite common with people with DLB and can be a good indicator as this tends to begin prior to diagnosis. This can lead to people with DLB sleeping throughout the day and then becoming restless at night. The night-time can become problematic as the person with DLB might start to hit out and begin yelling as they act out nightmares. This is called rapid eye movement sleep behaviour disorder.
As the disease progresses the person with DLB will need a lot of nursing care due to the decline in mobility and cognitive functions as there will be an increase in falls. Overall life expectancy from diagnosis is between 6-12 years.
For more information follow this link https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=113&gclid=Cj0KEQjwvve_BRDmg9Kt9ufO15EBEiQAKoc6quIHVr0VW-I8YeFNQ_lwHHMK0OnI__eww26_NT0l5oYaAt__8P8HAQ
Alcohol Related Dementia (Korsakoff's Syndrome)
Alcohol related brain damage dementia (ARBD) is caused by excessive intake of alcohol over many years and creates loss of brain tissue. This tends to develop gradually over the years. A large part of the brain is damaged by the toxic effects of alcohol and someone with ABRD would tend to have brain shrinkage and damage to the frontal lobe, which would impair decision making and social behaviour. There is usually shrinkage to the cerebellum at the back of the brain which would impair posture and balance.
The main symptoms of someone with ARBD would be poor planning and organisational skills, problems with impulsivity, problems with attention and slower reasoning, lack of sensitivity to other people and socially unacceptable behaviour.
The good news about ARBD is that if the person suffering from it abstains from alcohol and gets the right treatment, the condition can improve over time.
Korsakoff's Syndrome is a form of ARBD where the main cause is a clear lack of thiamine. Korsakoff's syndrome tends to develop as part of a condition known as Wernicke-Korsakoff's syndrome. This consists of two separate but related stages. Wernicke's encephalopathy(a disorder that hampers the function of the brain) followed by Korsakoff's Syndrome. Wernicke-Korsakoff's syndrome is diagnosed in about one in eight people with ARBD. However not everyone has a clear case of Wernicke's encephalopathy before Korsakoff's Syndrome develops.
Symptoms of Wernicke's encephalopathy include disorientation, confusion or mild memory loss. under-nutrition, involuntary jerky eye movements or paralysis of the muscles that control the eye and poor balance and unsteadiness.
If Wernicke's encephalopathy is suspected, immediate medical treatment is needed. The person will need high doses of thiamine injected slowly into a vein. If treatment is done in time, the effects will be reversible within a few days. However, permanent brain damage may result if Wernicke's encephalopathy is left untreated or not treated in time. In some severe cases, the person may die.
When Wernicke's encephalopathy is untreated or not treated in time, then Korsakoff's Syndrome can occur.
With Korsakoff's Syndrome, damage occurs in several arrears of the brain, particularly in small, deep within the brain, resulting in severe short term memory loss. Many other memories may remain intact, such as working memory where the person with Korsakoff's can still handle money effectively.
Another symptom can be repetitive questioning due to the effects of the short term memory loss. The person not recognising people that they have met before since the onset of the dementia. In some instances, long term memory loss can also be affected.
Other symptoms may include difficulty in acquiring new information and taking on new skills, changes in personality such as apathetic in nature, a lack of insight into their condition and confabulation (where a person creates events to fill in gaps in day to day memory, although this is more prevalent in the early stages of the condition).
Thank you for taking the time to read this blog and if there are any questions that you would like answered, then please feel free to leave comments or email me.
Next time out we will discuss dementia resources in your area
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