By now most people have heard of the word dementia. But do you know exactly what it is? It is a gradual loss of mental abilities such as memory, thinking, language, judgment, and usually accompanied by changes in behavior. Dementia isn’t simply occasional forgetfulness, but a problem in the brain that is severe enough to interrupt normal daily activities.
Where many people get confused is when they think dementia is a disease in and of itself. In fact, dementia is the result of a disease, brain disorder, or injury. It is not a disease, but a range of symptoms that tell us a disease or condition is causing physical changes in the brain.
A good way to think about this is to draw a parallel between dementia and another symptom like itching. This may seem odd at first, but the comparison is actually quite helpful. For instance, like dementia, itching can be mild or severe, can cause a minor problems at first or can turn out to be a very serious issue. Itching can be the symptom of a number of diseases or conditions that are treated very differently. For example, itching may be a symptom of psoriasis, allergies, kidney disease, poison ivy or even lymphoma. Each of the underlying causes is treated very differently from the others. Treatment of the symptom, in this case itching, may make it better. But the goal is to discover and address the underlying cause. So, like itching, it can help to think of dementia as a cluster of symptoms that indicates something is happening in the brain, though it does not tell us exactly what.
Types of Dementia
There are several types of dementia, caused by different underlying conditions. The most well known types of dementia include Alzheimer’s dementia (AD), Parkinson’s disease dementia, and Lewy Body dementia. But there are also types of dementia caused by vascular disease (such as strokes) and Frontotemporal dementia, which is caused by the breakdown of nerve cells in particular regions of the brain.
Early Signs of Dementia
If you recognize any of the following early signs in yourself or a loved one, it is important to speak with your doctor. You can then work together to find out what is causing your symptoms, including obtaining some tests or possibly finding a doctor who specializes in diagnosing and treating dementia:
• Forgetfulness that hinders your ability to get through the day: This can include asking about the same thing repeatedly, especially if it was just learned; this is different from sometimes forgetting names or dates and remembering them at a later time
• Growing challenges in planning or solving problems: This might include being unable to concentrate, focus, or follow directions. The difficulties are ongoing, and not just occasional errors. They might occur, for example, when balancing a checkbook, paying the bills or following a familiar recipe
• Difficulty completing tasks that used to be easy: Examples include getting lost while driving on a familiar route or needing help to use the settings on a microwave which were used independently before
• Confusion about what season it is, or the passage of time: Forgetting the date, time and location can occur; this is different from temporarily thinking it is Wednesday when it is Thursday
• New problems with words, speaking or writing to the point that joining a conversation is difficult: This is different from sometimes having trouble finding the “right” word
The very presence of any symptom, if it is more than just a minor, passing issue, means that it is time to get to a doctor to find out what is going on. There are different types of dementia with different causes. Some are even reversible, for example as with certain vitamin deficiencies or hormonal imbalances. In those not reversible, treatment may help with symptoms. An earlier diagnosis may also help patients and families learn as much as they can about the illness and what needs and choices may be anticipated.
Rachel Schindler, MD is a physician/scientist who leads the strategy for Neurosciences in the Clinical Sciences group at Pfizer’s Global Innovative Pharmaceuticals Medicines Development Group. She is the founder and former Director of the Neurobehavior and Memory Disorders Program at University Hospital at Stony Brook
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