What is Dementia? Types, Symptoms, and Management
Although “dementia” and “Alzheimer’s” are often used interchangeably they are not the same thing. Dementia is an umbrella term used to describe symptoms that impact memory, reasoning, performance of daily activities, and communication abilities. This extends to the point it interferes with a person’s daily life and activities.
It is important to obtain an accurate diagnosis of what type of dementia you have to maximize benefits from treatment and understand more about prognosis and symptoms. Our clinically licensed Life Care Managers at Holistic Aging are very familiar with all the types of dementia and can guide the family through the management and care of the varying types.
Although at present there is no cure, there are ways you can slow it down, maintain mental function and plan for managing the varying stages.
AD is the most common of the dementias. Although a true cause it not currently known, brains of people with AD are found to have small abnormalities. The so-called, amyloid plaques and tau tangles, formed in the brain and found in specific locations throughout, are two distinguishing hallmarks of Alzheimer’s Disease Dementia.
Symptoms: AD begins slowly, it first involves the parts of the brain that control thought, memory and language. Over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care.
Alzheimer’s has no current cure, but treatments for symptoms are available and research continues. Current medical treatments for Alzheimer’s cannot stop it from progressing. A Life Care Manager can offer suggestions on slowing the symptoms and improve quality of life for those with Alzheimer’s and their caregivers.
Formerly known as multi-infarct or post-stroke dementia, vascular dementia is the second most common cause of dementia.
These are disorders that affect the blood circulation in your brain. Proper control of blood pressure, blood sugars, or vascular issues improves outcomes with this type of dementia. The onset can occur suddenly post a stroke or slowly in the case of someone with uncontrolled diabetes.
Symptoms: Impaired judgment, decreased apathy, urinary changes, changes or difficulty with motor skills which may affect balance.
As clinicians, our Life Care Managers are always managing the client’s health to the point of wellness. We can help delay or ease the symptoms through clinical management.
Also known as FTD is the most common dementia diagnosed before age 60. FTD primarily affect the frontal and temporal lobes of the brain, rather than the widespread shrinking and wasting away (atrophy) of brain tissue seen in Alzheimer’s disease. FTD is a group of diseases.
Clinically, FTD is classified into two main types of syndromes:
- Behavioral variant frontotemporal dementia (bvFTD) involves changes in behavior, judgment, and personality. People with this disorder may have problems with cognition. Their memory may stay relatively intact. They may do impulsive things that are out of character such as gambling or having extramarital affairs. They may engage in repetitive, unusual behaviors. People with bvFTD also may say or do inappropriate things or become uncaring. Over time, language and/or movement problems may occur.
- Primary progressive aphasia (PPA) involves changes in the ability to speak, understand, and express thoughts and/or words and to write and read. Many people with PPA develop symptoms of dementia. Problems with memory, reasoning, and judgment are not apparent at first but can develop and progress over time. Sometimes a person with PPA cannot recognize the faces of familiar people and common objects (called semantic PPA). Other individuals have increasing trouble producing speech and may eventually be unable to speak at all (called agrammatic PPA).
Symptoms: In these disorders, changes to nerve cells in the brain’s frontal lobes affect the ability to reason and make decisions, prioritize and multitask, act appropriately, and control movement. Changes to the temporal lobes affect memory and how people understand words, recognize objects, and recognize and respond to emotions. Some people decline rapidly over 2 to 3 years, while others show only minimal changes for many years. The signs and symptoms may vary greatly among individuals as different parts of the brain are affected. No treatment that can cure or reverse frontotemporal disorders is currently available.
Families frequently do not recognize FTD in their loved one. They wonder why they have such a personality change and don’t seem to care anymore. Life Care Managers can help families understand the nature of this disease, provide the needed family support. This is not the person but the disease causing this change.
Lewy body dementia is a general term. It includes both Parkinson’s disease dementia (PDD) (in which Parkinson’s disease is first diagnosed but a year or more later includes dementia) and dementia with Lewy bodies (DLB) (which starts with dementia and is often misdiagnosed as Alzheimer’s disease, but may include Parkinson-like symptoms at the time of diagnosis or later).
It involves abnormal protein deposits called Lewy bodies, which are balloon-like structures that form inside nerve cells.
Symptoms: LBD includes dementia, visual hallucinations and frequent variations in cognitive ability, attention or alertness. There are also changes in walking or movement, as well as a sleep disorder called REM sleep behavior disorder, in which people physically act out their dreams. *LBD patients may also have a severe sensitivity to medications prescribed for hallucinations.
LBD affect not only the individual diagnosed with the illness, but also caregivers, families, and friends. The Life Care Manager can help families overcome these challenges.
Reversible Dementia-like Disorders and Conditions:
Many conditions that cause dementia-like symptoms can be halted or even reversed with the appropriate treatment. Our Life Care Managers can work with the client’s doctor(s) to assure that all needed testing is done.
- Normal pressure hydrocephalus is an abnormal buildup of cerebrospinal fluid in the brain. Elderly individuals with the condition usually have trouble with walking and with bladder control before the onset of dementia. Normal pressure hydrocephalus can be treated or even reversed by implanting a shunt system to divert fluid from the brain.
- Nutritional deficiencies of vitamin B1 (thiamine) and of vitamin B12 can be reversed with treatment. People who have abused substances such as alcohol and recreational drugs sometimes display signs of dementia even after the substance abuse has stopped.
- Side effects of medications or drug combinations may cause cognitive impairment that looks like a degenerative or vascular dementia but which could reverse upon stopping these medications.
- Vasculitis, an inflammation of brain blood vessels, can cause dementia after multiple strokes and may be treated with medications.
- Subdural hematoma,or bleeding between the brain’s surface and its outer covering (the dura), is common after a fall. Subdural hematomas can cause dementia-like symptoms and changes in mental function. With treatment, some symptoms can be reversed.
- Some non-malignant brain tumors can cause symptoms resembling dementia and recovery occurs following their removal by neurosurgery.
- Some chronic infections around the brain can cause dementia and may be treatable by drugs that kill the infectious agent.
- Thyroid dysfunction is associated with cognitive impairment.
How can a Life Care Manager help?
A Life Care Manager, licensed as a professional , can help people with dementia:
- get the correct diagnosis
- develop a support system to prepare and plan for the future
- encourage the person with dementia to take an active role in their condition
- customize a plan of care to meet the individual’s needs. It’s important to remember that everyone experiences dementia and its progression in their own way.
- offer suggestions to allow the person with dementia to be able to lead active and fulfilled lives
- coach the family and care providers on ways to communicate with people with dementia
- assure a safe environment
- improve the symptoms and slow the progression of the disease
- cope with changes in behavior
- offer recommendations when driving becomes a concern
- monitor money management and financial safety
- recommend methods that work when the person will not accept help
Life Care Managers are familiar with strategies and resources to ensure that proper care is provided whether in the home or facility setting. As a Life Care Manager, our goals are to ensure that a patient may function at the highest level of independence, in the least restrictive living environment as long as possible, while recognizing changes and modifications to the plan of may need to be made along the way.
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