Dementia Care: Symptoms and Effects
Around 50 million people have dementia worldwide, with nearly 60% living in low-and middle-income countries. Every year, there are nearly 10 million new cases. The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%.
The treatment for dementia is primarily supportive as there are no prescription medications to reverse or stop the process. Environmental changes, a structured schedule, regular exercise, and staying engaged with others can all be beneficial in treating dementia.
What is Dementia?
Dementia is a term that encompasses a variety of symptoms associated with cognitive impairment, such as forgetfulness. It is a general term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia, it is a symptom of a number of underlying diseases and disorders of the brain.
Dementia is an umbrella word that encompasses a wide variety of medical problems, which includes Alzheimer’s disease. Abnormal brain changes cause the disorders grouped under the umbrella word “dementia”.
These changes cause a decline in cognitive abilities, which is significant enough to interfere with everyday life and independence leading to dementia care. They also have an effect on one’s attitudes, emotions, and relationships.
Types of Dementia
The types of dementia include Alzheimer’s disease, Lewy body dementia, vascular dementia, and frontotemporal dementia. Other types include dementia associated with Parkinson’s disease or Huntington’s disease. Alzheimer’s disease is responsible for 60-80% of cases.
The second most common cause of dementia is vascular dementia, which is caused by microscopic bleeding and blood vessel blockage in the brain. Mixed dementia affects people who are affected by various forms of dementia at the same time.
Many other disorders, including those that are reversible, such as thyroid problems and vitamin deficiencies, can cause dementia symptoms.
Dementia is often incorrectly referred to as “senility” or “senile dementia,” which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.
Causes of Dementia
Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior, and feelings can be affected.
The brain has many distinct regions, each of which is responsible for different functions (for example, memory, judgment, and movement). When cells in a particular region are damaged, that region cannot carry out its functions normally.
Different forms of dementia are linked to specific types of brain cell damage in specific brain regions. High levels of certain proteins inside and outside brain cells make it difficult for brain cells to remain healthy and interact with one another; this is apparent in cases of Alzheimer’s disease.
The hippocampus is the brain’s learning and memory core, and its brain cells are always the first to be harmed. As a result, memory loss is often one of the first signs of dementia.
Although the majority of the changes in the brain that cause dementia are irreversible and worsen over time, thought and memory problems caused by the following conditions may improve when treated or addressed:
- Medication side effects.
- Excess use of alcohol.
- Thyroid problems.
- Vitamin deficiencies.
Symptoms of Dementia
Simple forgetfulness is not enough to lead to a diagnosis of dementia, as there needs to be evidence of problems in at least two areas of cognition (brain function) to confirm this diagnosis.
Signs of dementia can vary greatly. Examples include:
- Losing items
- Problems performing tasks or activities that were previously done without effort.
- Difficulty with learning new material is frequently one of the earliest signs of dementia.
- Memory loss.
- Problems with speaking including difficulty completing sentences or finding the right word to say
- Difficulty completing tasks.
- Difficulty recognizing items or people.
- Showing signs of poor judgment.
- People with dementia may have problems preparing food.
- Performing household chores
- Paying bills.
Effects of Dementia
Many patients with early Alzheimer’s disease or other types of dementia are unaware that they have any problem. As the disease progresses, behavioral changes can become evident and dementia care is needed.
- Patients have difficulty performing basic tasks, such as getting dressed or using the bathroom.
- Some patients begin to forget pieces of information about themselves, including their address or telephone number, or even their date of birth.
- They may have difficulty understanding what is occurring around them.
- Some patients have problems remembering to eat and may develop pronounced weight loss, this can be avoided with the help of dementia care personnel.
- In the late stages of dementia, patients often cannot recognize family members, and their ability to communicate effectively is markedly impaired.
- They are no longer able to effectively care for themselves and require dementia care for all activities of daily living.
- Over time, patients can forget how to walk or even how to sit up.
According to Public Health England’s Statistical commentary: dementia profile of April 2019, it shows that:
- in England, 4.3 people per 100 population aged 65 years and over have a recorded diagnosis of dementia on their GP practice record in 2018
- for people aged under 65 years in England, 3.4 people per 10,000 population have a diagnosis, an increase on the rate for 2017
- a lower proportion of people with dementia had their dementia care plan review documented in the primary care notes in 2018 when compared with 2017.
- the proportion of dementia care home and nursing home beds, for use by people with dementia, being rated as good or better than good quality increased by eight percentage points to 68.6% in 2018, compared to 2017
- the rate of emergency admissions to hospital for people that require dementia care in 2017 to 2018 was 3,609 per 100,000 population aged 65 years and over, an increase from 2016 to 2017 (3,482)
- the proportion of these admissions being for one night or less (short stay) increased to 28.9% from 28.2% in 2016 to 2017
- deaths, where dementia was mentioned on the death certificate, accounted for 903 deaths per 100,000 population aged 65 years and over in England during 2017: this rate increased from 868 in 2016.
- the proportion of deaths occurring in the usual place of residence (home or dementia care homes) for people with dementia increased to 68.5% in 2017 from 67.9% in 2016.
These statistics show a slight increase in dementia care homes and personnel, but there is room for more improvement. With the advent of the Covid-19, it has become more of a challenge for patients to gain access to dementia care owing to the high mortality rate of persons over the age of 65.
Some risk factors for dementia, such as age and genetics, cannot be changed. But researchers continue to explore the impact of other risk factors on brain health and prevention of dementia.
Research reported at the 2019 Alzheimer’s Association International Conference suggests that adopting multiple healthy lifestyle choices, including a healthy diet, not smoking, regular exercise, and cognitive stimulation may decrease the risk of cognitive decline and dementia.