Dementia
Dementia is a broad diagnosis for global cognitive impairment that is significant enough to interfere with daily functioning and represents a significant decline from a person’s baseline level of functioning. The spectrum of cognitive symptoms varies depending on the specific dementia diagnosis and the individual’s environment and baseline strengths and weaknesses, and in general includes:
- Memory loss
- Decline in other cognitive abilities, including decision-making, language, and navigating familiar spaces
- Agitation
- Anxiety
- Confusion
- Depression
- Difficulty with coordination
- Impaired communication
- Inappropriate behavior
- Changes in mood or personality
While there is no cure for most forms of dementia, symptoms may be managed and controlled with treatment. Early diagnosis and intervention are crucial to slowing symptom progression.
If you notice dementia symptoms in yourself or a loved one, it is vitally important to get a diagnosis as early as possible. Early diagnosis and intervention may help slow the progression of your condition and allow you to get the right help and resources early to maintain a higher standard of living for longer. Request a consultation at The CRCNJ today.
TYPES OF DEMENTIA
While types of dementia may be differentiated based on established clinical criteria describing specific symptom profiles, classifications of dementia are based on the underlying neuropathology. Each type of dementia is associated with specific brain changes that occur microscopically and, historically, could only be verified by autopsy. Current specialized imaging and laboratory techniques are now available for some diagnoses to allow for biological markers in living patients.
When a physician diagnoses dementia he or she will collect as much information as possible to try to determine what type of dementia a person has. The clinical profile, or spectrum of symptoms a patient exhibits or shows, is largely determined by the area of the brain affected rather than the type of pathology. So, if two different types of dementia affect the exact same areas of the brain, the symptoms would appear the same. This is why differential diagnosis of dementia is difficult and requires a comprehensive evaluation by a specialized team.
Furthermore, it is not uncommon for a person to have more than one type of dementia. In fact, having one dementia diagnosis increases the risk of having another dementia diagnosis. Mixed dementia is the classification term for brain changes characteristic of multiple types of dementia.
The following is a nonexclusive list of dementia types.
Alzheimer’s Disease
Alzheimer’s disease is the most common form of dementia. While the initial cause of Alzheimer’s disease is not fully known, research has shown that the physical changes that lead to symptoms are related to deposits of abnormal proteins in the brain. These abnormal proteins are known as amyloid beta plaques and tau tangles. Alzheimer’s disease is difficult to diagnose, and because it shares symptoms with many other conditions, it can be misdiagnosed.
Vascular Dementia
Second only to Alzheimer’s disease in terms of prevalence, vascular dementia is the result of restriction of blood flow to the brain, which leads to oxygen deprivation and cell death. The symptoms and severity of vascular dementia depend on the severity of the stroke or strokes and the brain area affected. Numerous small strokes can cause cumulative damage over time, while a single large stroke can result in severe damage immediately.
Dementia with Lewy Bodies
Like Alzheimer’s, this type of dementia is caused by abnormal protein deposits in the brain. In the case of dementia with Lewy bodies (also referred to as Lewy body dementia), the alpha-synuclein protein misfolds and forms structures known as Lewy bodies. The symptoms and brain changes that occur in dementia with Lewy bodies share similarities to both Alzheimer’s and Parkinson’s disease, and can be difficult to diagnose.
Frontotemporal Dementia
This form of dementia encompasses a number of conditions caused by progressive nerve cell loss in the brain's frontal lobes (areas behind the forehead) or temporal lobes (areas behind ears). Cell loss damages the brain areas that help govern memory, speech and language, cognitive function, behavior and personality, voluntary movements and sensation processing. Frontotemporal dementia is often mistaken for Alzheimer’s disease, but it generally presents earlier.
Other Disorders and Conditions that May Lead to Dementia
Parkinson’s disease dementia
Similar to dementia with Lewy bodies, Parkinson’s disease is caused by the formation of Lewy bodies in the brain. However, in Parkinson’s disease, Lewy bodies initially target a brain region that plays a key role in movement, causing movement disorders associated with Parkinson’s. If brain changes spread to other areas of the brain that serve cognitive functions, symptoms of dementia may develop.
Posterior cortical atrophy disease
Defined by gradual, progressive degeneration of the outer layer (cortex) of the brain in the posterior (back) area of the brain. Whether it is an original disease or variant of Alzheimer’s disease is unknown, but it is similar to other dementias caused by Lewy body formations.
Creutzfeldt-Jakob disease
Creutzfeldt-Jakob disease belongs to a family of conditions known as prion diseases. Creutzfeldt-Jakob disease is the result of misfolded proteins in the brain, and is sometimes acquired through infected meat or tissue. In other cases, the disease is hereditary.
Down syndrome dementia
People with Down syndrome are at high risk of developing an Alzheimer-like type of dementia, usually by around age 35 or 40. Though not everyone with Down syndrome develops Alzheimer’s symptoms, by age 40, a large majority have significant levels of beta-amyloid plaques and tau tangles, the abnormal protein deposits considered Alzheimer's hallmarks.
Huntington’s disease
Huntington’s disease is the result of a defective gene that causes a variety of cognitive and motor symptoms. Symptoms usually begin in the 30s or 40s and continue to progress for approximately 10 to 30 years.
Normal pressure hydrocephalus
Normal pressure hydrocephalus is caused by the brain’s ventricles filling with cerebrospinal fluid. Unlike most other forms of dementia, normal pressure hydrocephalus can be reversed by draining the ventricles.
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