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Understanding Dementia

Jay St. John, MD

Dementia is the name for a group of brain conditions that make it harder to remember, reason, and communicate. The ability to remember, reason, and communicate are collectively known as cognition. When a person has a perceived decrease in cognition that also affects daily function, we then say that person has Dementia.

The most common form of dementia is Alzheimer's disease. Other types include vascular dementia, mixed vascular and Alzheimer’s and less frequently seen are frontotemporal dementia and Lewy body dementia. Years ago, dementia was often called “senility.” It was even thought to be a normal part of aging. We now know that it is not a normal part of aging. It’s caused by ongoing damage to cells in the brain.

Symptoms of dementia

Symptoms differ depending on which parts of the brain are affected and the stage of the disease. The most common symptoms include:

  • Memory loss, including trouble with directions and familiar tasks
  • Language problems, such as trouble getting words out or understanding what is said
  • Trouble with planning, organizing, concentration, and judgment. This includes people not being able to recognize their own symptoms.
  • Changes in behavior and personality

How dementia affects the brain

The brain controls all the workings of the mind and body. Some parts of the brain control memory and language. Other parts control movement and coordination. With dementia, nerve cells in the brain are gradually damaged or destroyed. Why this happens is not yet clear. But over time, parts of the brain begin to shrink (atrophy). This often starts in the part of the brain that controls memory, reasoning, and personality. Other parts of the brain may not be affected until much later in the illness.

The stages of dementia

Dementia is a progressive disease. This means it gets worse over time. Symptoms differ for each person, but there are 3 basic stages. Each may last from months to years:

  • Early-stage. A person may seem forgetful, confused, or have changes in behavior. However, he or she may still be able to handle most tasks without help.
  • Middle stage. More and more help is needed with daily tasks. A person may have trouble recognizing friends and family members, wander, or get lost in familiar places. He or she may also become restless or moody.
  • Late-stage. Dementia can cause severe problems with memory, judgment, and other skills including bathing, eating, and toileting. At this stage, help is needed with nearly every aspect of daily life.

Treating dementia

Unfortunately, there is no cure for Dementia in any of its various forms. There are medications available for treatment per current guidelines, however, the benefits have not been well established.

If you suspect a loved one may have dementia it is important to discuss with the primary care physician to establish a plan of care.

When a family member or loved one is diagnosed with Dementia it can be an incredibly overwhelming time for everyone involved. I would encourage everyone involved to look up www. alz.org for information on group forums, expectations, and how to plan for the future, how to best preserve quality of life and the latest research.

Dr. Jay St. John specializes in Geriatric Medicine and is in charge of the Senior Care Services a