Dementia

What is dementia?

Dementia is the loss of the ability to think, remember, and make decisions, which affects daily life. It is not a single disease, but a broad term that includes different conditions. Each type of dementia has specific symptoms. For example, in Alzheimer's disease, memory loss is usually the first sign; whereas in frontotemporal dementia, the most noticeable changes occur in personality, behavior, and judgment

Symptoms

The symptoms of dementia can vary depending on the type of disease, the areas of the brain involved, and the severity, but they generally include:

• difficulty remembering recent information and memory loss
• trouble finding words or following conversations
• challenges in reasoning and performing tasks that require visual and spatial skills
• feeling of confusion and disorientation
• changes in behavior and lack of inhibition
• apathy or depressive feelings

Causes

The causes of dementia depend on the disease it is associated with:

• age is one of the main risk factors for Alzheimer’s, the most common type of dementia. In addition, a family history of the disease, lack of physical activity, smoking, obesity, or exposure to pollution can also contribute to the development of the condition
• vascular dementia arises due to various cardiovascular issues that affect blood circulation and oxygen supply to the brain, such as high blood pressure, elevated cholesterol levels, arrhythmias, and diabetes
• frontotemporal dementia occurs when the frontal or temporal lobes of the brain are damaged. This condition is influenced by both genetic and environmental factors

Types

Alzheimer’s disease and vascular dementia are among the most common forms of dementia in older adults, accounting for about 80% to 90% of cases. In addition to these, frontotemporal dementia is also notable, as described below:

• alzheimer’s dementia: caused by the degeneration of brain tissue, with the loss of nerve cells due to the accumulation of proteins in that region
• vascular dementia: results from the obstruction or reduction of blood flow in the brain. It usually occurs after a stroke but can also arise from multiple small infarcts
• frontotemporal dementia: stems from the degeneration of the frontal or temporal lobes. It often has hereditary causes and typically appears after the age of 45

Diagnosis

Diagnosing dementia requires an evaluation of symptoms along with physical and neurological examinations. The main steps in the diagnostic process include:

• clinical interview: the healthcare professional gathers information about symptoms, medical history, and family background
• physical examination: to assess the patient’s overall health and rule out other medical conditions that may contribute to the symptoms
• imaging tests: magnetic resonance imaging (MRI) and computed tomography (CT) scans may be performed to identify abnormalities in the brain
• laboratory evaluation: blood tests may be conducted to assess glucose levels, kidney and liver function, and other factors that can affect brain function

The medical specialty responsible for diagnosing and treating dementia varies depending on the symptoms and type, but neurologists are often involved in the care of these patients

Treatment

Treating the various types of dementia is challenging. For Alzheimer’s, for example, there is no definitive cure. However, in addition to medications, there are other therapies such as activities that stimulate the mind and body, which help improve the patient’s quality of life:
 

• speech therapy: helps the person maintain communication skills, even as the disease progresses
• psychosocial support: psychosocial support is essential for both the patient and caregivers. This may include counseling, support groups, and education about the disease
• healthy lifestyle: a balanced diet, regular physical exercise, and mentally stimulating activities can help slow the progression of the disease

In the case of vascular dementia, managing conditions that affect heart health helps slow the disease’s progression, in addition to medications that assist in symptom control. For frontotemporal dementia, certain medications and speech therapy sessions may be beneficial in delaying its development

Prevention

There is still no definitive way to prevent dementia. However, in general—and considering its different types—some strategies can help prevent or delay its symptoms:

• maintain regular physical activity
• follow a balanced diet
• avoid smoking and excessive alcohol consumption
• manage conditions such as diabetes and high blood pressure
• keep the mind active through reading, logic games, and learning new skills

References

Ministry of Health

Scientific Culture Institute of the Federal University of São Carlos

By Einstein Editorial Board