Dementia
Last week we reviewed a very common geriatric issue, Polypharmacy. This week let’s jump into another major personal and public health problem - Dementia.
Dementia is an umbrella term that covers all sorts of different cognitive decline. The four most common types are Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia. Often Alzheimer’s disease and dementia are thought of as equivalent terms, but this is not the case. Alzheimer’s disease the most common cause of dementia, accounting for up to 4/5 of cases and thus it is easy to use the term Alzheimer’s as a substitute for dementia! But we must not forget the other etiologies (causes).
Many adults, young and old, fear the diagnosis of dementia, and rightfully so. For all causes of dementia there is no treatment for reversal or cure. It is a progressive decline and ultimately leads to disability and death. Short term memory decline is usually the most common presenting symptom - i.e. the symptom that brings someone to the doctor; but dementia includes loss of several different cognitive domains that may not be as apparent or obvious. Things like our ability to problem solve, language skills, mood regulation, visual perception skills, and orientation to our situation. Many spouses or caregivers - usually children - notice discrepancies in bills or bank statements where there were none before, or maybe things that are odd or incongruent with their loved one’s previous ability.
This is an important distinction between dementia and normal aging. All of us to some extent will experience changes in our memory as we age. We will forget people’s names, doctor’s appointments, where we put our keys, etc. But the difference is that with normal aging, eventually we will remember those things; with dementia, we won’t and it will affect our day to day lives.
Again, there are no cures for the different types of dementias. There are medications that might slow the progression of certain types, but ultimately trying to prevent dementia from occurring is the best option. Daily physical, mental, and social exercise and exertion are some of the things at our disposal for prevention. And this is not something we need wait to start at age sixty-five when we retire, but today! It’s never too early to take these steps to prevent this awful incurable process from setting in.
Key Points:
Dementia is an overarching term covering many different types of cognitive decline
Dementia affects our day to day life, whereas normal memory changes with aging do not
Currently dementia is incurable, but physical, mental, and social exercise may prevent it from occurring
