Are these the warning signs of dementia, or something else?
Have you noticed your loved one is having memory or language problems? Are they having trouble judging distance for driving, navigating stairs, or with depth perception? This loss of spatial awareness, the ability to be aware of oneself in space, could be a warning sign for dementia. Are you concerned because their decisions no longer make sense or that they could put themselves or someone else in danger? Loss of executive function, the ability to plan, organize and complete tasks, is another warning sign for dementia.
Having problems with two or more of these core mental abilities: memory, language, visuospatial and executive functions means a health issue, whether it is dementia or something else.
Let’s start with the fact that dementia is not a disease. It is a category of symptoms that illustrate a decline in cognitive abilities which impact daily living. Often people use the term Alzheimer’s and dementia interchangeably, but that is incorrect. There are, in fact, several neurodegenerative diseases that cause the symptoms of dementia, each of which has different symptoms and behaviors. The most common and the one people are most familiar with is Alzheimer’s. The term “neurogenerative explains what is happening in the brain: Neuro=messenger and Degenerative=destroy.
The five most common neurodegenerative disease that cause symptoms of dementia.
Most common among the elderly, especially after age 85. Yet, more and more early-onset Alzheimer cases are being diagnosed. Early-onset is a difficult financial challenge, given how long your loved one might live with the disease. Add to that someone in their prime of life who has lost executive function but is used to being active, and caregivers of persons with early-onset Alzheimer’s have a long journey ahead of them.
There are three stages to Alzheimer’s: early, moderate and late. As damage to the brain increases, people living with Alzheimer’s move through the three stages. Short-term memory loss is the most notable symptom in the early stage. Many families do not realize that their loved one’s behavior is more than memory loss until they notice loss of executive function, like safety awareness. One thing to note, this disease will magnify your loved one’s personality, good or bad.
Lewy Bodies Dementia (dementia with Lewy bodies)
This is the second most common type of progressive dementia after Alzheimer’s. In this dementia, protein deposits called Lewy Bodies to develop in nerve cells in the regions of the brain that involve thinking, memory and motor control (movement). In the early stages, it may involve hallucinations, delusions, and restlessness. About half the people with Lewy Bodies suffer from a sleep disorder. Most people with Parkinson’s develop dementia as it progresses. It is thought that this occurs due to the related Lewy Bodies (sticky clumps of protein found in nerve cells) of people with Parkinson’s.
This type of dementia is caused by a series of small strokes (TIA’s). Where the strokes occur in the brain will affect behavior because these are the areas where the brain is damaged. A person with vascular dementia may show problems with the slowness of thought, difficulty planning, trouble understanding, problems with concentration, mood or behavioral changes, and short-term memory will come and go.
Frontotemporal Dementia (FTD)
This disease is less common than the others. It tends to hit people with an average age of 40-60 and it progresses much more rapidly than the other dementia-related neurogenerative diseases. It is caused by progressive nerve cell loss in the areas behind your forehead (frontal lobes) and the regions behind your ears (temporal lobes.) Signs of FTD include poor judgment, lack of inhibition, loss of empathy and socially inappropriate behavior. In addition, people with FTD may show signs of repetitive compulsive behavior, frequent mood changes, the inability to plan or concentrate and speech difficulties. The behavior of individuals with FTD are unpredictable and can change with no warning. They will be OK in one moment and enraged in the next.
Too often, particularly when we are dealing with our aging loved ones, we see these warning signs and chalk it up to old age. Ignoring them is easy to do in the early stages when your loved one may look and sound the same. But in the choice to not pursue or rule out a diagnosis, you may be missing health concerns which are temporary and reversible.
Here is a list of conditions that can cause the symptoms of dementia, but that, with intervention, can be managed and cured:
- The older the body, the longer a drug stays in the body. In addition, the way our bodies react to the drugs change as we age. Scheduled medication reviews are important.
- UTI can cause delusions and confusion. UTI’s do not present the same way in our seniors, so they are easy to overlook.
- Dehydration can also cause delusion, confusion and balance issues.
- Malnutrition can affect thinking ability.
- Lack of B Vitamins: niacin, thiamin, and B12.
- Metabolic imbalances in the kidney, thyroid, and liver.
- Depression is one of the most overlooked causes in our isolated and lonely seniors.
If you are noticing these changes in your loved one, don’t brush them off. There are often multiple causes when a person is showing signs of decline, so diagnosis is important. There will be several evaluations and a rule-out diagnosis used. Through this process, there is a 90%-95% accuracy rate in determining the cause of the dementia symptoms.
With thanks to Amy Matthews from Engaging Alzheimer’s for her input.