Understanding Dementia: Types, Symptoms, Epidemiology, Treatment and Effects

This article provides an in-depth understanding of dementia, including its different types, diagnosis criteria, signs and symptoms, epidemiology, recovery and prevention, treatment and interventions, communication and professionalism, and effects on individuals, caregivers and families. It also offers expert insights on how to communicate and care for individuals with dementia.

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Dementia
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Dementia
Dementia is a mental health condition characterized by cognitive decline in
thinking, reasoning, remembering as well as the behavioral abilities to an extent that an
individual may not carry out daily life and activities (Alzheimir’s Association). The
different types of dementia include Alzheimer’s, lewy body, perkinsons, vascular,
frontotemporal, wernicke-korsakoff, creutzfeldt-jakob and mixed dementia. Dementia
extends in seriousness from the mildest stage (National Institute on Aging 2018).
Diagnosis Criteria
Doctors diagnose dementia based on medical history, physical examination,
behavior associated with an individual’s day to day functions, laboratory tests as well as
distinguishable changes in thinking (Dubois et al. 2014). Alzheimir’s Association argues
that diagnosis criteria should be focused on the three stages.
Signs and Symptoms
The signs and symptoms of dementia greatly vary depending on the type of
dementia as well as the stage. They may slowly start out and gradually worsen.
However, the most common signs and symptoms that cut across all types of dementia
include memory loss, difficulty in communicating, finding words, solving problems,
handling complex tasks as well as difficulty in planning and organizing (Mayo Clinic
2017). Changes in personality, depression, anxiety, agitation, hallucinations and
inappropriate behaviors are also signs of dementia. Additionally, difficulty with motor
functions and coordination as well as confusion and disorientation are also signs and
symptoms of dementia (Singh-Manoux et al. 2017).
Epidemiology (Causation, Prevalence, Co-Morbidity, Prognosis)
Several different illnesses can cause dementia. A considerable lot of these
diseases are related to an irregular development of proteins in the brain (Alzheimer's
Association 2017). This development causes nerve cells to work less well and
eventually die. As the nerve cells die, diverse regions of the mind shrink. Genetic
mutation may also cause some nerve cells in the brain and the spinal cord to waste

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away. According Wood (2018), gout is associated with a 17 to 20 percent higher risk of
dementia in the elderly. This is because its treatment involves lowering the use of uric
acid which is believed to protect the brain. Dementia may also be as a result of
repetitive head trauma (Mayo Clinic 2017). This damages the vessels which supply
blood to the brain as well as degeneration of nerve cells.
According to National Health Service (2018), 1 person in every 130 people
suffered from dementia. This indicates a progressive increase by 0.29% from the
previous recorded prevalence in 2017. This research found out that 69.7% of people
who are over 65 years old have a coded dementia diagnosis recorded. In addition to
that, dementia diagnosis is 18% higher in people from the black ethnic group as
compared to Asian and white people (Pham et al. 2018). However, this varies among
men and women. Nonetheless, it is also important to note that dementia occurs to
people of all ages (Van De Vorst et al. 2016).
In most cases, people with dementia are always living with undiagnosed co-
morbidities. The two most successive comorbidities both for people with dementia are
hypertension and diabetes (Prince et al. 2016). The comorbidities which are
fundamentally connected with dementia are Parkinson's ailment, congestive heart
failure, cerebrovascular ailment, iron deficiency, cardiovascular arrhythmia, perpetual
skin ulcers, osteoporosis, thyroid infection, retinal issue, prostatic hypertrophy, sleep
deprivation and tension and mental issues (Poblador-Plou et al. 2014). These
cormobidities may result to prolonged hospital stays and may accelerate the
progression towards a condition of psychological and useful debilitation that is as an
outcome of under-diagnosis and under-treatment of dementia.
The prognosis of dementia varies from one type to another. However, it is
important to note that they all occur from early stages to the late stages (Perani et al.
2016). The prognosis of dementia greatly varies from the amount of damage caused,
health and the age of an individual. According to Pujades-Rodriguez et al. (2018), the
average life expectancy of a person suffering from dementia ranges from 8 to 10 years
from the time of diagnosis even though others may live up to 20 years.

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Recovery and Prevention
Dementia and cognitive decline can be reversed by balancing the body sugar
levels and controlling the insulin (National Academies of Sciences, Engineering, and
Medicine, 2017). This helps an individual to overcome diabesity and boos the mood and
thus focusing and balancing the energy levels. To recover and and prevent dementia,
an individual should take low-glycemic diet, eat healthy fats and exercise daily. Solomon
eta al. (2014) argue that keeping the brain active by engaging socially and carrying out
new tasks helps recover and prevent dementia.
Treatment and Interventions
Although at present there is no cure for dementia, there are medicines and other
treatments which are being used to slow down the progression of dementia (Livingston
et al. 2017). The pharmacological treatments which are commonly referred to as anti-
dementia drugs include Acetylcholine Inhibitors which boosts the level of acetylcholine
in the brain, Memantine which blocks excessively produced chemicals, and
antipsychotic medicines to reduce the challenging behaviors. According to James and
Jackman (2017), the non-pharmacological treatments include exercise, cognitive
rehabilitation, cognitive stimulation therapy, aromatherapy, validation therapy and reality
orientation. Reminiscence therapy has also proved to be useful in the treatment of
dementia (Woods, O'Philbin, Farrell, Spector, and Orrell 2018).
Communication and Professionalism
Dementia gradually progresses and a person is at risk of completely losing
memory. Therefore, to effectively and professionally communicate with a person
suffering from dementia, a health practitioner should be patient, avoid distractions, use
non verbal cues as well as show respect (Anderson 2015). Savundranayagam and
Moore-Nielsen (2015) emphasize that one should actively listen and avoid being
quibble. It is also important for one to talk about one thing at a time, avoid criticizing and
arguing as well as offer comfort.

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Effects on Individual, Carer and Family
Dementia affects an individual’s cognitive functions which include memory, visual
perception, reasoning and judgment, language and communication, ability to focus and
pay attention, as well as self-management. Some people suffering from dementia may
not be able to control their feelings and their personalities may change (Mormino et al.
2014). The caregivers of dementia patients may face different obstacles while trying to
balance care giving and other demands which include stress, burden and other health
complications (Adelman 2014). The family of a person suffering from dementia may also
strain to get funds for support, psychological illnesses and exhaustion (Fonareva and
Oken 2014).

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References
Adelman, R.D., Tmanova, L.L., Delgado, D., Dion, S. and Lachs, M.S., 2014. Caregiver
burden: a clinical review. Jama, 311(10), pp.1052-1060.
Alzheimir’s Association., What Is Dementia? Alzheimer's Disease and Dementia.
Available at: https://www.alz.org/alzheimers-dementia/what-is-dementia (Accessed: 13
January 2019).
Alzheimer's Association, 2017. 2017 Alzheimer's disease facts and figures. Alzheimer's
& Dementia, 13(4), pp.325-373.
Anderson, J., 2015. Communication strategies for dementia: a place for mom:
Connecting families to senior care.
Dubois, B., Feldman, H.H., Jacova, C., Hampel, H., Molinuevo, J.L., Blennow, K.,
DeKosky, S.T., Gauthier, S., Selkoe, D., Bateman, R. and Cappa, S., 2014. Advancing
research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. The Lancet
Neurology, 13(6), pp.614-629.
Fonareva, I. and Oken, B.S., 2014. Physiological and functional consequences of
caregiving for relatives with dementia. International Psychogeriatrics, 26(5), pp.725-747.
James, I.A. and Jackman, L., 2017. Understanding behaviour in dementia that
challenges: a guide to assessment and treatment. Jessica Kingsley Publishers.
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S.G., Huntley, J., Ames, D.,
Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J. and Cooper, C., 2017.
Dementia prevention, intervention, and care. The Lancet, 390(10113), pp.2673-2734.
Mayo Clinic., 2018. Symptoms and causes - Mayoclinic.org. Available at:
https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-
20352013?p=1 (Accessed: 13 January 2019).
Mormino, E.C., Betensky, R.A., Hedden, T., Schultz, A.P., Amariglio, R.E., Rentz, D.M.,
Johnson, K.A. and Sperling, R.A., 2014. Synergistic effect of β-amyloid and

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neurodegeneration on cognitive decline in clinically normal individuals. JAMA
neurology, 71(11), pp.1379-1385.
National Academies of Sciences, Engineering, and Medicine, 2017. Preventing
cognitive decline and dementia: A way forward. National Academies Press.
National Institute on Aging., 2018. What is dementia: psych central
National Health Service., 2018 Recorded Dementia Diagnoses, - NHS Digital, NHS
Digital. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/
recorded-dementia-diagnoses/january-2018 (Accessed: 13 January 2019).
Perani, D., Cerami, C., Caminiti, S.P., Santangelo, R., Coppi, E., Ferrari, L., Pinto, P.,
Passerini, G., Falini, A., Iannaccone, S. and Cappa, S.F., 2016. Cross-validation of
biomarkers for the early differential diagnosis and prognosis of dementia in a clinical
setting. European journal of nuclear medicine and molecular imaging, 43(3), pp.499-
508.
Prince, M., Ali, G.C., Guerchet, M., Prina, A.M., Albanese, E. and Wu, Y.T., 2016.
Recent global trends in the prevalence and incidence of dementia, and survival with
dementia. Alzheimer's research & therapy, 8(1), p.23.
Pujades-Rodriguez, M., Assi, V., Gonzalez-Izquierdo, A., Wilkinson, T., Schnier, C.,
Sudlow, C., Hemingway, H. and Whiteley, W.N., 2018. The diagnosis, burden and
prognosis of dementia: A record-linkage cohort study in England. PloS one, 13(6),
p.e0199026.
Pham, T.M., Petersen, I., Walters, K., Raine, R., Manthorpe, J., Mukadam, N. and
Cooper, C., 2018. Trends in dementia diagnosis rates in UK ethnic groups: analysis of
UK primary care data. Clinical epidemiology, 10, p.949. doi: 10.2147/CLEP.S152647
Poblador-Plou, B., Calderón-Larrañaga, A., Marta-Moreno, J., Hancco-Saavedra, J.,
Sicras-Mainar, A., Soljak, M. and Prados-Torres, A., 2014. Comorbidity of dementia: a
cross-sectional study of primary care older patients. BMC psychiatry, 14(1), p.84. doi:
10.1186/1471-244X-14-84

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Savundranayagam, M.Y. and Moore-Nielsen, K., 2015. Language-based
communication strategies that support person-centered communication with persons
with dementia. International psychogeriatrics, 27(10), pp.1707-1718.
Singh-Manoux, A., Dugravot, A., Fournier, A., Abell, J., Ebmeier, K., Kivimäki, M. and
Sabia, S., 2017. Trajectories of depressive symptoms before diagnosis of dementia: a
28-year follow-up study. JAMA psychiatry, 74(7), pp.712-718.
Solomon, A., Mangialasche, F., Richard, E., Andrieu, S., Bennett, D.A., Breteler, M.,
Fratiglioni, L., Hooshmand, B., Khachaturian, A.S., Schneider, L.S. and Skoog, I., 2014.
Advances in the prevention of Alzheimer's disease and dementia. Journal of internal
medicine, 275(3), pp.229-250.
Van De Vorst, I.E., Vaartjes, I., Geerlings, M.I., Bots, M.L. and Koek, H.L., 2016.
Prognosis of patients with dementia: results from a prospective nationwide registry
linkage study in the Netherlands. BMJ open, 5(10), p.e008897.
Wood, J., 2018. Gout linked to higher risk of dementia: Psych central
Woods, B., O'Philbin, L., Farrell, E.M., Spector, A.E. and Orrell, M., 2018. Reminiscence
therapy for dementia. Cochrane database of systematic reviews, (3).