Dementia: Risk Factors, Pathophysiology, and Treatment

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Pathophysiology: Cortical and subcortical neuronal organ
system is involved in the pathogenesis of the disorder [1].
In dementia, the common causes and pathophysiology is
often dependant on the nature of the dementia and its
common causes i.e. in vascular dementia, the loss of blood
supply to the brain leads to the loss of brain functionality
[3].
Pathophysiology
Risk Factors
Aetiology
Clinical
manifestations
Diagnostic tests
Treatment
There are several risk factors involved in dementia are: age, alcohol, atherosclerosis, diabetes
mellitus, hypertension, congenital reasons, psychological reasons, smoking etc [1]. These risk factors
are involved in the development of dementia and they enhance the chance of development of
dementia [1]. Age: Dementia is very common in the elderly and typically occurs in the old age [1].
Alcohol abuse is yet another common risk factor for dementia [1]. Regular consumption of alcohol
and unusually heavy amounts of alcohol consumption leads to the development of dementia in the
old age [1].
Risk factors: Dementia is a chronic illness and associated degeneration and loss of cognition [1]. Several
cognitive functions and attributed loss of functionality and behaviours in the elderly [1]. It is one of the most
crippling and prevalent conditions worldwide [1].
The development of dementia occurs at a stage earlier to
the manifestation in a clinical setting [3].
Aetiology: Dementia is commonly preceded by Alzheimer’s disease [1].
The accumulation of amyloid beta protein in the brain region leading to
the loss of cognitive functions, memory, and understanding are
common aetiological factors of dementia [1]. Clumps of proteins,
plaques, or tangles are formed in the brain in Alzheimer’s disease
leading to loss of brain functionality [2].The most common form of
dementia is vascular dementia which is caused by the interruption in
the supply of blood to the brain [1]. Dementia with Lewy bodies is also
a common occurrence and is due to the development of circular ‘Lewy
bodies’ or protein lumps that develop and accumulate in the brain [1].
The pathological characteristics of the
disease are only visible at an old age [3].
The treatment involves two
crucial aspects: clinical
(pharmacological and non-
pharmacological) and health
care interventions [3].
In Alzheimer’s disease and dementia with
Lewy bodies, there is an abnormal
deposition of protein lumps in the brain [3].
The primary clinical presentations include
loss of memory, cognition, speech,
behaviour, social living etc [3].
Diabetes mellitus: Research has enumerated that diabetes mellitus is
strongly associated with dementia in the elderly [1]. Several studies
have demonstrated that diabetes mellitus is a strong predisposing
factor for dementia [1]. Evidence suggesting a direct relationship
between diabetes mellitus and dementia is scarce; however, diabetes
without control is an important risk factor for several health
complications such as cardiovascular disease leading to vascular
dementia. The other risk factors include genetic predisposing factors
that lead to erroneous production of amyloid beta protein and its
accumulation in the brain leading to degeneration, hypertension,
mental or emotional issues, and lifestyle issues such as smoking
behaviour [1].
Pharmacological interventions mainly depend
on the stage of the disease [3]. Psychological
and social health organisations are important
contributors to the health of the patients [3].
Palliation is a crucial part of dementia
treatment [3].
Several interdisciplinary units are present for the
treatment and intervention for empowerment of the
patients for social living [3].
Due to such deposition, dementia occurs
in most aged adults [3].
Diagnostic tests: In dementia, nueroimaging is a
crucial diagnostic tool [3]. Blood tests such as
Thyroid function tests, serum vitamin B12,
complete blood count, blood urea nitrogen level
measurement, serum electrolytes, and
measurement of blood glucose, blood urea, HIV,
syphilis, RBC etc are carried out [3]. Computed
tomography scan is essential to eliminate
differential diagnosis [3].
Key