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Memory Loss and Dementia

memory loss


Many people become forgetful as they become older. This is common and is often not due to dementia. There are also other disorders such as depression and an underactive thyroid that can cause memory problems. Dementia is the most serious form of memory problem. It causes a loss of mental ability, and other symptoms. There are certain situations that can affect your memory and make you become more forgetful than you normally are. They can include the following.

  • Poor concentration
  • Depression
  • Physical illness
  • Medicines
  • Age

As everyone gets older, it often becomes harder to remember things. This is called age-associated memory impairment. Many people over the age of 60 have this common problem, and it is not dementia. Dementia is the most serious form of memory problem.

What is dementia?

Dementia is a condition of the brain which causes a gradual loss of mental ability, including problems with memory, understanding, judgement, thinking and language. As dementia progresses, a person's ability to look after themself from day to day may also become affected.

What are the different causes of dementia?

Dementia can be caused by various diseases or disorders which affect the parts of the brain involved with thought processes.

Alzheimer's disease

This is the most common type of dementia, causing about half of all cases. In Alzheimer's disease the brain shrinks and the numbers of nerve fibres in the brain gradually reduce. Alzheimer's disease gradually progresses over time as the brain becomes more and more affected.

Vascular (blood vessel) dementia

This causes about a quarter of all cases of dementia. It is due to problems with the small blood vessels in your brain. In effect, this is like having many tiny strokes, that otherwise go unrecognised. A stroke is when a blood vessel blocks and stops the blood getting past. So, the area of brain supplied by that blood vessel is damaged or dies . So, a person's mental ability gradually declines.

The risk of developing vascular dementia is increased by the same things that increase the risk of stroke. For example: high blood pressure, smoking, high cholesterol level, lack of exercise, etc.

Lewy body dementia / dementia with Lewy bodies (DLB)

This causes about 15 in every 100 cases of dementia. Lewy bodies are tiny abnormal protein deposits that develop in nerve cells in the brain of people with this condition.

Other causes of dementia

There are over 60 diseases which can cause dementia. Many are rare and, in many, the dementia is just part of other problems and symptoms.

Who gets dementia?

Dementia is a common problem. However, dementia is not a normal part of ageing. It is different to the age-associated memory impairment that is common in older people.
Rarely, dementia affects younger people. Dementia is said to be early-onset (or young-onset) if it comes on before the age of 65.
There are some groups of people who are known to have a higher risk of developing dementia. These include people with:

  • Down's syndrome
  • Parkinson's disease.
  • Risk factors for cardiovascular disease (angina, heart attack, stroke and peripheral vascular disease). The risk factors for cardiovascular disease (high blood pressure, smoking, high cholesterol level, lack of exercise, etc) are risk factors for all types of dementia, not just vascular dementia.
  • Schizophrenia or severe depression
  • A limited social support network.
  • Low physical activity levels.
  • Dementia also seems to run in some families

What are the main dementia symptoms?

Memory problems are usually the most obvious symptom in people with dementia. The most recent events are the first forgotten. However, events of the past are often remembered well until the dementia is severe. Many people with dementia can talk about their childhood and early life. As dementia progresses, sometimes memory loss for recent events is so severe and the person may appear to be living in the past. Language problems can also develop. they may have difficulty understanding what is said to them or understanding written information. Problems with attention and concentration can also occur .New surroundings and new people may confuse a person with dementia. However, in familiar places, and with old routines. Losing track of time is also a common problem .A person with dementia may get lost easily.The ability to think, calculate and problem-solve can be affected as intellect begins to fail. Difficulties with planning and decision making can develop.

Changes in mood, behaviour and personality is common. At first, someone with dementia may appear to be easily irritated or moody.A person with dementia may become quite disinhibited. Some people with dementia can also become agitated or even agressive.They may become suspicious or fearful of others and, in some people, delusions (abnormal beliefs) and hallucinations (a false perception of something that is not really there) can occur.

Problems carrying out day-to-day activities.

Difficulty with self-care usually develops over time without help. Driving may be dangerous and not possible for someone with dementia.

How does dementia progress?

Typically, symptoms of dementia tend to develop slowly, often over several years. In the early stages of the disease, many people with mild dementia cope with just a small amount of support and care. As the disease progresses more care is usually needed.

How is dementia diagnosed?

Because the symptoms of dementia tend to develop slowly, they may be difficult to recognise at first. Commonly, it is relatives, or friends who have concerns that the person may have dementia. However, people with a high intellect or a demanding job, may notice it themselves .

Visit your doctor

The first step if you are concerned that you may be developing dementia is to see your doctor.

Referral to a specialist

Referral for the opinion of a specialist is usually needed to confirm the diagnosis of dementia. The specialist may be able to determine the likely cause of dementia and decide if any specific treatment may be helpful .They may suggest further investigations such as an MRI scan of the brain.

Can medication help people with dementia?

There is no cure for dementia and no medicine that will reverse dementia. However, medication is generally used  as treatment to help with symptoms that affect thinking and memory and as treatment to help with symptoms that affect mood and how someone behavior.

The medicine is started by a specialist in the care of people with dementia.

An antidepressant may be advised if depression is suspected.

Aspirin and other medicines to treat the risk factors for stroke and heart disease may be appropriate for some people - especially those with vascular dementia.

Sleeping tablets are sometimes needed if difficulty sleeping is a persistent problem.

A tranquilliser or an antipsychotic medicine is sometimes prescribed as a last resort for people with dementia who become easily agitated.

There are several other medicines which have been suggested for the treatment of Alzheimer's disease. These include gingko biloba (a herbal medicine), non-steroidal anti-inflammatory drugs (NSAIDs), vitamin E, oestrogens and statins.

Research continues and new medicines are being developed to help with dementia, which show some promise.

Support and care is the most important part of treatment

  • Physiotherapy
  • Measures to help simplify the daily routine and enhance memory may help some people.
  • Planning out and writing down a daily routine.
  • An occupational therapist may be able to advise.
  • Reality orientation is thought to help in some cases. This involves giving regular information to people with dementia about times, places, or people to keep them orientated.
  • Stimulating the brain, by recreational activities, problem-solving activities, and talking to the person with dementia may help to improve memory.
  • Regular physical activity
  • Behavioural therapy for depression that is quite common in people with dementia.

Can dementia be prevented?

At present, there are no specific medicines or treatments that are definitely known to reduce your chance of developing dementia. However, Keeping your brain active may also help to reduce your risk of developing dementia. So, for example, consider reading books, learning a foreign language, playing a musical instrument, taking up a new hobby.Further research is ongoing to try to find other ways of preventing dementia.

 

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