About the condition
Alzheimer’s disease is the most common cause of dementia. Age, genetic inheritance, environmental factors, lifestyle and general health are all possible causes. The chemistry and structure of the brain change, leading to the death of brain cells. Problems of short term memory are usually the first noticeable sign.
Vascular dementia may arise when the oxygen supply to the brain fails due to vascular disease which can cause brain cells to die. This can occur either suddenly, following a stroke, or over time through a series of small strokes.
Dementia with Lewy bodies Abnormal structures that develop inside nerve cells in the brain lead to the degeneration of brain tissue. Symptoms can include disorientation and hallucinations, as well as problems with planning, reasoning and problem solving. Memory may be affected to a lesser degree. This form of dementia shares some characteristics with Parkinson’s disease.
Fronto-temporal dementia (including Pick’s disease) Damage is concentrated in the front part of the brain. Personality and behaviour changes are the most obvious signs.
Rarer diseases may lead to dementia, including HIV/AIDS and Creutzfeldt-
Jakob disease (CJD), progressive supranuclear palsy, Korsakoff’s syndrome, Binswanger’s disease. Some people with multiple sclerosis, motor neurone disease, Parkinson’s disease and Huntington’s disease may also develop dementia as a result of disease progression.
Dementia is progressive, which means the symptoms will gradually get worse. How quickly, will depend on the individual and what type of dementia they have.
* Memory loss, especially short-term memory. Long-term memory is usually still quite good.
* Mood changes - people with dementia may be withdrawn, sad, frightened or angry. It can lead to depression.
* Communication problems - including difficulty finding the right words, struggling with numbers, getting confused.
This can be very difficult, especially determining which type of dementia a person has. Many people worry they have dementia, particularly if they think that their memory is getting worse. Becoming forgetful can be an effect of ageing as well as a sign of stress or depression. In rare instances, dementia-
like symptoms can be caused by vitamin deficiencies and/or a brain tumour. It is therefore very important to get a proper diagnosis. Doctors may carry out a number of tests to check basic thinking processes and the ability to perform daily tasks.
Most types of dementia are progressive and cannot be cured. However, there are some exceptions, including dementia caused by vitamin and thyroid hormone deficiences, which can be treated with supplements. Some causes can be treated surgically, for example, some brain tumours, excess fluid on the brain (hydrocephalus) or head injury. For neurodegenerative types of dementia, it is important to prevent additional damage by modifying risk factors, such as treating high blood pressure, high cholesterol, type 1 diabetes and stopping smoking.
For dementia that cannot be cured, such as Alzheimer’s disease, medicines can be prescribed that may prevent symptoms getting worse for a period of time. These are generally prescribed to people in the early and middle stages of the disease.
It is fairly common for people with dementia to have depression as well, and this can be treated.
Medications that may be prescribed for Alzheimer’s disease include donepezil, galantamine, rivastigimine and memantine. The first three are all AChE inhibitors and can be prescribed for people with mild to moderate Alzheimer's disease. Memantine may be prescribed for people with moderate Alzheimer's who cannot take AChE inhibitors or for those with severe Alzheimer's disease.
There are steps people can take which may delay the onset of dementia such as stopping smoking and cutting down on alcohol, eating a healthy diet, and staying physically fit and mentally active. Older people should have regular health tests since progress of the condition can be slowed if caught early.
There are also drugs that can temporarily alleviate some of the symptoms of some types of dementia.
Did you know?
* Terry Pratchett, Iris Murdoch, George Melly and Ronald Reagan all have or had Alzheimer’s.
* Alzheimer’s disease is the most common cause of dementia affecting around 496,000 people in the UK. Dementia is a common condition that affects around 800,000.
* Alzheimer’s disease is the most common in people over 65 and affects slightly more women than men. Dementia in people under 65 known as early onset dementia, is less common. In the UK around 2% of all dementia cases are early onset. The risk increases with age and people who are over 80 have an estimated 1 in 6 chance of developing the condition.
* There is no cure for Alzheimer’s disease although medication can slow down the development of the condition in some people.