Dementia is not something that happens suddenly, overnight, but a gradual worsening of cognitive functions. It could be described as a chronic brain impairment and not only a more serious memory loss, which may be frequent in elderly. It is much more than that and it is not a normal part of aging. Understanding that dementia is a disease with serious outcomes may help you to prepare for the worst times, when you might not be even recognized any more by your loved one.
A pile of problems, deterioration of ability to perform daily tasks, or manage overall affairs, manage time, control behavior, remember instructions, focus attention, plan things, doing the right things. These processes are called executive functions. Language, judgment, reading and comprehending also can be affected.
Early Dementia Signs
Unfortunately, early diagnosis often fail, as the signs are mostly attributed to aging, while they are mild:
-memory problems
-lack of concentration, attention
-lower ability to solve a problem
-difficulty with learning new information
Only when some more serious symptoms occur, dementia appears as a possibility to the observer (the person themselves, or a family member) and may be a reason for an examination:
-frequent confusions
-disorientation (in time and even place)
-obvious mood changes, to worse
-depression which consistently becomes worse,
-anxiety
-irrational fear
-ill-founded accusations
-paranoia
-delusions and hallucinations
After these, many more are following, as the disease is progressive.
Dementia Risk Factors
If you read some of my previous articles on physical health and various illnesses related to age, you will find these causes familiar. More or less these are factors that increase risk of developing many diseases, and not only at old age. Only one or two are specific risks of dementia, the others are pretty much general risks for your overall health, as well:
-physical inactivity
-smoking,
-excessive use of alcohol,
-being overweight,
-eating an unhealthy diet,
-unhealthy sleeping,
-high blood pressure,
cholesterol and/or blood sugar levels
-existing depression,
-loneliness, social isolation,
-letting your brain rust, not challenging it
-side effects of certain medications
What Dementia Is Caused By?
While health experts believe the direct cause of the dementia are modifications in or around the brain cells caused by abnormal protein build-up into a form of plaque, which interferes with normal brain functioning, it is not very clear what exactly triggers this build-up.
There were researches and studies that indicate some protein structures are capable of independent replication once they are spontaneously formed. This formation is said to take several decades, though, but once it is formed, can rapidly multiply. Still, I was not able to find an explanation for the cause of this spontaneous formations during my research.
Another abnormality can lead to a form of dementia, specifically called vascular dementia. Here the vessels in the brain, carrying oxygen and nutrients to the brain cells get damaged. The small vessels can be narrowed by plaque, or can have a blockage. It may appear suddenly, after a stroke or TIA, for example, or it can develop gradually in accordance with the vessels narrowing.
There are many more forms of dementia, the best known of which is Alzheimer’s disease, which often accompanies vascular dementia. If a person suffers from one dementia, another form also may be present, which makes dealing with it more complicated.
Stages of Dementia
Mild dementia can be easily mixed with normal aging and it’s difficulties, as at this stage the sufferer have mild memory problems, perhaps forgetting names, or finding the right expression at the moment. Some organizational problems may occur and some lack of concentration. All these we usually attach to normal aging brain function decline.
At this stage a person is still capable of performing the daily activities and may require help with tasks like shopping, housekeeping, cooking, managing money, paying bills, perhaps transporting, although they probably still can drive themselves, as well.
Moderate dementia symptoms will rarely leave someone in doubt whether there is a need to visit the doctor or not. Signs are more pronounced, more obvious. Stopping in the middle of the sentence forgetting what they were about to say, not being able to follow others’ sentences, forgetting names of their interlocutors, are just a few examples. The same question might be repeated over and over, forgetting it was answered already…
They may forget where they are or where they came from, even the name of their street, not to mention the way home. Wandering is quite common in this stage and causes numerous headaches to their caregivers. Your loved one with dementia will fail to inform anyone about getting out. Having a personal alarm device with a built in tracker may be a good solution.
Depression or aggressiveness is not rare, either. An earlier mild, good-hearted person may now show complete lack of any empathy or even impatience, anger towards others. Some new fears may appear, irrational from our point of view, but very real to them. For example, a fear of water, which makes more difficult to maintain a normal personal care, as bathing, showering is often out of reach at this stage.
Delusions and hallucinations may make them see and hear things that you don’t. No persuasion of “but, no one is there, believe me…” type will help. It will only worsen things. If you care for someone with such manifestations of dementia, you’ll need to approach this with something like: “Oh, I see. Do you want me to ask them to leave, so you can rest?”
It will require a lot of patience and a lot of creativity to deal with such situations and that is partly the reason why it is so difficult to be a dementia patient’s carer.
Some physical appearances will in time include incontinence of urine and bowels, tremors, sometimes constant munching (even when not eating anything)…They are usually not aware of any of these. Try to remember this when you need to clean up the stains from the carpet as it was yet again mistaken for the toilet. None of that is done on purpose.
Their actions are very unpredictable and they may present danger for themselves, as they might decide, for example, to rearrange things in a room and break a foot bone by dropping a heavy statue on it, or set a fire in the middle of the kitchen, thinking they are having a picnic in the woods (both examples are real, sadly), so in this stage it already becomes essential that they are never left alone.
Severe Dementia is the advanced stage of the disease, where all the symptoms are highly enhanced. The communication becomes very difficult if not impossible altogether. Forgetfulness is always present and very often the person will forget in just minutes what happened, even if it was a dinner or a visit of a loved one.
They need to be prompted multiple times to drink, eat, or take medications. You could be asked to give a reason for administering the medication, and a simple “for your health” often isn’t good enough. You might be not understood whatever you say, so you just might want to try again a bit later. Dementia might also bring a person to be frightened of something particular, or generally frightened of everything.
At any moment a person might feel decades back in time and genuinely believe they are young and just dealing with some event that happened then. It can be such a realistic feeling that they are ready to go to work, or to the playground to play marbles with other boys, play with a doll or look for their mother. Again, they usually can’t recall any of this later.
They might recognize family, but forget or mix their names. They are incapable of performing ADSL (daily activities) and need a constant care with almost everything. Sometimes a feeding may be needed, as well. A physical deterioration might be also present to the point when walking is either very difficult, or impossible without aids or constant support.
Sleeping becomes more than an old age insomnia-it’s not rare that they change night for the day, which usually drives crazy the person caring for them. They can effectively doze the whole day in a chair, or even refuse to stand up in the morning and then require company at night as they can’t sleep. Or in the middle of the night they think it’s time to get up and go to work, or to an appointment, or meet a long gone friend, or catch a train… It will take a long reassuring or distracting conversation to get a person back into bed. It can be extremely tiring for the carer.
Is There a Cure for Dementia?
No, there isn’t. That said, although there are no known ways to cure or reverse dementia, (except in very rare cases, when the cause is an underlying treatable illness), there are ways to manage the symptoms to a certain level, either by medication, or by therapies.
It is not at all easy to accept dementia diagnose, neither for the person itself, nor for the loved ones. However, it is important to realize that the sooner it’s accepted as a reality, the sooner the proper treatment may be applied.
Memory-, problem solving skills- or language-improving exercises are called cognitive stimulation therapy and they can be fairly effective, mostly in the first, mild stage and somewhat in the second, moderate stage dementia.
Severe dementia will require medications, which will be determined by the doctor. Never try to add any medication or alternative remedies (various plants and vitamins that can be of help, but can also interfere with medications) without consulting a doctor first.
Final Thoughts
Dementia is a disease that has a huge impact not only on the person suffering from it, but on the family and the caregiver, as well. Coping with this illness is very complex and very exhausting.
In this article we only touched the tip of the iceberg, but hopefully you do understand now what is happening, why and what to look for if you suspect your loved one might be at the start of it. This can also give you a small glimpse into what to expect and how to start preparing for it.
I will be writing more about it, with more details on how to cope with various issues typical for dementia in my next posts.
Do you have any experience with dementia in your surroundings? Would you share it in the comments? We could all learn something…
And, as always, feel free to reach out should you have any question and I’ll be happy to answer to the best of my knowledge.
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A very informative read. I haven’t come across a family member or any other close ones who has dementia, so this read has been an insightful one.
It must be painful to be in their shoes. I’m sure at some point (before it worsens) they feel powerless already.
And still, it is as painful to be the person watching your beloved one to digress further into the disease..
Keeping the brain healthy and challenged is so important. I’m glad you shared this.
Cheers.
SAM
It is indeed, painful for both, the sufferer and the supporter, I’m glad you did not have to experience for yourself.
Thank you for your comment
All the best,
Kerryanne
Great post.
My grandmother passed away from Alzheimer’s, such sad disease. It’s very hard to watch by as you lose that person you knew right before your eyes.
I didn’t know all this information, so will be useful to keep an eye out in the future.
Really informative information, and enjoyed the read.
Thank you,
Adam
Thank you Adam, I’m glad you found my article useful.
Thank you also for sharing memory of your Grandma.Hopefully you’ll never be forced to go through it again.
All the best,
Kerryanne
I lost my grandmother to Alzheimer’s. It was rather slowly developing at first. I think it took about 5 years from the first symptoms of her becoming a bit “silly” to losing her ability to form understandable words. Even then she had moments of clarity. But the worst thing is that soon after that she was hospitalized and remained that way for several years. I remember very vividly how the last Christmas out of the hospital she had only one moment of clarity when she said something along the lines of “I’m an old woman, I should be dead already!”.
I know I have the gene (tested) and my parents are closing in on their 70’s so this is a topic that haunts me at times. I’ve read quite a bit of the research about dmentia, Alzheimers specifically. One of the leading theories is that it’s a metabolical condition of the brain, diabetes type 3 they’ve even called it. It’s actually fascinating that both a ketogenic diet and creatine supplementation can significantly affect (positively) the progression of Alzheimer’s. I’m confident some forms of dementia will be treatable in the future but other might not be. A horrible way to go in any case.
Hi Chuck, thank you for sharing your thoughts, I appreciate it.
It is so sad and cruel in the same time to be the silent observer of your loved one drifting away, incapable of stopping it.It is even more horrible for the patients, who in some moments of clarity, even for a very short time, may completely understand what their life became and wish they weren’t any more. So sad, but not that uncommon.It is sad also for you, as you remember exactly that so vividly.
As for the gene-I’m sure you found a lot of informations about the genes that are associated with Alzheimer’s onset, but also represent only one of many factors that will determine whether a person will or will not develop any of dementias, so Alzheimer’s amongst them. In other words, you may have the genes, but never develop any of dementias, as lifestyle factors bear at least that much influence as the genes, if not more. If you take proper care of yourself with a healthy lifestyle, lots of physical and mental activities and keep any cardiovascular or other risky condition under control, you should be fine.
There is a lot of controversy about the classification of Alzheimer’s as Diabetes Type3, as scientists say much more research is needed yet. However, they really found that diabetes can in some cases limit insulin resistance effects to the brain instead of on the whole body and thus develop Alzheimer’s. Also, the risk of developing it seems to be 65% higher in people with diabetes than in those without it, so it looks like some strong arguments are in favour of accepting the term.
It is interesting that you mention keto, as its very low carb composition can significantly influence the insulin resistance and lower the risk of AD development, indeed.
Actually, you gave me a very good idea for one of my next posts, so thank you.
All the best,
Kerryanne
Hi there,
There’s such valuable information here, and very important information that everyone should be aware of. I find is scary that so many health issues can be attributed to mental health (in this case, loneliness). It sounds as if there’s certain things that can be done to diminish the risk of developing this cruel disease.
Sharon
Absolutely-Every man is the architect of his own fortune, i.e. in this case health. As much as we take care of our body and mind that much we’ll be rewarded by a disease-free life later, even with such a common one as dementia.
Thanks for popping in, it’s nice to see you here.
All the best,
Kerryanne
Hi there,
I do not know anyone who has dementia, but I have read about it (in some novels) and I have also seen it portrayed in movies. The moderate and advanced form sound terrible. While I was reading through your article, I kept on thinking how difficult this must be, not only for the patient, but also for the family. Not recognizing a loved one must feel terrible … Can the therapy exercises you mention alleviate the symptoms a little or keep an advancement of the disease at bay for a while? When someone has a mild form of dementia, will it gradually get worse, go from mild to moderate and then advance, or is it possible that the disease does not worsen and you can keep it in a mild or moderate stage?
Hi Christine, hopefully you will never have to see it closely 😉
It is a cruel disease that takes away not only the physical, but also the mental being, the essence of a person, forever.
The therapy can’t really cure the disease, nor can it stop from worsening, but can teach a person how to use the parts of the brain which are still healthy to replace the ones that are, thus keeping some functions which would otherwise be lost.
Unfortuantely, if present, dementia will deteriorate and in time it will inevitably get into the severe stage, at an advanced age. At the present time, we know nothing that could keep it frozen at a milder stage.
That, I’d say is the background that makes even worse to have a loved one with this cruel disease, ’cause you know how it ends and you can do absolutely nothing.
Dementia is so sad and horrible. I have been through this with a family member. It was so incredibly hard to watch. I remember feeling so sad when my grandmother didn’t recognize me or thought I was someone else. You are right about the advanced stage of their body failing. That was equally as hard to watch how fast it all happened. My once very happy and mobile grandmother became bedridden angry and didn’t know anyone or remember normal body functions. I can’t even imagine how hard it is on the caregiver. I have always focused on how hard it was for us as family, but you gave me another perspective to look at it from. We all need to have more compassion for caregivers. It takes a special person to do this job.
Hi Cheyenne, yes it is sad and horrible on everyone involved-on the person who suffers from it, on the family, on the caregiver-whether it is a family member or not. Carers working with dementia are specially trained for the job, but very frequently, they develop a more devoted relationship and feel almost as horrible as the actual family members, on top of the every day, not so easy tasks they perform.
But, it is still the worst for the person who at some moments does not even know who, or where they were, nor who is that “unknown person” (very often their very partner for decades) trying to give them some food or help with medication. It is as if you were ripped out from your own world and placed to another, completely unknown to you. It is horrible, indeed.
Thank you for sharing this memory with us!
Your article brought back a lot of painful memories. My father suffered from Alzheimer’s. You name a list of possible causes. The only two I can think of that he might have had were depression and a rusty brain. The first question the intaker at the nursing home asked: is there more dementia in the family? There was. So I said: hmm, then I know what will happen to me.
She responded that it’s not a hereditary ailment.
Then why the question, I wondered.
Anyway, we’ll see 🙂
Hi Hannie, sorry to remind you of such a painful period, I know it is always heartbreaking to watch someone you love deteriorate in such a way and not be able to help. 🙁
Do not be worried, though-Alzheimer’s and Dementia in general, except in very-very rare cases, are not hereditary indeed. What can be inherited are the predispositions for the underlying diseases than can lead to the development of dementia of any kind. But, even then, not everyone will develop one.
As long as you keep your overall health under control and keep challenging your brain (which you very well do) you should be ok.