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Dr. Vijayakumar D.R MBBS, DPM, DNB (NIMHANS), CCST (UK)
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Alzheimer's and Dementia

DEMENTIA

What is dementia?

Dementia is a disease which causes change in the behaviour, memory, intellect and personality of the person. The decline is gradually and the rate of decline depends upon the underlying cause.  

It usually occurs after the age of 65 yrs and the older you get the chances of getting dementia increases.

Some people can get dementia even before the age of 65yrs.

What are the causes of dementia?

The following types of dementia account for 90% of all cases

  1. Alzheimer’s disease
  2. Diffuse lewy body dementia
  3. Frontotemporal dementia 
  4. Vascular dementia

The cause of Alzheimer’s disease is not known but we know that it can be associated with Down’s syndrome. We know that it causes damage to the brain leading to the symptoms of dementia. It is the most common cause of dementia.

Vascular dementia also causes damage to the brain by causing small blocks in the blood vessels supplying the brain called infarcts.  The more the infarcts the more the degree of damage to the brain.

Diffuse lewy body dementia is neurodegenerative disease in which the person can suffer from Parkinson’s disease symptoms.

What are the symptoms of dementias?

Depending upon the cause of dementia and the site of brain involved symptoms of dementia can vary. The person gradually loses the functions of the brain leading to memory loss, initially for immediate and recent memory and gradually remote memory. They forget instructions given, misplace keys, lose their way, fail to identify people and can also lose the ability to wear clothes and take care of their personal care.  There can be change in their personality and they can get irritable and angry easily, abusive, sleep can be disturbed, they can become talkative and disruptive.  Some people can suffer with psychiatry problems like visual hallucinations, depression and auditory hallucinations.

How is dementia treated?

 When a person first presents with symptoms the doctor will examine the person and advice a battery of tests both blood tests and CT/MRI of the brain. This is to find out the cause for dementia and look for any reversible causes of dementia.

The aim of the treatment is maintain the quality of life and dignity of the person. Hence the approaches are with medication and counseling the carers about the illness and how to manage such patients.

Medications like donapezil may be prescribed to slow down the rate of deterioration of the brain.