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Q & A

What are the causes of dementia and alzheimers and how can it be prevented?

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    • 0 votes vote up vote up

      Linda L wrote Jan 27, 2011
    • My mom may be in the early stage of dementia.  Her mom had alzheimers.  Is it hereditary - I’m starting to worry?

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    • 0 votes vote up vote up

      Cathie Beck wrote Jan 28, 2011
    • Linda, I don’t know for sure that it’s hereditary. I haven’t heard from others with a family member that has Alzheimers that they had a family history of it.  


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    • 0 votes vote up vote up

      Denise Richardson wrote Jan 28, 2011
    • The word dementia comes from the Latin de meaning “apart” and mens from the genitive mentis meaning “mind“. Dementia is the progressive deterioration in cognitive function - the ability to process thought (intelligence).

      Progressive means the symptoms will gradually get worse. The deterioration is more than might be expected from normal aging and is due to damage or disease. Damage could be due to a stroke, while an example of a disease might be Alzheimer’s.
      Dementia is a set of signs and symptoms
      Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention. Dementia, unlike Alzheimer’s, is not a disease in itself. When dementia appears the higher mental functions of the patient are involved initially. Eventually, in the later stages, the person may not know what day of the week, month or year it is, he may not know where he is, and might not be able to identify the people around him.  

      Dementia is significantly more common among elderly people. However, it can affect adults of any age.
      What are the symptoms of dementia?
      Memory loss - the patient may forget his way back home from the shops. He may forget names and places. He may find it hard to remember what happened earlier on during the day.  

      Moodiness - the patient may become more and more moody as parts of the brain that control emotion become damaged. Moods may also be affected by fear and anxiety - the patient is frightened about what is happening to him.  

      Communicative difficulties - the affected person finds it harder to talk read and/or write.
      As the dementia progresses, the patient’s ability to carry out everyday tasks diminishes and he may not be able to look after himself.
      Diseases that cause dementia

       Alzheimer’s disease - This is by far the most common cause of dementia. The chemistry and structure of the brain of a person with Alzheimer’s disease changes and his brain cells die prematurely.  

      Stroke (Vascular problems) - this means problems with blood vessels (veins and arteries). Our brain needs a good supply of oxygen-rich blood. If this supply is undermined in any way our brain cells could die - causing symptoms of vascular dementia. Symptoms may appear suddenly, or gradually. A major stroke will cause symptoms to appear suddenly while a series of mini strokes will not.  

      Dementia with Lewy bodies - spherical structures develop inside nerve cells. Brain cells are nerve cells; they form part of our nervous system. These spherical structures in the brain damage brain tissue. The patient’s memory, concentration and ability to speak are affected. Dementia with Lewy bodies is sometimes mistaken for Parkinson’s disease because the symptoms are fairly similar.  

      Fronto-temporal dementia - this includes Pick’s disease. The front part of the brain is damaged. The patient’s behavior and personality are affected first, later his memory changes.  

      Other diseases - progressive supranuclear palsy, Korsakoff’s syndrome, Binswanger’s disease, HIV and AIDS, and Creutzfeldt-Jakob disease (CJD). Dementia is also more common among patients who suffer from Parkinson’s disease, Huntington’s disease, Motor Neurone disease and Multiple Sclerosis. People who suffer from AIDS sometimes go on to develop cognitive impairment.
      What is schizophrenia? According to most experts, there are two main categories of dementia - cortical and subcortical dementias.
      Cortical Dementia - The cerebral cortex is affected. This is the outer layer of the brain. The cerebral cortex is vital for cognitive processes, such as language and memory. Alzheimer’s disease is a form of cortical dementia, as is CJD (Creutzfeldt-Jakob disease).  

      Subcortical Dementia - A part of the brain beneath the cortex (deeper inside) becomes affected or damaged. Language and memory are not usually affected. A patient with subcortical dementia will usually experience changes in his personality, his thinking may slow down, and his attention span may be shortened. Dementias which sometimes result from Parkinson’s disease are subcortical dementias, as are those caused by AIDS and Huntington’s disease.
      A patient with multi-infarct dementia will have both the cortical and subcortical parts of the brain affected or damaged.
      Diagnosis of dementia
      Although there are some brief tests, a more reliable diagnosis needs to be carried out by a specialist, such as a geriatric internist, geriatric psychiatrist, neurologist, neuropsychologist or geropsychologist.  

      The following tests are commonly used:
      AMTS (Abbreviated Mental Test Score) A score lower than six out of ten suggests a need for further evaluation.
      MMSE (Mini Mental State Examination) A score lower than twenty-four out of thirty suggests a need for further evaluation)
      3MS (Modified Mini-Mental State Examination)
      CASI (Cognitive Abilities Screening Instrument)
      It is important that the patient’s score is interpreted in context with his socio-economic, educational and cultural background. The tester must also factor in the patient’s present physical and mental state - does the patient suffer from depression, is he in great pain?  

      What is the treatment for dementia?
      In the majority of cases dementia is incurable. Researchers are making inroads into treatments that may slow down dementia’s progress. Cholinestaerase inhibitors are frequently administered during the early stages. Cognitive and behavioral therapies may also be useful. Several studies have found that music therapy helps patients with dementia. It is important to remember that the patient’s caregiver also needs training and emotional support.  

      See our specialized news channels

      Psychology / Psychiatry news

      Attention Deficit Hyperactive Disorder (ADHD) news

      Alzheimer’s / Dementia news

      Anxiety / Stress news

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      Bipolar disorder news

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      Eating disorders news

      Mental health news

      Neurology news

      Schizophrenia news In the USA, Tacrine (Cognex), donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon) have been approved for the treatment of dementia caused by Alzheimer’s disease - some physicians prescribe these drugs for vascular dementia as well. Selegiline, which is used for treating Parkinson’s disease, has been found to slow down the progress of dementia.  

      In Canada, a country where two languages are spoken, English and French, researchers found that bilingual people who develop dementia do so four years later than monolingual people who develop dementia. The four year difference prevails even after factoring for such variables as cultural differences, education, employment, gender and immigration.
      How common is dementia?
      United Kingdom - According to a report by the Alzheimer’s Society (UK), approximately 700,000 people in the United Kingdom have dementia, out of a total population of about 61 million. Your chances of having dementia are 1 in 100 during your late 60s, this rises to 6 in 100 in your late 70s, and 20 in 100 in your late 80s. As people live longer experts predict dementia will rise significantly. According to predictions, there will be 940,000 people with dementia in the United Kingdom by 2021.  

      Worldwide - According to a study published in The Lancet, approximately 24.3 million people had dementia worldwide in 2005, with 4.6 million new cases every year. The number of people with dementia will double every two decades and reach 81.1 million by 2040. The rate of increase is expected to be faster in developing countries which have rapidly-growing life expectancies. (Lancet. 2005 Dec 17;366(9503):2112-7)
      Sources - The Alzheimer’s Society

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    • 0 votes vote up vote up

      Denise Richardson wrote Jan 28, 2011
    • Symptoms and Stages of Alzheimer’s disease
      There are many things the medical community understands about Alzheimer’s disease and many things it doesn’t yet know. For example, it’s not clear why some people with Alzheimer’s disease experience faster decline than others. Early Alzheimer’s diagnosis and treatment may help to slow progression of Alzheimer’s symptoms.  

      One way doctors are able to make a determination about which stage of the disease a person is suffering from is by using the Functional Assessment Staging (FAST) scale developed by Dr. Barry Reisberg, professor at the New York University School of Medicine. The FAST scale divides the progression of Alzheimer’s disease into areas of functional loss, such as degrees of forgetfulness, agitation and behavior and deficits in intellect and reasoning, as well as the ability to perform daily activities. By understanding the various areas, Alzheimer’s caregivers can better meet the needs of the person suffering from Alzheimer’s.19  

      Alzheimer’s Disease: Progressing through Three Stages
      In people with Alzheimer’s disease, changes in the brain may begin 10 to 20 years before any visible signs or symptoms appear. Some regions of the brain may begin to shrink, resulting in memory loss, one of the first signs of Alzheimer’s disease.  

      Over time, Alzheimer’s disease progresses through three main stages: mild, moderate, and severe. Because it is not easy to look inside a living brain to see the damage Alzheimer’s disease causes, these stages are characterized by a collection of signs and symptoms and behaviors the people with Alzheimer’s disease experience.  

      Mild Alzheimer’s Disease
      People with mild symptoms of Alzheimer’s disease often seem healthy, but they are actually having trouble making sense of the world around them. It often takes time for an observer to realize that something is wrong because the initial symptoms are often confused with changes that take place in normal aging. Symptoms and early signs of Alzheimer’s disease may include:  

      •Difficulty learning and remembering new information
      •Difficulty managing finances, planning meals, taking medications on schedule
      •Depression symptoms (sadness, decreased interest in usual activities, loss of energy)
      •Difficulty with some activities such as driving a car
      •Gets lost going to familiar places
      Moderate Alzheimer’s Disease
      In moderate Alzheimer’s disease, the damaging processes occurring in the brain worsen and spread to other areas that control language, reasoning, sensory processing, and thought. In this stage, symptoms and signs of Alzheimer’s disease become more pronounced and behavioral problems may become more obvious. Signs and symptoms of moderate Alzheimer’s disease may include:  

      •Forgetting old facts
      ◦Continually repeats stories and/or asks the same questions over and over
      ◦Makes up stories to fill gaps
      •Difficulty performing tasks
      ◦Following written notes
      ◦Using the shower and toilet
      •Agitation, behavioral symptoms common
      ◦Restlessness, repetitive movements
      ◦Paranoia, delusions, hallucinations
      •Deficits in intellect and reasoning
      •Lack of concern for appearance, hygiene, and sleep become more noticeable
      To learn more about slowing the progression of Alzheimer’s disease with Namenda, along with additional Alzheimer’s resources, click on the link that best describes your current Alzheimer’s disease treatment situation.

      Severe Alzheimer’s Disease
      In the advanced stage of Alzheimer’s disease, damage to the brain’s nerve cells is widespread. At this point, full-time care is typically required. For friends, family, and Alzheimer’s caregivers, this can be the most difficult stage. People with severe Alzheimer’s disease may have difficulty walking, and they often suffer complications from other illnesses, such as pneumonia. Signs of severe Alzheimer’s disease may include:  

      •Vocalizations such as groaning, screaming, mumbling, or speaking gibberish
      •Behavioral symptoms
      ◦Refuses to eat
      ◦Inappropriately cries out
      •Failure to recognize family or faces
      •Difficulty with all essential activities of daily living
      People with moderate to severe Alzheimer’s disease may benefit from treatment with
      Namenda® (memantine HCl)*, the first Alzheimer’s medication approved to treat moderate to severe Alzheimer’s disease. Namenda works in an entirely different way than currently available medications, and offers an important advance in the treatment of Alzheimer’s disease.

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    • 0 votes vote up vote up

      Linda L wrote Jan 29, 2011
    • Thank you Neicy for doing the homework for me.  The above information was very helpful.


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