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Dementia and how to recognise it

Dr Chris Browne describes the symptoms of dementia.

Dementia is the deterioration of brain function that results in memory loss, poor communication skills, impaired reasoning and difficulty in carrying out normal living tasks.

In the UK over 750,000 people suffer from dementia.  It affects one person in 20 aged over 65 and one person in five over 80.

As the population of the UK gets older, so dementia will become a growing illness that needs increased resources to treat, and to care for sufferers.

Alcohol-related dementia is also set to increase as alcohol abuse, particularly within the middle-aged, has risen in the last 20 years.

There are over 100 different types of dementia. The most common are Alzheimer's disease; vascular dementia; and dementia with Lewy bodies.

Most common symptoms

Although there are common symptoms of dementia, each individual can be affected in different ways.

Depending on the type and severity of dementia, symptoms can include:

  • memory loss, especially of more recent events, losing or misplacing objects and forgetfullness;
  • becoming disoriented, especially in new or unfamiliar surroundings;
  • inability to find the correct words or understand others;
  • poor concentration;
  • problems with new ideas or skills;
  • poor judgemental and reasoning ability;
  • becoming irritable, saying or doing inappropriate things or becoming suspicious or aggressive.

In more advanced stages, dementia will cause severe intellectual, behavioural and physical problems, including loss of speech, immobility, frailty and incontinence.

These symptoms may, however, be caused by stress, depression, diabetes, vitamin deficiency, infections or many other illnesses. It is therefore important for the person to be examined by a doctor and an accurate diagnosis made, possibly by a specialist.

Types of dementia

Alzheimer's disease
This is the most common type of dementia. In Alzheimer's disease, the number of nerve cells in the brain gradually reduces.

The person with Alzheimer's therefore gets progressively worse as more cells are destroyed.

The nerve signals that are essential for language and problem solving and controlling movements are impaired. During late stages of the disease, people with Alzheimer's will become totally dependent on others for their care.

Symptoms of Alzheimer's disease:

  • usually starts with forgetfulness;
  • problems working things out;
  • difficulty finding the right words;
  • behaviourial changes;
  • difficulty with everyday tasks;
  • disorientation - loss of sense of time and place;
  • confusion caused by new surroundings and people;
  • difficulty recognising well-known family and friends.

Dementia with Lewy bodies
Dementia with Lewy bodies accounts for up to 15 per cent of all cases of dementia in older people.

Lewy bodies are tiny protein deposits found in nerve cells. Their presence in the brain interrupts the action of chemical messengers, and disrupts its normal functioning.

It causes impairment of memory, language and reasoning. It can also affect areas of the brain that control movement, balance and vision.

People with Lewy body disease may have symptoms including:

  • difficulty moving, resulting in falling and slowness;
  • problems judging distances;
  • hallucinations, causing the person to become agitated and disturbed;
  • rapid deterioration in abilities.

Vascular dementia
Vascular dementia, or multi-infarct dementia, accounts for 20 per cent of all dementias.

It is caused by small blood vessels in the brain becoming blocked which prevents oxygen reaching nearby brain cells, leading to their death.

This type of dementia is usually identified by sudden changes in behaviour. The exact changes will depend on the area of the brain where the small strokes have occurred.

As more of the brain is damaged by these strokes, the dementia starts to resemble Alzheimer's disease.

Vascular disease is treatable and treatment may help to reduce the risk of further incidents to the brain.

Other types of dementia
There are other types of dementia including fronto-temporal dementia (Pick's disease) which initially affects behaviour and personality more than memory, and alcohol-related dementia that normally affects those in middle age with a history of alcohol abuse.

People with multiple sclerosis, motor neurone disease, Parkinson's disease and Huntington's disease are more likely to develop dementia.

If you are concerned about a friend, relative, or even yourself,  seek advice as soon as possible by visiting your doctor.

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