As we age, sometimes we get forgetful. For example, we may walk into a room and think, “What did I need in here?” This is common, especially with a busy lifestyle and many tasks circling in our brain at any given time. It’s also very normal for older adults to have slight memory loss. However, when memory loss begins to affect your daily life and relationships or seems to be getting worse, you may have dementia. We will discuss what dementia is, the different types of the disease as well as symptoms, diagnosis and treatments.
What is dementia?
Dementia is a loss of mental skills that affects your daily life. It can cause problems with memory, problem solving and learning, as well as cognitive processes like thinking and planning. Dementia usually gets worse over time, but how quickly it worsens is different for each person—some people stay the same for years, while others will lose skills quickly. Your chances of having dementia rise as you get older, but not everyone will develop the condition.
What are the types of dementia?
Dementia is caused by different diseases that affect the brain. The types of dementia are, therefore, named by the disease or changes in the brain that cause the dementia symptoms.
- Alzheimer's disease. This causes the loss of brain cells in many areas of the brain, and the brain shrinks.
- Vascular dementia. This is usually caused by several small strokes. In a stroke, blood supply to areas of the brain is cut off.
- Dementia with Lewy bodies. In this condition, abnormal structures called Lewy bodies form in the brain.
- Parkinson's disease dementia. This dementia may develop a year or more after problems with movement begin.
- Frontotemporal dementia. This is caused by a group of diseases in which certain areas of the brain shrink.
What are the symptoms of dementia?
Usually, the first symptom of dementia is memory loss. Often the person who has the memory problem doesn't notice it, but family and friends do.
People who have dementia may have increasing trouble with:
- Recalling recent events. They may forget appointments or lose objects.
- Recognizing people and places.
- Keeping up with conversations and activity.
- Finding their way around familiar places or driving to and from places they know well.
- Keeping up personal care such as grooming or bathing.
- Planning and carrying out routine tasks. For example, they may have trouble following a recipe or writing a letter or email.
How is dementia diagnosed?
To diagnose dementia, your doctor will:
- Do a physical exam.
- Ask questions about recent and past illnesses and life events. The doctor will want to talk to a close family member to check details.
- Ask you to do some simple things that test your memory and other mental skills. For example, your doctor may ask you to say what day and year it is, repeat a series of words or draw a clock face.
The doctor then may do tests to look for a cause that can be treated. For example, you might have blood work done to check your thyroid or to check for infection. You might have an MRI or a CT scan so your provider can see a picture of your brain to check for tumors or brain injury.
How is dementia treated?
Dementia can be treated with medicines that can slow down the decline and make it easier to live with. These treatments may also improve mental function, mood or behavior. Patients will receive routine follow-up visits with their providers to monitor their medicines and their level of functioning. The goals of ongoing dementia treatment are to keep the person safely at home for as long as possible and to provide support and guidance to their caregivers.
If the dementia was caused by a stroke, making lifestyle changes to reduce the risk of another stroke are typically also recommended. Lifestyle adjustments may include eating healthy foods, being active, staying at a healthy weight and stopping smoking.
As dementia progresses, patients may also experience depression or anger. An active social life, counseling and sometimes medicines can help with these changing emotions.
How can you care for yourself when you have dementia?
After a dementia diagnosis, it’s important to continue to take care of yourself as best as you are able. Here is some helpful advice:
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Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
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Eat healthy foods including whole grains, fruits, and vegetables every day. If you don’t feel hungry, try snacks or nutritional drinks such as Boost, Ensure or Sustacal.
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Get a good night’s sleep. If you have problems sleeping:
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Try not to nap too close to your bedtime.
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Exercise regularly. Walking is a good choice.
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Try a glass of warm milk or caffeine-free herbal tea before bed.
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Do tasks and activities during the time of day when you feel your best. It may help to develop a daily routine.
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Use labels, lists and sticky notes to help you remember things. Write your activities on a calendar you can easily find. Put your clock where you can easily see it.
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Stay active. Take walks in familiar places, or with friends or loved ones. Try to stay active mentally, too. Read and work crossword puzzles if you enjoy these activities.
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Do not drive unless you can pass an on-road driving test. If you are not sure if you are safe to drive, your state driver's license bureau can test you.
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Keep a cordless phone and a flashlight with new batteries by your bed. If possible, put a phone in each of the main rooms of your house, or carry a cell phone in case you fall and cannot reach a phone. Or you can wear a device around your neck or wrist where you push a button that sends a signal for help.
What to do after a dementia diagnosis
Learning you have dementia can be an overwhelming and emotional experience. Give yourself time to process. When you are ready you can acknowledge your emotions and start to make a plan for the future. This can take different forms, but commonly this process includes:
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Talk openly and honestly with your doctor.
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Let yourself grieve. It is normal to feel angry, scared, frustrated, anxious, or depressed.
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Get emotional support from family, friends, a support group or a counselor experienced in working with people who have dementia.
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Ask for help if you need it.
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Tell your doctor how you feel. You may feel upset, angry, or worried at times. Many things can cause this, including poor sleep, medicine side effects, confusion, and pain. Your doctor may be able to help you.
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Talk to your family and doctor about preparing a living will and other important papers while you can make decisions. These papers tell your doctors how to care for you at the end of your life.
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Consider naming a person to make decisions about your care if you are not able to.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.