What Are Different Types Of Dementia?

: Admin : 2021-12-14

What are neurological disorders?

The central nervous system formed of the brain and spinal cord, coordinates different movements, sensations, nerve impulses through a complex network of nerves fibres projecting all across the human body. Structural, biochemical and electrical abnormalities in the brain, spinal cord and nerves cause different symptoms, medically termed as neurological dysfunction or disorder. Many bacterial and viral infections or low immune responses also cause neurological disorders. Millions of people worldwide are affected by these disorders. An epidemiological survey reveals about 47.5 million people suffering from dementia—a common disorder, worldwide with up to 7.7 million new cases found each year.

Epilepsy, stroke, Parkinson's disease, Amyotrophic lateral Sclerosis and dementia are common neurological disorders. Patients can be affected by neurological disorders during any phase of life. Headache is a common disorder that can be felt or experienced at any age whereas dementia – a neurological disorder that causes memory loss is observed in the geriatric age group of patients. 

What is Dementia?

Old age is the most difficult phase of life that is considered a second childhood. Every human being grows, evolves, enters different milestones, competes with the world for survival and finally turns old. The idea or the belief to live in a nuclear family have enforced an independent life for people. Life begins when a child is dependent on a parent and ends with the dependence of the same human being on his children. However, the traditional custom of living with elders, parents and grandparents is now gradually declining with a system on the modern concept of nuclear families.

People who are above 60 years of age, living alone or in old age homes, sometimes live a very miserable, sorrowful life. They suffer from different acute and chronic diseases without any family support to rescue them from harsh circumstances. Degenerative chronic diseases, shock from acute conditions cause mental, physical and emotional trauma when they sense a feeling of being alone. Lack of knowledge, facility, neglect of symptoms, inadequate medical care cause detrimental harm to their lives and eventually they fall prey to neurological disorders from chronic grief or shock.

DEMENTIA is a group of symptoms from damaged or diseased parts of the brain that once were normally functional. Cognitive skills, loss of memory, ability to logical reasoning, intellect, language or speech are severely impaired from the damaged pathological state of the brain. It is estimated that up to 8% of people during old age suffer from dementia. The percentage increases every 5 years after 65 years of age where patients are triggered by minor discomfort, trauma, grief with gradual loss or retardation in normal functions of the brain.

What are the risk factors that cause dementia?

There are certain physical and lifestyle factors responsible to cause dementia.

AGE – As age advances above 65, more people are affected by this neurological disorder.

FAMILY HISTORY – If there is a family history of dementia, then the patient is at a high risk of dementia.

COMORBID CONDITIONS or illnesses like diabetes mellitus, Down syndrome, multiple sclerosis, heart disease, depression and sleep apnoea are risk factors that cause dementia.

HABIT OF smoking, regular heavy intake of alcohol, lack of nutrition-rich balanced diet and exercise are a few risk factors that develop dementia.

INJURY TO BRAIN, STROKE, emotional trauma, mental shock, infections of brain-like meningitis or syphilis are risk factors that eventually and gradually cause dementia.

What are the causes of dementia?

Common causes of dementia can be grouped as under.

DEGENERATIVE NEUROLOGICAL CONDITIONS that damage, impair, destroy different parts of the brain are responsible for an irreversible pathological diseased state termed dementia. These include Alzheimer's disease, Parkinson's disease, Huntington’s disease and certain types of multiple sclerosis.  Dementia that weakens brain functions to a state of complete loss of memory to lack of cognitive brain functions, worsen over a period of time in patients with above-diseased conditions.

VASCULAR DISEASES affect the normal blood circulation of the brain. Traumatic brain injury from accidents or fall, infections of the central nervous system like HIV, meningitis, accumulation of fluid in the brain and drug abuse can cause dementia.

METABOLIC DISORDERS like hypothyroidism, vitamin B12 deficiency, hypoglycemia, blood clots in the brain can cause dementia.

What are the symptoms of dementia?

A patient who shows signs and symptoms of memory loss, reasoning skills, forgetting routine activities, being unable to do daily household chores, getting lost at places from where they cannot find their own way, depression and mood swings should consult a neuro physician.  The patient finds difficulty while speaking and is unable to comprehend any language.

How is dementia diagnosed?

When the patient with any of the above symptoms consults a physician, the doctor records all signs and symptoms from his family members. The diagnosis of the disease is based on certain parameters and the degree of brain damage that has caused loss of memory, cognitive skills, attention deficit with signs of depression. Routine laboratory investigations like blood, urine tests, CT scan, MRIs, electroencephalograms or EEGs and analyses of spinal fluid are also done by the physician.

What are specific diagnostic tests for dementia?

A neuro physician analyses brain deterioration and damage through special diagnostic tests.

COGNITIVE DEMENTIA TEST – In this method, a physician asks a set of questions to the patient. It may be his age, address, his date of birth and current year. All the observations are recorded by the physician.

A MINI-MENTAL STATE EXAMINATION notes patients ability to remember words, places and time. His attention to minute details, calculations, language skills and visuospatial skills. It is a very useful test to assess how severe the disease is and decide on treatment or management therapies for dementia.

MINI-COG TEST – A patient is asked to remember three words as told by the physician. He has to memorize them and talk about them chronologically. If he is unable to do this, he is asked to draw a clock, but the numbers and set the hands to any time on the clock he draws on the sheet. The patient has to complete the task in three minutes. A patient who is unable to do these tasks is diagnosed to have dementia.

NEUROLOGICAL TESTS are conducted by the doctor that tests balance during motion, reflexes and eye movements to understand how well these senses work in a patient who is a suspected case of dementia.

What are the different types of dementia?

Dementia is classified into two groups.

CORTICAL DEMENTIA is a pathological diseased state in the cerebral cortex, the outer layer of the brain. These are centres of memory, language, speech and knowledge on different words,  controlled by the cerebral cortex. Damage to the cerebral cortex causes loss of memory and impairment of speech. Alzheimer's disease us a form of cortical dementia.

SUBCORTICAL DEMENTIA is a disorder from damage in parts below the brain.  Thinking reasoning skills along with language problems and forgetfulness get developed in this disease.

In Lewy Body dementia both segments of the brain are affected. A protein present in the brain affects these changes within both cortex and subcortical areas.

What are the stages of dementia?

World Health Organization has divided dementia into three stages—

EARLY STAGE – A patient shows signs of certain symptoms that may not be alarming or minor in nature. He experiences forgetfulness, loss of track of time and feels lost in a familiar location.

In MIDDLE STAGE, the patient forgets names, recent events of life and areas. His communication skills are affected. He has associated psychological diseases like depression and mood swings.

LATE STAGE is an advanced stage where symptoms are severe. He fails to recognise people, relatives, is unaware of time and faces difficultly during speech or complete loss of words.

What is the treatment and management for dementia?

Dementia is an irreversible degenerative pathological condition of the brain. It depends on the age of the patient, his medical history and extent of brain damage to determine treatment measures and whether it is curable within the scope of Allopathic science.

Medication is prescribed by the physician according to the patients condition. Medicines that improve the chemical processes in the brain, stabilize to improve normal memory functions are prescribed by the physician. The common ones are NMDA receptor antagonists and cholinesterase inhibitors, antidepressants and antipsychotic medicines. Alternative therapies and support from family members help patients to gradually overcome and recover from dementia.  However, it is a very crucial, tough phase to withstand or endure a lack of normal brain functions.

Dementia caused by metabolic disorders, blood clots, tumours can be cured by treating the root cause of the disease that triggers a state of loss of memory and cognitive skills.

SUPPORTIVE THERAPIES from friends and family members relieve patients from depression, frustration, help to cope up, manage daily routine and revive memory and thinking skills.

REMINISCENCE THERAPY involves talking with family members and friends about hometown, pleasant past events, work, life, hobbies and playing soothing music to create a cheerful environment. An organized approach from a team of family members and friends give the patient moral, emotional and psychological support to annihilate the negative spectrum of the disorder.

COGNITIVE STIMULATION THERAPY is a group of structured programs designed to engage patients in different activities like talking about current events, playing word jugglery, singing and repeatedly involving patients in routine activities like cooking.

REALITY ORIENTATION TRAINING is repeated sessions on asking patients names, dates, times, recognizing different places at home and surroundings. This helps patients remember thereby improving memory.

Lifestyle modifications that create a positive impact, contribute to healthy feelings in the heart, mind and mood help patients with dementia.

Patients who accept this syndrome by adopting challenging treatment options and different approaches by means of fitness, staying active, exercising, gardening, dancing and performing routine jobs willingly by self-driven motivation are relieved early from symptoms of dementia.

Patients should relax, should be encouraged to indulge in calm soothing activities and take adequate rest and sleep.

Intake of a healthy diet, focusing on a nutritive diet can reduce risk to dementia. Food rich for brain development, to restore its normal functions are green leafy vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and an unadulterated, pure healthy balanced diet. Counselling sessions with a psychologist, psychiatrist or a therapist can treat certain symptoms and behavioural changes in a patient diagnosed with dementia.

Can dementia be prevented?

Dementia is a permanent dysfunctional pathological state from damage to the brain of the vital part. It cannot be prevented but certain modifications, a healthy lifestyle can reduce the risk of dementia. Regular screening for blood glucose levels, cholesterol levels, thyroid function tests, maintaining normal blood pressure, weight through regular exercise and a nutritive diet reduces the risk of dementia.

A healthy normal brain with adequate oxygen-rich blood circulation helps it to function at its maximum possible strength. In a stressful competitive era, people struggle for various basic needs for a normal livelihood. To maintain a definite standard of living in present times, every individual goes through a battle of tough incidents and displeasing events. Diseases affect vital organs of the body like the brain with degenerative damage in the form of dementia in patients who neglect health.

People who believe in a holistic health care approach, social interaction, living in a peaceful, energetic cheerful environment stay diseased free throughout their life. Rudimentary customs or traditions, rigid thoughts, depressive negative fixed ideas, beliefs can ruin patients mental and physical well-being. Those patients having a high risk of dementia should go to places that encourage, motivate and sharpen the mind, brain functions and cognitive skills.

Efforts on following a strong practical, productive and constructive mindset yields to focus positive impact on the brain.

Health awareness camps, society for senior citizen, government health care organizations and old age homes should enforce programs on activities that encourage geriatric health, support,  create a jovial environment that boosts their morale. Senior citizens should enjoy every right of living in a peaceful place that does not harm mental, emotional and physical well-being. An era where there is union, the interaction between different generations to bridge the distance or generation gap,  communication and developing an attitude of respect, love, mercy, care for senior citizens by staying together in one community can eradicate several degenerative psychological traumas and disorders from the world.