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Friday, March 24, 2017

Defining Dementia

Dementia vs. Alzheimer's Disease

 

Sometimes, it is easier to define dementia by what it is not. Many people use the term “dementia” and “Alzheimer’s” as if they are the same thing. However, dementia is simply the condition of having impairments in memory, thinking, judgment, behavior, and communication. Dementia is a term used to describe a set of symptoms related to these impairments. There are several different causes of dementia and Alzheimer’s Disease is just one of the illnesses that can present dementia symptoms.

Delirium Versus Dementia

Delirium is similar to dementia in that it is a condition describing a group of similar cognitive symptoms. However, delirium is short-term, has different causes and different types of treatment. Delirium is also usually preventable, treatable, and reversible. Typical causes of delirium are poorly managed medication interactions, alcohol or other addictive drug withdrawal, nutritional deficiencies, dehydration, and certain types of systemic infections. With delirium, the onset of symptoms is usually sudden and more dramatic while onset of dementia is typically gradual over time and starting with minor symptoms. Often, when the cause of the delirium is found, it can be treated effectively.

So What is the Definition of Dementia?
Dementia is a term used to describe a set of symptoms related to a decline in mental functioning. It is not a disease itself, but rather a condition that is the result of some underlying disease process. Sixty to 70% of dementia patients do have Alzheimer’s Disease. Dementia is not a normal part of aging.

In order to have dementia, a person must have impairment in at least two of the following areas:

  • Memory
  • Communication and/or language
  • Ability to pay attention
  • Judgment and decision-making
  • Visual perception

Causes of Dementia

Dementia is essentially caused by damage to the brain cells that communicate with each other and carry out certain functions. A variety of things can interfere with the brain’s functional ability.

  • Alzheimer’s Disease is a specific disorder that is thought to be genetic in origin and associated with advanced age. In this disease, high levels of certain proteins make it harder for cells within the brain to communicate. While there are some newer treatments for patients that may help slow it down, AD is considered to be an irreversible, progressive disease that will become worse over time.
  • Alcohol-Related Dementia. Chronic or long-term alcoholism can destroy the brain cells over time causing dementia symptoms due to the toxic effect of alcohol. Alcoholics also tend to have b- vitamin deficiencies that can cause a certain type of dementia called Wernicke-Korsakoff syndrome. While discontinuing alcohol may relieve some of the symptoms, some of the damage may be irreversible.
  • Medications can have side effects that cause mental impairment. Often discontinuing the medication can restore a person to their health.
  • Intensive Care Unit (ICU) visits can also, for yet unknown reasons, can cause a permanent dementia in all ages.
  • Nutritional Deficiencies. Some nutrients like b-vitamins, can be very important in mental functioning. When low, dementia type symptoms may occur. Sometimes, older people are prone to this problem because they may have a small appetite and limited food budget. This type of dementia is typically reversible once nutrient levels are restored to normal.
  • Depression and Stress can also cause some decline in mental functioning. The part of our brain that stores temporary information and is associated with age-related memory loss is called the hippocampus. When very stressed, our adrenal glands release a hormone called cortisol. This hormone is directly toxic to neurons in our brain and destroys cells in the hippocampus area. Reducing stress levels may therefore slow down the process of age-related memory loss.

Prevention

The brain is part of the body and therefore, benefits from the things that benefit our overall health. Prevention is really about a healthy lifestyle.  A diet rich in vegetables, fruits, whole grains, and good fats like Omega-3 fatty acids found in fish and flax seeds, can all contribute to not only a healthy heart, but also a healthy brain. Some research has also shown that vitamin E and C are protective along with blueberries. Blueberries are thought to have a chemical called anthocyanin that not only makes the berries blue, but also is rich in anti-oxidants that protect the brain.

To simplify dietary recommendations, research has shown over and over again that people benefit from a Mediterranean diet of high quality fresh fruits, vegetables, nuts, beans, whole grains, olive oil, Greek yogurt, low-fat cheese and occasional fish. Other types of meat, eggs and sweets are generally avoided or only consumed about once a week.

Exercise also improves circulation and health to the brain. Just 30 minutes a day of walking can help ward off all types of health problems, including Alzheimer’s Disease.

Staying away from toxins - like unnecessary medications, drugs, alcohol, and cigarettes - can also eliminate causes of brain cell damage.

Meditation and other ways to reduce stress can reduce the amount of cortisol in our bodies that directly harm brain cells. Dealing with, addressing, and/or eliminating things in our lives that cause stress may help prevent the onset of dementia.

Treatment

Treatment depends on the cause of the dementia. In the case of Alzheimer’s Disease, there are medications that can ward off symptoms for some time, but today, we do not have a cure for AD. Staying healthy overall through diet and exercise is recommended.

There are special treatments for other types of dementia like nutritional and alcohol related dementia.  It is important to seek a good doctor well trained to diagnose and treat dementia of all types. The diagnosis is not a clear-cut lab test and will sometimes require several different tests to determine the type of dementia and best treatment. The earlier it is addressed, the better in all cases.

 

  
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