Dementia is an umbrella term for a cluster of symptoms that affect cognition, behaviour, and functioning.
Most people feel that dementia is synonymous with Alzheimer’s disease, but this is not the case. Whilst Alzheimer’s disease is the leading cause of dementia, there are a number of other causes that are also significantly represented.
First, let’s take a step back. So, what is dementia? Dementia is primarily a cognitive disorder that must be acquired and represents a decline from a person’s usual level of functioning.
As we age, dementia becomes more prevalent in the community. It is rare to be diagnosed with dementia before the age of 65.
According to the current guidelines, dementia, or major neurocognitive disorder as it is now known in the Diagnostic and Statistical Manual of Mental Disorders V, is represented by a change in a number of domains:
From time to time we can all experience any one of these symptoms. Who hasn’t walked into a room and been unable to recall why they are there?
The difference between this experience and dementia is that in dementia, the changes are sustained and impairing, leading to a loss of independence or functioning in activities of daily life.
Now, back to the other subtypes of dementia. The most commonly seen subtypes include:
Lewy Body Dementia - which can present with visual hallucinations and motor changes like those seen in Parkinson’s disease;
Fronto-temporal dementia - which can be indicated by changes in personality, mood, and behaviour; and,
Vascular dementia - where changes occur due to impaired blood flow in the brain.
However, dementia can develop from many other conditions such as HIV, Parkinson’s disease, Huntington’s disease, chronic excessive alcohol intake, and a number of other neurological conditions.
Dementia is caused by many different diseases but there are some over-riding principles in improving our brain health. Alzheimer’s Australia recommends the following:
Treatment of dementia relates largely to slowing cognitive decline rather than reversal of any deficits that are already seen.
We have a number of medications for this purpose. We also treat any conditions that occur as dementia progresses such as depression, anxiety, or psychosis. Support for patients and their carers is paramount.
It’s important to remember that if you or someone you know is experiencing any cognitive changes, the cause may NOT be dementia. These changes must be investigated as there are a number of other conditions that can mimic the changes of mild cognitive impairment.
These include, severe depressive episodes, vitamin deficiencies, other neurological conditions, and even certain medications. A great starting point, as always, is your general practitioner, who can kick off the process of investigation of any cognitive change.
Dr Martin is a consultant psychiatrist with a sub-speciality interest in geriatric psychiatry. Dr Martin works in the private sector, providing mental health care to both younger and older adults. She also provides psychiatric care to residents at a number of Brisbane nursing homes.