In Part One of this series we presented a general overview of the topic indicating how dementia provides significant challenges in Elder Care and Aging in Place. In this Post, and in those to come, I’d like to get specific. Today we’re going to consider some different types of dementia and look at their etiology (cause), characteristics and symptoms.
Alzheimer’s Disease
Alzheimer’s disease is the most common form of dementia, accounting for between 60% and 80% of all cases. Alzheimer’s is thought to be caused by “plaques” between the dying cells in the brain and “tangles” within the cells (both are protein abnormalities: a build-up of “beta-amyloid” in plaques and the disintegration of “tau” proteins in tangles).
These are always present with the disorder but whether they are themselves the cause, or if there is some other underlying process, is not known – and there is some overlap with other disorders that show similar changes in brain cells. The brain tissue in a person with Alzheimer’s has progressively fewer nerve cells and connections, and the total brain size shrinks.
Its most common symptoms are short-term memory loss and word-finding difficulties. People with Alzheimer’s also have trouble with visual-spatial areas (for example they may begin to get lost often), reasoning, judgement, and insight. Insight refers to whether or not the person realizes he/she has memory problems Common early symptoms of Alzheimer’s include repetition, getting lost, difficulties keeping track of bills, problems with cooking especially new or complicated meals, forgetting to take medication, and word-finding problems. It is also characterized by confusion about where he is or what day or year it is; problems speaking or writing; losing things and being unable to backtrack to find them; poor judgment; and, mood and personality changes.
The part of the brain most affected by Alzheimer’s is the hippocampus. Other parts of the brain that will show shrinking (or atrophy) include the temporal and parietal lobes. Although this pattern suggests Alzheimer’s, the brain shrinkage in Alzheimer’s disease is very variable, and a scan of the brain cannot actually make the diagnosis.
Vascular Dementia
Vascular dementia is the cause of at least 20% of dementia cases, making it the second most common cause of dementia. Indeed, it is caused by disease or injury to blood vessels that damage the brain, including strokes. Indeed, it is usually because the person has had a major stroke, or one or more “silent” strokes, which can happen without him or her realizing it.
The symptoms of this dementia depend on where in the brain the strokes have occurred and whether the vessels are large or small. Multiple injuries can cause progressive dementia over time, while a single injury located in an area critical for cognition (i.e., hippocampus, thalamus) can lead to sudden cognitive decline.
On scans of the brain, a person with Vascular Dementia may show evidence of multiple different strokes of different sizes. They tend to have risk factors for artery disease such as tobacco smoking, high blood pressure, atrial fibrillation, high cholesterol or diabetes, or other signs of blood vessel disease such as a previous heart attack or angina.
While Alzheimer’s usually begins with memory problems, vascular dementia more often begins with poor judgment or trouble in planning, organizing, and making decisions. Other symptoms may include: memory problems that disrupt their daily life; trouble speaking or understanding speech; problems recognizing sights and sounds that used to be familiar; being confused or agitated; changes in personality and mood; and, problems walking and having frequent falls.
Lewy Body Dementia
This is also known as “Dementia with Lewy Bodies” (DLB). Lewy bodies are microscopic deposits of a protein that form in some people’s brains, generally in the cortex. They’re named after the scientist who discovered them. Lewy Body Dementia is the third most common form of dementia, accounting for approximately 15% of dementia cases.
This is a dementia that has the primary symptoms of visual hallucinations and “Parkinsonism.” Parkinsonism is a term that describes a person with features of Parkinson’s disease. This includes tremor, rigid muscles, and a face without emotion. The visual hallucinations in Lewy Body Dementia are generally very vivid hallucinations of people and/or animals and they often occur when someone is about to fall asleep or just waking up.
Other prominent symptoms include problems with attention, organization, problem solving and planning (executive function), difficulty with visual-spatial function, making decisions, paying attention, memory difficulties, unusual sleepiness during the day, periods of “blanking out” or staring, problems with movement – including trembling, slowness, and trouble walking and, dreams where they act out physically, including, talking, walking, and kicking.
Optimal Senior Care Solutions caregivers are uniquely and specifically trained in the unique type of care dementia patients require. We routinely provide seniors with assistance with many activities of daily living, easing the burden of both the sufferer and their family. We can help you or those seniors in your family comfortably age in place by providing exceptional in-home care giving services. We also can provide referrals for many Service Providers, such as massage therapists, acupuncturists, music therapists, exercise therapists, physical therapists, and more. Contact us today to learn more.
