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What is Dementia

When hearing the word “dementia”, we immediately imagine an elderly individual who is losing their ability to remember their loved ones. The term almost always evokes a negative response.

We would like to dispel any misinformation and misunderstandings about dementia.  Plainly stated, dementia is the term for loss of memory along with loss of other mental faculties severe enough to interfere with daily life. It is a progressive, degenerative disease that affects the brain circuitry, causing changes in brain function. While some people believe that Alzheimer’s disease and dementia are two separate diseases, Alzheimer’s is the most common type of dementia. Other types of dementia include Vascular dementia, Frontotemporal dementia, and dementia with Lewy Bodies.

The most common symptom of dementia is loss of short-term memory (long-term memory is usually preserved early on). Common signs and symptoms of dementia are listed below. Not everyone with dementia will have all these symptoms and people may lose abilities or notice changes at different rates.

Recent memory loss

All of us forget things for a while and then remember them later. People with dementia often forget things and they never remember them. They might ask the same question over and over, forgetting each time that they have been given the answer. They will not even remember that they already asked the question.

Problems with language

People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want

Poor judgment

Even a person who does not have dementia might get distracted. But people with dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.

Misplacing things

People who have dementia may put things in the wrong place. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they cannot find these things later.

Personality changes

People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.

Difficulty performing familiar tasks

People who have dementia might cook a meal but forget to serve it. They might even have difficulty in preparing a meal.

Time and place disorientation

People who have dementia may get lost on their street or in their home. They may forget how they got somewhere and how to get back home.

Problems with abstract thinking

Anybody might have trouble balancing a checkbook, but people with dementia may forget what the numbers are and what has to be done with them.

Changes in mood

Everyone is moody at times, but people with dementia may have fast mood swings, going from calm to tears to anger in a few minutes. Apathy (lack of interest, enthusiasm, or concern) is also a very common problem found with this disease. Apathy interferes with the person’s motivation and concern for the feelings of others.

Loss of initiative

People with dementia may become passive. They might not want to go places or see other people.

Are my children, grandchildren, siblings, or other family members at risk to develop dementia?

The majority of cases of dementia are non-genetic. Most likely, your family members are not at significant risk for developing dementia. Dementia may run in families when 3 or more people have been diagnosed, or when someone is diagnosed younger than the age of 60.  You may read online about the APOE gene and its relationship with Alzheimer’s disease/dementia.  This handout can provide more information about the APOE gene.  Genetic testing is usually not recommended unless there are more than three members of a family diagnosed with dementia, or someone is diagnosed younger than 60. 

Mild Cognitive Impairment (MCI)

This is a term that refers to patients who have more cognitive problems than expected when compared to others of the same age but don’t have a diagnosis of dementia.  Cognitive problems include short-term memory loss, poor attention, slow mental function, language difficulties, bad orientation, poor visuospatial reconstructions, poor judgment, etc. Some patients are more affected in one area (single domain) and some are affected in multiple areas.  There are many causes.  Some of the symptoms are transient or reversible.  For example, patients who have chronic insomnia or sleep apnea may experience cognitive symptoms of lack of concentration or mental slowing which may not be dementia.  Those symptoms improved after the conditions are treated.  There are also patients suffering from certain medical conditions during hospitalization that cause confusion, delusions, and memory loss but they return to normal once the medical conditions are resolved.  Underlying mental health conditions are also a common factor that affects performance (test anxiety, focusing).  There are unfortunately also patients suffering from a gradual degeneration of the brain, and those symptoms may represent early stages of dementia.  Patients with mild cognitive impairment suffer from cognitive deficits (for example, short-term memory loss) but are still able to maintain their normal day-to-day function.  The diagnosis of dementia is made once the daily functions are affected.  You may receive the MCI diagnosis in our Memory clinic, and frequently we recommend patients to re-test to check for progression after the medical conditions have been treated or resolved.  Dementia is a progressive disease and one would anticipate progression over 6 months to a year time if the cause of mild cognitive impairment is related to a brain degenerative disorder.   

There is no medication treatment for MCI.   One would focus first on the reversible causes.  These include medication exposure, other medical conditions (such as sleep issues), and mental health-related issues (KP Behavioral Health Classes, by provider referral, most are at no cost*).  Keeping our brains healthy is most important.   

* Classes that need referral by your primary provider:
Managing Stress Class (6 session series)
Managing Depression Class (6 session series)
Understanding Anxiety Class (6 session series)
Improving Your Sleep Class (4 session series)