Dementia: Understanding This Common Condition

Dementia: Understanding This Common Condition

Dementia is a syndrome that causes a gradual and permanent decline in memory and cognitive abilities. This condition is becoming increasingly common in people over 60, with the prevalence doubling every five years.

According to the DSM-IV, dementia is diagnosed when:

• The individual experiences difficulties in two cognitive function groups:

• Memory impairment: Difficulty remembering new information or recalling past events.

• Impairment in at least one other function:

• Language disturbance: Difficulty expressing thoughts, understanding language.

• Apraxia: Difficulty performing complex movements.

• Agnosia: Difficulty recognizing people, objects, or spaces.

• Executive function disturbance: Reduced ability to plan, focus, or make judgments.

Symptoms of Memory Loss:

• Early stage: Difficulty remembering new information, but still able to recall past events.

• Later stage: Forgetting important details such as names, appointments, or even past events.

Differentiating Dementia from Other Issues:

• Depression: Can cause memory loss and cognitive decline, but is often accompanied by sadness and loss of interest in life.

• Mania: A mental disorder characterized by delusions, hallucinations, and is not dementia.

• Age-related memory decline: A common phenomenon that does not significantly impact life.

Differences Between Age-related Memory Decline and Dementia:

• Age-related memory decline:

• Caused by a decline in the number of brain cells and neurotransmitters.

• Requires some thought before recalling, may not remember immediately, but will remember later.

• Does not affect quality of life.

• Dementia:

• A serious and progressive cognitive decline process affecting multiple brain functions.

• Causes difficulty remembering new information and recalling past information.

• Affects quality of life and the ability to take care of oneself.

Main causes of dementia:

• Alzheimer’s disease (55%): The most common cause.

• Vascular dementia (20%): Caused by damage to brain blood vessels.

• Lewy body dementia (15%): Caused by the accumulation of abnormal proteins in brain cells.

Pathology of Alzheimer’s disease:

• Atrophy of the brain, particularly in the temporal lobe, due to atrophy of the basal ganglia and hippocampus.

Pathophysiology of Alzheimer’s disease:

• Accumulation of ?-amyloid1-42 into amyloid plaques in the extracellular space.

• Formation of neurofibrillary tangles from tau protein within neurons.

Diagnostic criteria:

• A: Memory impairment appearing early, gradual and progressive for > 6 months, confirmed by testing.

• B: Atrophy of the temporal lobe on brain imaging.

• C: Abnormal CSF biomarkers.

• D: Specific functional imaging on PET.

• E: Demonstration of a dominant gene mutation in the family.

Treatment:

• There is currently no cure for dementia.

• Medications and therapies are available to help reduce symptoms and improve quality of life.

Note: Seek medical advice if you or a loved one has any signs of dementia. Early diagnosis and treatment help control the disease more effectively.