There’s More to Dementia Than Forgetfulness

By Dan Tracy, Editorial Contributor

As we grow older, it’s not unusual to forget things, like an appointment or a recent conversation. But how can you tell if forgetfulness is simply a normal part of aging -- or a sign of something more serious?

Dementia is a broad term that describes impaired brain function involving memory loss, says Dr. Steven Seltzer, a board-certified internal medicine physician with Bayfront Health St. Petersburg Medical Group Internal & Family Medicine.

But dementia, which includes Alzheimer’s disease, isn’t just memory loss. Other signs include:

• Getting lost in a familiar place
• Not being able to complete simple tasks
• Planning and judgment difficulties
• Mood and behavior changes
• Sudden or frequent urges to urinate

Dementia typically has seven stages, starting with no symptoms. In the middle is mild cognitive decline marked by forgetfulness and repeatedly asking the same question. The end stage is severe cognitive decline, where patients no longer can care for themselves and may lose the ability to speak or walk.

The disorder afflicts about 5 million Americans, and that number is expected to climb to 14 million by 2060, according to the Centers for Disease Control and Prevention. And it doesn’t affect just older people. As many as 500,000 Americans under the age of 65 may have dementia.

Different Types of Dementia

Alzheimer’s disease is the most prevalent type of dementia, accounting for an estimated 60 percent to 70 percent of cases. It is a neurodegenerative disease that destroys brain cells over time, causing memory and thinking abilities to decline. Symptoms include memory loss, difficulty completing familiar tasks, confusion with time or place, misplacing things and trouble communicating through spoken or written language.

Lewy Body dementia occurs when protein deposits — known as Lewy bodies — develop in nerve cells in the sections of the brain involving memory, thinking and movement. In addition to memory loss, the condition may cause hallucinations and changes to a person’s alertness and focus. Some sufferers also experience balance problems, rigid muscles, stiffness, slow movements and trembling.

Vascular dementia is caused by issues with blood flow to the brain — often resulting from stroke — that temporarily deprive the brain of oxygen and nutrients. Vascular dementia causes issues with judgment, memory, planning, reasoning and other thought processes. About 10 percent of dementia cases fall under this category. 

Is It Dementia?

Lapses in memory can be caused by other conditions, such as depression and side effects from some medications. Your doctor will do a complete physical exam and take a full medical history, looking at all conditions, medications, and family and behavioral history.

Memory or cognitive testing can assess short- and long-term memory, concentration and attention span, language and communication skills, plus awareness of time and place.

You may be referred to a psychiatrist or neurologist who may order a brain scan, such as a CT scan or MRI scan, before giving an official diagnosis and developing a treatment plan.

Living with Dementia

There is no “one size fits all” treatment because there are many types and causes of dementia. But there are treatments that can improve symptoms. These include:

Medications. Some drugs help reduce symptoms of dementia and support brain function.

Cognitive behavioral therapy (CBT).  Depression and anxiety are common in people with dementia. CBT can help you understand the connections between thoughts, feelings and behaviors in order to make positive life changes. It also may boost the immune system and reduce inflammation, research suggests.

Occupational therapy. A therapist can help you prepare for dementia progression and make your home safer by modifying the environment and simplifying everyday tasks.

Exercise, Lifestyle Changes Can Help

Exercise appears to be the single, most important factor for slowing the progression of dementia. You should aim for 150 minutes of moderate to vigorous physical exercise each week. Other lifestyle behaviors that can help include:

• Don’t smoke.
• Drink alcohol in moderation.
• Eat a high-quality Mediterranean diet.
• Engage in mentally stimulating activities, such as using a computer.
• Maintain social ties.
• Get restorative sleep. 

Tips for Caregivers

If you’re caring for someone with dementia, there are ways you can support your loved one.

• Attend doctor appointments.
• Find support services in your area.
• Join a support group.

“You can’t pour from an empty cup,” Dr. Seltzer says. “Practice self-care. Eat a healthy, balanced diet, and get regular exercise and plenty of sleep.”