Dementia is a phenomenon that can be caused by a number of diseases that destroy nerve cells and damage the brain, causing cognitive function (i.e., the ability to process ideas) to deteriorate beyond biological aging. Changes in mood, emotional control, behavior, and motivation often precede cognitive decline, which does not alter awareness.

Dementia has physical, psychological, social, and economic consequences, not only for dementia sufferers but also for their careers, families, and society as a whole. Frequently, a lack of awareness and comprehension of dementia leads to stigmatization and obstacles to diagnosis and care.

Common forms of dementia

Multiple diseases or injuries that directly or indirectly impair the brain are the causes of dementia. Alzheimer's disease is the most prevalent type, accounting for 60–70% of cases. Other forms of dementia include vascular dementia, dementia with Lewy bodies (abnormal protein deposits within nerve cells), and a group of diseases that contribute to frontotemporal dementia (frontal lobe degeneration).

Dementia may also develop after a stroke, in the context of certain infections such as HIV, as a consequence of excessive alcohol consumption, repeated brain injuries (known as chronic traumatic encephalopathy), or nutritional deficiencies. Indistinct boundaries exist between different forms of dementia, and blended forms frequently coexist.

Symptoms and signs of dementia

Signs of dementia can vary greatly. Examples include problems with:

· Short-term memory.

· Keeping track of a purse or wallet.

· Paying bills.

· Planning and preparing meals.

· Keeping appointments in mind.

· Traveling out of the neighborhood.

Many conditions are progressive, meaning that the symptoms of dementia begin slowly and progressively worsen. If you or someone you know is experiencing memory problems or other changes in cognitive abilities, you should not disregard them. See a physician immediately to ascertain the cause.

An expert evaluation may uncover a treatable condition. And even if symptoms suggest dementia, early diagnosis enables a person to maximize the benefits of available treatments and provides the opportunity to participate in clinical trials or research. It also affords the opportunity to plan for the future.

Causes

Alzheimer's disease is caused by brain cell injury. This injury interferes with brain cells' ability to communicate with one another. When brain cells are unable to communicate normally, thinking, behavior, and emotions may be impaired.

Each region of the brain is responsible for a particular function, such as memory, judgement, or movement. Damaged cells in a region prevent that region from performing its functions ordinarily.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed:

While the majority of changes in the brain that lead to dementia are permanent and worsen over time, thinking and memory difficulties may improve if the following conditions are treated or addressed:

· Drug adverse effects.

· Excess use of alcohol.

· Thyroid disorders.

· Vitamin deficiencies.

Diagnosis of dementia

There is no single test that can definitively diagnose dementia. Doctors diagnose Alzheimer's disease and other forms of dementia based on a thorough medical history, a physical examination, laboratory tests, and the cognitive, functional, and behavioral changes associated with each type.

A person's dementia can be diagnosed with a high degree of certainty. However, it is more difficult to identify the precise form of dementia because the symptoms and brain changes of various dementias can overlap. In some instances, a physician may diagnose "dementia" without specifying a subtype. If this occurs, a specialist such as a neurologist, psychiatrist, psychologist, or geriatrician may be required.

Treatment and Care

There is no cure for dementia, but a great deal can be done to assist both those with dementia and their careers.

People with dementia can maintain their quality of life and well-being by:

· engaging in physical activity

· participating in activities and social interactions that stimulate the brain and maintain daily function.

Moreover, certain medications can aid in the management of dementia symptoms:

· Cholinesterase inhibitors like donepezil are used to treat Alzheimer’s disease.

· Memantine and other NMDA receptor antagonists are used to treat severe Alzheimer's disease and vascular dementia.

· Blood pressure and cholesterol-lowering medications can prevent further brain injury from vascular dementia.

· Selective serotonin reuptake inhibitors (SSRIs) can alleviate severe symptoms of depression in dementia patients if lifestyle and social modifications are ineffective, but they should not be the first line of treatment.

Medications such as haloperidol and risperidone can assist dementia patients who are at risk of hurting themselves or others, but they should never be used as the initial treatment.

Caregiving for someone with dementia requires patience

Patience is essential when caring for a person with dementia. Frequently, the burden of care falls unevenly on a spouse or a child who resides nearby. It takes us some time if at all, to realize that more than one person is required to support a person with dementia.

When an interaction is not going as planned, we suggest the following steps:

1. Step Back: It is fine not to respond immediately. Think before acting, and make sure your facial expressions and body language match your words. Before delivering a verbal message, we want to ensure that the visual stimuli are enticing. As suggested by Teepa Snow, engage the senses by providing signals in the following order: visually, verbally, and physically.

2. Respond instead of Reacting: Analyzing why we want to change behavior is necessary for a complete response. We sometimes correct narratives rather than behaviors. Dementia patients may hallucinate or time travel. Instead of trying to realign them, enquire about their past or future. We often connect best by patiently asking them to tell us more.

3. Make plans, but expect them to change: Carry your agenda. Non-caregivers struggle to comprehend why daily tasks take so long. Why is showering an hour? Why do meals take two sittings?

Our approach counts because, unlike a kid, an older adult has lived a long life and expects to be treated with dignity and respect. Despite fading memories, these prideful impulses remain. We must follow them.

4. Figure out what you can and cannot control: We must keep in mind that activities are a means of connecting with a person with dementia. If we are playing an established game, it is okay to disregard the rules. Instead of playing a card game, for instance, why not organize the deck?

As the disease progresses, your loved one may find greater solace in holding items rather than organizing them. This holds true. We are learning to adapt to their evolving senses and utilizing them to discover new ways to greet them.

5. Take care of yourself: We apply our reasoning to the person with dementia, but not to ourselves. Regardless of how much assistance you have, you need a vacation! Caregiving for a dementia patient can be a daunting endeavor.

If you are emotionally depleted or physically incapable of performing your duties, you will be less helpful to the individual requiring your care. It is not selfish, but essential, to take time to appreciate life and maintain your health.

References:

www.news-medical.net/condition/Dementia

www.ncbi.nlm.nih.gov/pmc/articles/PMC4488926/

www.helpguide.org/articles/alzheimers-dementia-aging/tips-for-alzheimers-caregivers.htm