Some basic facts about dementia you should know

Dementia is the name for a group of brain disorders that are associated with a decline in thinking, reasoning, and remembering. What are the differences among the most common types of dementia and their possible causes?

The most common form of dementia is Alzheimer’s disease, which accounts for about 60 to 70 percent of all dementias. Other forms of dementia include vascular dementia (caused by stroke), Lewy body dementia (visual hallucinations, stiffness, tremors, sleep disorders) and Frontotemporal dementia (personality change, social disinhibition, impulsiveness). Since each type of dementia has a different presentation, it’s important to have a dementia expert perform a thorough evaluation to determine the type of dementia and the most effective treatments.

What are the symptoms of the seven stages of dementia that patients or caretakers should look out for? When is it time to seek professional help?

For Alzheimer’s disease, the first and most prominent symptom is difficulty with short-term memory. For other types of dementia, while memory difficulty is present, the more prominent symptom may be difficulty with walking, changes in personality, behavioural problems or loss of ability to perform activities of daily living. Whenever the needs for care and safety of the person with dementia exceed the caregivers’ ability, professional help is required. That way, both the person with dementia and the caregiver can remain safe, and adverse outcomes, such as hospitalisation and accidents, can be avoided.

Since dementia is a progressive disease that worsens with age, are there some preventive methods to avoid developing the disease?

There are several ongoing clinical trials whose goal is to prevent dementia, specifically Alzheimer’s disease. However, these are experimental at this point. Currently, the strongest evidence for prevention of memory decline is regular physical exercise. Other ways to prevent dementia are to maintain cardiovascular health by controlling risk factors such as hypertension, diabetes and high cholesterol, continue to have social contact or cognitive stimulation, and avoid head trauma.

Although there is no cure for dementia yet, what are some ways to slow down its progress or maintain a patient’s mental abilities?

There is evidence that certain medications can slow the progression of dementia, albeit modestly. These medications include acetylcholinesterase inhibitors, which increase the availability of neurotransmitters to facilitate information transfer between brain cells. They have been shown to benefit all stages of dementia, but in many the effect may be subtle. Reducing cardiovascular risk factors, while maintaining social and cognitive stimulation can also help.

How can caretakers or family members prepare to care and plan for the future of those affected by dementia?

Caregivers of persons with dementia should seek ways to educate themselves on the disease—common challenges, progression, treatments—in order to be better equipped to deal with present and future demands of dementia caregiving. Caregivers should seek out resources from local organizations such as the Alzheimer’s Disease Association because available classes and community-based resources vary by geographic area. For general information about caregivers, a good place to start is the UCLA Improving Caregiving for Dementia (I-CareD) program website.

Zaldy S. Tan, MD, MPH, is the medical director of the UCLA Alzheimer's and Dementia Care program and professor and assistant dean at David Geffen School of Medicine of the University of California Los Angeles (UCLA).

This story was originally published in the Global Health and Travel issue of January 2018