Dementias

Definition:

• Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember, affecting a person’s daily functioning.

Types:

1. Alzheimer’s Disease (AD):
   • Most common type.
   • Characterized by beta-amyloid plaques and neurofibrillary tangles in the brain.
   • Symptoms: Memory loss, disorientation, mood and behavior changes, confusion about events, time and place.
2. Vascular Dementia:
   • Caused by conditions that block or reduce blood flow to the brain, leading to brain damage.
   • Symptoms: Impaired judgment or ability to make decisions, plan, or organize.
3. Lewy Body Dementia (LBD):
   • Involves abnormal deposits of a protein called alpha-synuclein in the brain.
   • Symptoms: Visual hallucinations, sleep disturbances, parkinsonian movement features.
4. Frontotemporal Dementia:
   • Affects the frontal and temporal lobes of the brain.
   • Symptoms: Changes in personality and behavior, difficulty with language.

Etiology:

• The exact cause is often unknown.
• Risk factors: Age, family history, genetics, lifestyle and heart health.

Diagnosis:

• Comprehensive assessment including medical history, physical and neurological exams.
• Cognitive and neuropsychological tests.
• Brain scans (CT, MRI) to rule out other conditions.
• Biomarkers can also be helpful, especially in AD.

Management:

• No cure; treatment focuses on managing symptoms.
• Medications: Cholinesterase inhibitors and memantine for AD, medications to address other symptoms like sleep disturbances, agitation, etc.
• Non-pharmacological approaches: Cognitive stimulation, occupational therapy, modifying the environment to improve safety and ease caregiver burden.

Prognosis:

• Progressive and irreversible decline in mental function.
• Life expectancy varies depending on type and age of onset.