What is Dementia?

Dementia is classified as a syndrome (a group of related symptoms) that affects the brain’s functioning and ability. It is extremely common and currently affects around 850,000 people in the UK, to varying degrees.

Symptoms can include short-term memory loss, communication difficulties, difficulty completing multi-step tasks, orientation and navigational difficulties. Dementia, though often referred to as a free standing diagnosis, is not a diagnosis, but rather the result of cognitive changes caused by a neurodegenerative disease.

There are well over one hundred diseases that can cause dementia. The most commonly occurring diseases are:

Alzheimer's Type Dementia 62%
Vascular dementia 17%
Mixed (Vascular/Alzheimer’s) 10%
Dementia with Lewy bodies 4%
Frontotemporal dementias 2%
Parkinson’s dementia 2%
Other dementias 3%

The condition usually affects people over the age of 65 but in some cases, can develop earlier (known as early-onset dementia). The Alzheimer’s Society estimate that around one in three people over 65 will develop dementia at some point in their lives.

The number of people being diagnosed with dementia is increasing on a yearly basis, mainly due to people living longer. In 2013, an estimated 86,000 people were thought to be living with dementia in Scotland. It is estimated that by 2025, over 1 million people will be living with dementia UK-wide, that number almost doubling to over 2 million by 2051. For further statistics on figures of dementia in Scotland, visit Alzheimer Scotland.

+What are the signs of dementia?

Many of us notice that our memory gets worse as we get older and we can become more forgetful. It can be difficult to tell whether this could be a sign of an underlying condition like dementia or just a part of growing older. If you are worried about your memory or that of a loved one, it is always helpful to seek advice from a medical professional. Your GP will be able to talk through your symptoms with you and determine what may be causing your memory problems.

Dementia itself is not a disease, but a culmination of symptoms as a result of damage to the brain. There are a number of conditions associated with these symptoms, the most common being Alzheimer’s disease.

Although Alzheimer’s disease and other forms of dementia can affect everyone in different ways, it is advisable to make an appointment to see your GP if you notice any of the following:

  • Memory loss, in particular having trouble remembering recent events or general forgetfulness such as having difficulty recalling names, important dates or asking the same question a number of times.
  • Difficulty engaging in/following conversations or TV programmes.
  • Problems with thinking and reasoning.
  • Feelings of confusion, even when in familiar environments.
  • Changes in personality and mood.
  • Difficulty with language and finding it hard to ‘find the right words’
  • Feelings of anxiety or depression and feeling ‘frustrated’ with oneself.

Dementia and its related conditions are progressive, which means that symptoms may change and become more severe over a period of time. It is therefore important to talk with a medical professional as soon as possible if you are concerned about your memory.

Initial symptoms can be very mild and often put down to ‘old age’ by the person or their family members and changes in a person during the early stages can often be very subtle.

Symptoms progress dependent on the cause of the person’s dementia, their overall health and personal circumstances. This is why experiences of dementia can vary greatly from person to person and treatment and level of support must be tailored to the individual.

+What causes dementia?

Dementia is caused by damage or changes to the brain and its chemistry. The most common cause is a neurodegenerative disease such as Alzheimer’s disease, frontotemporal dementia or dementia with Lewy bodies. This form of disease causes brain cells to degenerate and die at a faster pace than is common of the aging process.

The affect that this has on a persons mental and, at times, physical abilities can be drastic, with symptoms becoming progressively worse over time. The changes seen in a persons brain with dementia are caused by a build-up of abnormal proteins. These proteins vary in each type of neurodegenerative disease.

Diseases that cause dementia may impact different areas of the brain and at different rates, causing wide variances in ability and functioning of the person living with the dementia. For instance, Alzheimer’s disease, which makes up nearly two-thirds of all cases of dementia, causes deterioration in all lobes of the brain (global deterioration) whereas the damage in people with frontotemporal lobe dementia occurs primarily in the frontal lobes and the temporal lobes of people with dementia. Because of these differences, it is important to have as accurate a diagnosis as possible as this can help to better understand the type and level of support a person will need.

Is dementia hereditary?

Dementia is not a hereditary condition, meaning that it is not passed down from family member to family member. There has however been some research to suggest that a small number of cases of Alzheimer’s disease and frontotemporal dementia can be more
prevalent in some families.

For more information on the causes of specific types of dementia and non-progressive dementia or dementia-like conditions, visit the NHS Causes of Dementia Information Pages

+Worried someone you know has dementia?

If you are worried that someone you know may have the early signs of dementia, it is important to encourage them to make an appointment to see their GP. It may be helpful to suggest that you go with them for support and to act as a ‘second pair of ears’ at what can be a daunting and frightening time.

It is important that you are aware of the ‘key signs’ of dementia and look out for them in a loved one you may be concerned about. Memory loss is often one of the major symptoms but others can include:

  • Difficulty in concentrating (during conversations or TV programmes)
  • Increased mental confusion 
  • Marked changes in mood and personality
  • Anxiety and depression 
  • Difficulty with language (finding the right words) and simple maths

Talking about dementia

Talking to a loved one about dementia can often be the hardest step. The person experiencing the symptoms may be confused, concerned or unaware of what is happening to them. It is important to make them aware from the outset that the reason you are having the conversation with them is because you care.

It is important to be open and honest with them and explain the reasons for your concern. The Alzheimer’s Society also suggest having the discussion in a comfortable, safe and familiar environment and creating a positive plan of action together.

When discussing dementia, it is important to be positive, so as not to alarm the person with the symptoms and to be supportive, taking care not to create a sense of ‘blame’.

For further information and ‘top tips’ about speaking to someone about dementia, visit www.alzheimers.org.uk/toptips. Note: insert outbound link to Alzheimer’s Society website.

What if it is dementia?

If a medical professional does diagnose dementia, it can be a big shock, not only for the person with the diagnosis but also for family members and loved ones.

However, it is important to remember that there is a wealth of information, help and support out there that can help manage the condition and improve the quality of life for the person with dementia and their family going forward.

+How is dementia diagnosed?

An official diagnosis of dementia should always be made by a medical professional. The first port of call should be your GP and an appointment should be made with them to discuss any concerns you may have in the first instance.

As dementia can be difficult to diagnose, due to it’s differing symptoms in many people (particularly in the initial stages), your GP may refer you to a consultant who will specialize in this type of medicine.

Are there specific assessments for dementia?

The Mini Mental State Examination (MMSE) is the most widely-used test when attempting to diagnose the cause of memory problems. Note: I’d like to have a click-through to a downloadable PDF outlining what is involved with an MMSE. Please advise if you would like me to write this.

Other assessments can include conversations with the person being diagnosed or their loved ones, a physical examination, memory tests and/or a brain scan.

Once the necessary tests have been carried out, your doctor will make a diagnosis based on the results and if you are thought to have dementia, explain what it will mean for you. They will discuss a treatment plan with you and give you opportunity to ask any questions you may have. They should also put you in touch with care and support services in your local area and provide you with written information about dementia, covering a range of areas from financial and legal advice to details of how the disease may develop in the future.

+How is dementia treated?

There are a number of treatments that can help manage a dementia diagnosis. As most types of dementia are progressive and cannot be cured, the focus in recent years, in particular, at Balhousie Care, is on management of symptoms using a range of different therapies.

Treatment will vary from person to person and a detailed treatment plan should be discussed with a medical professional once a diagnosis has been made. The course of treatment suggested for you will take into account the type of dementia you have been diagnosed with, level of symptoms you are dealing with and the impact these have on your day-to-day life and the severity and rate at which the dementia is progressing.

There are a number of treatment options that are proven to vastly improve the lives of those living with dementia and help them cope with the symptoms. Some of the more widely-used therapies are:

  • Person-centred care. This form of care views the person with dementia as a whole and doesn’t just focus on their illness and course of treatment for their symptoms. It takes into consideration the persons life history, interests and the social and physical environment in which they live/have previously lived. It is Balhousie Care’s belief that when a person-centred approach is taken, care can be specifically tailored to the person dealing with dementia, enabling triggers of behavioral symptoms to be identified and planned for.
  • Tailored psychological therapy
  • Standardised therapies

+Visiting a GP (practical help and information)

Making an appointment to see your GP if you are worried about dementia can be a big step. Early diagnosis allows the best possible chance to prepare and plan for the future, as well as receive any treatment that may be required. With treatment, help and support, many people are able to lead active, full and happy lives.

At the GP appointment

It is a good idea to ask a family member or friend to accompany you to your appointment for support. Many people also find it useful to write down the symptoms they are concerned about and any questions they may have prior to the appointment.