Brain Health and Dementia

Dementia is a general term for loss of memory and/or difficulty with language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life.

 What is normal?

• Able to function independently despite occasional memory lapses

• Able to recall and describe incidents of forgetfulness

• May pause to remember directions but doesn’t get lost in familiar places

• Occasional difficulty finding the right word, but no trouble holding a conversation

• Judgment and decision-making ability same as always

 Mild Cognitive Impairment is sometimes used to describe memory loss that is beyond normal for a person’s age but not significant enough for a diagnosis of dementia.

 Is it Dementia?

• Difficulty performing simple tasks or making decisions

• Forgetting how to do things done many times before

• Unable to recall where memory lapses caused specific problems

• Gets lost or disoriented in familiar places; Unable to follow directions

• Words frequently forgotten, misused, or garbled. Repeats phrases or stories in same conversation

• May show poor judgment or behave in socially inappropriate ways

Any memory loss or change in behavior or cognition warrants a full medical evaluation.

Delirium is used to describe an episode of acute confusion. This has many causes including medications and infections. Individuals with dementia have an increased susceptibility to delirium.

TYPES OF DEMENTIA

Alzheimer’s Dementia

• 60-80% of dementias

• 6th leading cause of death in US, only 25% of people with Alzheimer’s have been diagnosed

• Most people are older, but onset in the 40-50’s does occur

• Initial symptoms may be difficulty with word finding and visuospatial skills, rather than memory loss

• Medications are available to slow the progression of the disease, but there is no cure

• There is no single test to diagnose Alzheimer’s

Vascular Dementia

(Vascular Cognitive Impairment)

• 2nd leading cause of dementia

• Caused by one or more strokes, or any disorder that causes decreased blood flow to the brain (For example, after a heart attack)

• Symptoms vary, but may include focal neurological deficits (such as weakness on one side)

Diffuse Lewy Body Dementia

• 3rd leading cause of dementia

• Memory loss with initial early symptoms of sleep disturbances, visual hallucinations, Parkinson symptoms

Frontotemporal Dementia

• 4th leading cause of dementia

• Onset is younger than Alzheimer’s (40-60’s)

• Prominent language difficulty with the memory loss

• Other symptoms include personality changes, behavioral disturbances early in disease

There are several other causes of dementia and/or decreased cognition or change in mental status:  Parkinson’s Disease/other Parkinson syndromes, Normal Pressure Hydrocephalus, Huntington’s Disease, Multiple Sclerosis, Low Thyroid, B12 or B1 deficiency, subdural hematomas, Low/High levels of Sodium or Calcium, infections, hypoglycemia, Depression (Pseudodementia), and others.

Some people may have a mixed dementia (more than one cause).

HEALTHY BRAIN TIPS

• Be Social – those with the most social interaction experience the least memory decline

• Exercise – walking 6-9 miles per week reduces brain tissue loss in the elderly

• Don’t Smoke – smoking increases risk of Vascular and Alzheimer’s dementias

• Manage Stress – high cortisol (a stress hormone) levels impair memory formation

• Get Quality Sleep – Sleep is necessary for memory consolidation (forming new memories)

• Eat a good Diet – high in antioxidants and omega-3 fatty acids (leafy greens, fruits, fish)

• Do Mental Workouts – play games, do crossword puzzles, word scrambles, learn a new skill

• Avoid certain medications– Benadryl (diphenhydramine), oxybutynin, older antidepressants like Elavil (amitriptyline), pain medications, sedatives (Valium, etc.)

Impaired vision and hearing can cause dementia to appear worse than it is. Always encourage use of appropriate eyewear and hearing aids.

For more information check out these sites:

https://www.alz.org/

https://www.cdc.gov/aging/index.html

https://www.nia.nih.gov/health/topics/dementia

https://www.lbda.org/

https://www.theaftd.org/