Dementia

People with dementia – or the age-related decline of mental functions – may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there.

At Atrium Health Floyd and Harbin Clinic, we're here to help people with dementia live safely through appropriate therapies and treatment.

What is dementia?

Dementia is the name for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. Poor memory, disrupted thinking and erratic or unpredictable behavior can all be signs of dementia, especially when these symptoms are new or grow worse over time and negatively impact daily life.

Alzheimer’s disease is the most common form of dementia. Other types can include mild cognitive impairment (MCI) and vascular dementia. Though dementia may occur in people as young as 30, it typically isn’t seen in those under the age of 60 and may likely worsen with age.

Most types of dementia are degenerative, or nonreversible, caused by changes in the brain that cannot be stopped or turned back.

What causes dementia?

Dementia is caused by wear and tear on brain cells, particularly over time. Many things can contribute to this wear and tear. Some of these causes can be stopped, or the damage they cause can be reversed. These causes include:

• Brain injury
• Brain tumors
• Chronic alcohol abuse
• Changes in blood sugar, sodium, and calcium levels (dementia due to metabolic causes)
• Low vitamin B12 level
• Normal pressure hydrocephalus
• Use of certain medicines, including cimetidine and some cholesterol drugs

While some causes may lead to treatable and reversible forms of dementia, other causes are less treatable, including:

• Serious brain injury
• Multiple sclerosis
• Infections such as HIV/AIDS, syphilis and Lyme disease
• Parkinson’s disease
• Pick’s disease
• Progressive supranuclear palsy

Signs and symptoms of dementia

Dementia usually first appears as forgetfulness, but other signs and symptoms may include:

• Altered perception
• Change in emotional behavior or personality
• Difficulty swallowing
• Language difficulties
• Memory loss
• Problems controlling bowel movements or urine
• Thinking and judgment impairment

Early signs of dementia

• Increased difficulty with tasks that require consideration, such as balancing a checkbook, playing games and learning new information or routines
• Getting lost on familiar routes
• Language problems, including recalling specific words
• Losing interest in old passions
• Flat mood
• Misplacing items
• Personality changes
• Loss of social skills
• Inappropriate behaviors

Advanced signs of dementia

• Reduced ability to take care of oneself
• Change in sleep patterns, like waking up at night
• Inability to prepare meals
• Inability to choose proper clothes
• Impaired driving
• Forgetting details about current events or events in one’s own life
• Loss of self-awareness
• Hallucinations
• Becoming argumentative, lashing out or getting violent
• Delusions, depression or agitation
• Greater difficulty reading or writing
• Worsening judgment or loss of ability to recognize danger
• Using the wrong word, not pronouncing words correctly or speaking in confusing sentences
• Withdrawing from social interactions
• Inability to feed, dress or bathe oneself
• Inability to recognize family members
• Struggling to understand one's own language

Types of dementia

As many things can lead to dementia, there are several types of the disease.

Mild cognitive impairment (MCI)

Mild cognitive impairment (MCI) is the stage between normal forgetfulness and the development of dementia. MCI doesn’t prevent the individual from living a normal life, but it may make day-to-day activities, such as accomplishing tasks or remembering events, more challenging. While there isn't a cure for MCI, it can be slowed or improved through regular exercise, socialization, treating underlying conditions and cognitive training. People with mild cognitive impairment do not always develop dementia.

Alzheimer’s disease

Alzheimer’s disease is the most common cause of dementia among older people. It is a progressive neurological disorder caused by a buildup of proteins in the brain which reduces communication between nerve cells. This can prevent the development of new memories, make it harder to recognize people or places, and impair language and judgment.

Vascular dementia

Vascular dementia is the product of damage to blood vessels in the brain, frequently caused by stroke, hardening of the arteries, high blood pressure or diabetes. Other reasons this may occur include aging, obesity, lack of exercise, smoking, high cholesterol and heart conditions.

Lewy body dementia (LBD)

LBD is caused by “Lewy bodies,” abnormal masses of the alpha-synuclein protein that build up in the brain. Lewy bodies impair normal neuronal functioning, leading to the damage and death of brain cells.

Diagnosing dementia

Diagnosing dementia may include a review of your medical history, cognitive exams, brain imaging (such as MRIs and CT scans), psychiatric evaluation or even blood and spinal fluid tests. When dementia does occur, it usually gets worse over time. Early diagnosis can help provide support for those experiencing dementia and ease the reduction of quality of life and life expectancy.

Risk factors of dementia

While some types of dementia may be driven primarily by one factor, most types are influenced by a combination of factors, which could include:

• Traumatic brain injuries (TBI) increase the risk of dementia. Moderate or severe injuries may increase the risk of dementia by as much as 400% and is a primary driver of Chronic Traumatic Encephalopathy (CTE) and is more common among athletes.
• Environmental factors can be a large determining factor in developing dementia. Sources include air pollution such as exposure to dust, dirt, smoke, soot, nitrogen dioxide, pesticides, solvents, vehicular and industrial emissions; or exposure to heavy metals like aluminum or lead. Noise pollution can also contribute to dementia, as it can increase stress and decrease quality of sleep.
• Genetics and heredity history can be a primary driver for conditions such as Alzheimer’s disease and Lewy body dementia. Other genetic factors, like high cholesterol levels, can trigger conditions like vascular dementia.
• Diet and lifestyle choices such as frequently eating foods high in sugar, saturated and trans fats, or ultra-processed food (like fried food, soda, chips, and frozen dinners) increases the likelihood of dementia. Smoking and overindulging in alcohol may also be factors.

Can dementia be prevented?

There is no guaranteed way to prevent dementia. However, there are many steps you can take to reduce your risk, including:

• Protecting your head
• Managing chronic conditions
• Exercising regularly
• Being mindful of your diet
• Socializing frequently
• Staying mentally engaged

Are there any treatments for dementia?

There is currently no cure for most types of dementia. At Atrium Health Floyd and Harbin Clinic, we’ll work to identify treatments that help manage it, allowing you to enjoy a greater quality of life. These treatments include medication, cognitive engagement, occupational and physical therapy, and even lifestyle adjustments, like building routines and social support. Early diagnosis and individualized treatments are essential.