How is dementia different from normal aging?
With age, thinking actually slows down: a person needs more time to remember a name or master a new device. But this does not prevent you from living independently, running a household and managing money. With dementia, the disturbances are qualitatively different: a person forgets recent events entirely, repeats the same questions, gets lost in familiar places, and experiences difficulties with usual activities - preparing food, paying bills, taking medications. The character also changes: suspicion, apathy or unusual irritability appear, and criticism of one’s condition decreases.
- Forgetting recent events rather than individual details
- Repeating the same questions
- Difficulties with usual household activities
- Disorientation in time and familiar places
- Difficulty finding words
- Changes in character and behavior
- Reduce criticism of your condition
Main reasons
Alzheimer's disease is the most common form in which recent memory and orientation are the first to suffer. Vascular dementia is associated with strokes and chronic disruption of the blood supply to the brain and often develops in stages, with periods of stability. Dementia with Lewy bodies presents with fluctuations, visual hallucinations, and signs of parkinsonism. The frontotemporal form begins earlier and is manifested primarily by changes in behavior and speech, rather than memory. Conditions that mimic dementia and are treatable are considered separately.
- Alzheimer's disease
- Vascular dementia
- Dementia with Lewy bodies
- Frontotemporal dementia
- Mixed forms
- Reversible causes: vitamin B12 deficiency, hypothyroidism, depression
- Side effects of medications and alcohol abuse
Early signs that loved ones notice
At an early stage, changes can easily be attributed to age and character. Repeated questions, loss of things with accusations of theft by others, difficulties with money and paying bills, confusion with taking medications should be alarming. Planning often suffers before memory: a person stops coping with tasks that require several steps. The range of interests narrows, initiative decreases, and sleep disturbances appear. The person himself often hides difficulties or denies them, so information from relatives is important, and not just self-esteem.
- Recurring questions and stories
- Losing things and being suspicious
- Difficulties with money and documents
- Confusion with taking medications
- Giving up previous activities and hobbies
- Sleep disorders and nighttime activity
- Decrease in neatness
Diagnostics
The examination solves two problems: to confirm the decline in cognitive functions and to find its cause, including a reversible one. The doctor conducts cognitive tests assessing memory, speech, attention and orientation, and always talks with relatives about how daily life has changed. Laboratory examination includes tests for vitamin B12 deficiency, thyroid function, blood and metabolic parameters. MRI of the brain helps to identify the consequences of strokes, atrophy, tumors and hydrocephalus. Depression, which can mimic dementia in older people, is assessed separately.
- Cognitive tests
- Talking with relatives about daily changes
- General and biochemical blood test
- Vitamin B12 and folic acid
- Thyroid hormones
- MRI of the brain
- Depression Assessment
- Review of medications taken
Treatment and care organization
If a reversible cause is found, treating it can significantly improve the condition. For Alzheimer's disease and other forms, medications are used that are prescribed by a doctor: they do not cure, but can temporarily improve well-being and delay the loss of skills. The non-medicinal part is no less important: control of blood pressure, sugar and cholesterol, physical activity, treatment of hearing and vision impairment, regular communication and feasible activities. Care is based on predictable routines, the safety of the home, and simple, easy-to-understand instructions. It is useless to argue and convince someone with false beliefs - it is better to gently switch attention.
- Treatment of reversible causes
- Medicines prescribed by a doctor
- Control blood pressure, sugar and cholesterol
- Physical activity and walking
- Hearing and vision correction
- Consistent daily routine and clear prompts
- Home safety: handrails, lighting, stove and medication control
- Supporting caring relatives and preventing their burnout