What is Dementia?
Dementia is irreversible. It does not get better. There is no cure. Dementia is an umbrella term describing a clinical syndrome characterized by a decline in memory, executive functions, language, and other cognitive skills that affect a person’s ability to adequately perform everyday activities. It is not a disease in and of itself. Again, it is an umbrella term. There are multiple diseases that fall under the umbrella term dementia, and different diseases manifest differently, have different trajectories, and often have different types of care providers and costs associated with them.
General information about dementia
Affected tasks often include managing medications, finances, transportation, food preparation, and housekeeping (IADLs), as well as more basic skills such as bathing, dressing, toileting, eating, and transferring (ADLs).
The onset usually is slow. Patients and their families, friends, and caregivers often have difficulty pinpointing the exact onset, because the appearance of dementia usually is gradual and insidious enough to inspire denial in even the most aware and insightful. By the time the patient has stopped driving or being able to manage finances, the underlying disease often has been present for years.
How is it diagnosed?
A diagnosis of dementia requires a thorough, multi-dimensional assessment, usually with a combination of neuroimaging, a neuropsychological evaluation of cognition, and a physical exam to rule out other potential medical problems that could cause confusion (i.e., delirium). People with dementia may have difficulty with one or more of the following:
• Retaining new information (e.g., remembering events)
• Handling complex tasks (e.g., balancing a checkbook)
• Reasoning (e.g., analyzing the costs and benefits of two different options)
• Spatial ability and orientation (e.g., finding your way around familiar places)
• Language (e.g., being able to find the right word to communicate your intended message)
• Behavior (e.g., delusions, hallucinations, agitation)
What are different types of dementia – the underlying diseases?
Dementia is divided into types based on the underlying disease contributing to the dementing process. The following are some types of dementia:
• Alzheimer’s disease (~65 percent of patients)
• Vascular dementia (~20 percent)
• Lewy body dementia (~5 percent)
• Frontotemporal dementia (~8 percent)
• Wernicke-Korsakoff syndrome
• Mixed dementia (any two dementing illnesses, such as Alzheimer’s disease and vascular dementia, manifesting at the same time)
• Chronic traumatic encephalopathy (CTE)
• Parkinson’s disease and dementia
More than 90 percent of dementing illnesses are due to one of four of the most common types of dementia: Alzheimer’s disease (AD), vascular dementia (VD), frontotemporal dementia (FTD), and Lewy body dementia (LBD). Most unusual cases of dementia either are characterized as subtypes of more common dementing illnesses, or they can be found under a category familiar to medical students: “OTHER.” This is where rare diseases of any type are classified; dementia is no exception. If you or a loved one develops one of these rarer diseases, it can be a big challenge to get an accurate diagnosis.
