Symptoms causes and possible solutions of Dementia

Symptoms causes and possible solutions of De handstiaIntroduction (source, NHS) craziness is a syndrome (a group of related symptoms) that is associated with an ongoing declineof the oral sex and itsabilities. These includethinking,language,memory,understanding, andjudgement.People with craziness whitethorn also have problems go pop bring outling their emotions orbehaving appropriately in social situations. Aspects of their personality whitethorn change. Most cases of madness atomic number 18 caused by trauma to the structure of the brain.How common is alienation?Dementia is a common condition. InEngland alone, there are currently 570,000 slew living with lunacy. That number is expected to two-fold over the next 30 years.Usually dementia occurs in people who are 65or over. The older you scram, the to a greater extent likely you are to stand up it.It is estimated that dementia occurs in1.4% of men and 1.5% of women aged amongst 65 and 69,3.1% of men and 2.2% of women aged between 70 and 74,5.6% of men and 7.1% of women aged between 75 and 79,10.2 % of men and 14.1% of women aged between 80 and 84, and19.6% of men and 27.5% of women aged 85 or over.Types of dementiaListed below are the several(predicate) types of dementia.Alzheimers disease, where subatomic clumps of protein, known as plaques, put down to develop around brain cells. This disrupts the normal produceings of the brain.vascular dementia, where problems with stock circulation result in set outs of the brain not receiving enough rip and oxygen.Dementia with Lewy bodies, where abnormal structures, known as Lewy bodies, develop inside the brain.Frontotemporal dementia, where the frontal and temporal lobes (two slices of the brain) begin to shrink. Unlike other types of dementia, frontotemporal dementia usually develops in people who are under 65. It is much rarer than other types of dementia.Thissection focuses on vascular dementia, dementia with Lewy bodies and frontotemporal d ementia. See Useful links for more training about(predicate) Alzheimers disease. anticipationIn clinical terms, the outlook for dementia is not good. In most cases, there is no cureand symptoms will get worse over time.However, fifty-fifty if a persons dementia lowlifenot be cured, there are a number of effective treatments that potentiometer economic aid them to bed better with their symptoms and improve their quality of life.SymtomsVascular dementiaThe symptoms of vascular dementia keep develop suddenly and quicklyworsen.Or they drive out develop gradually overmany months.Symptomsinclude change magnitude difficulties with tasks and bringivities that require concentration and planning,memory mischief,depression,changes in personality and mood,periods of genial confusion,low attention span,urinary incontinence,stroke-like symptoms, much(prenominal) as tendon weakness or paralysis on one side of the body,wandering during the night, andslow and unsteady gait (the way th at you walk).Symptoms of dementia with Lewy bodiesThe symptoms of dementia with Lewy bodies usually develop graduallybut getmore fearful over the course of many years.The symptoms of dementia with Lewy bodies includememory loss,low attention span,periods of mental confusion,delusions (believing in things that are not true), clog planning ahead,muscle stiffness,slower movement,shaking and trembling of arms and legs,shuffling while walking,problems sleeping,loss of facial expression, andvisual hallucinations (seeing things that are notthere). Usually people will see other people or animals that are not real.Symptoms of frontotemporal dementiaFrontotemporal dementia is caused by damage to the parts of the brain that inspection and repair control emotional responses and behaviour. at that placefore, many of the initial symptoms of frontotemporal dementia involve changes in emotion, personality and behaviour.Someone with frontotemporal dementia maybe deduce less sensitive to other peo ples emotions. This hobo arrive themseem cold and unfeeling.They may also lose nearly of their inhibitions. This could lead to st lay out behaviour, such asmaking sexually suggestive gestures in a public place, being rude to others or making tactless comments.Other symptoms of frontotemporal dementia includeaggression,compulsive behaviour,being easily distracted,an increasing lack of interest in washing themselves, andpersonality changes. Aperson who was previously withdrawn may become very outgoing, or vice versa.Some people with frontotemporal dementia alsohave problems with language.Symptoms affecting language includespeaking far less than usual, or not speaking at all,having problems finding the proper words to express themselves, and using many words to describe something wide. For example, saying a metal and wooden tool used for digging instead of a spadeCauses of dementiaVascular dementiaVascular dementia is caused when there is an goion to the riptide supply to the b rain.Like all organs, in order towork properly the brain haves a constant supply of oxygen and nutrients that is provided by the beginning. If the supply of blood is restricted or stopped, brain cells begin to die, resulting in brain damage.The blood supply to the brain can become blocked during a stroke where eithera blood clot blocks the supply of blood to the brain, known as an ischaemic stroke, ora blood vessel becomes weakened and then splits. This is known as a haemorrhagic stroke.Sometimes, less tough blockages to the brain do not result in a stroke, but they can damage the brain to a lesser extent. This is known as a silent brain infarction.Not everyone who has had a stroke or a silent brain infarction will go on toget vascular dementia. Butit always go forwards a possibility, particularly in people who have multiple strokes or silent brain infarctions.Vascular dementia can also develop if the vessels inside the brain narrow and harden. Narrowing and hardening of the blo od vessels is known as arteriosclerosis.Know endangerment factors for arteriosclerosis includediabetes,obesity,smoking, insobrietytoo muchalcohol,lack of lesson, andeating a high- expound dietDementia with Lewy bodiesLewy bodies are small, circularlumps of protein that develop inside the brain. It is not known what causesthem. It is also ill-defined howthey damage the brain and cause dementia. One theory is that they block the effects of two neurotransmitters called dopamine and acetylcholine.Neurotransmitters are messenger chemicals that send selective information from one brain cell to another.Both dopamine and acetylcholine are thought to play an important role in helping to regulate many important mental utilizations, such as memory, learning, mood and attention. Therefore, by blocking their effects, Lewy bodies may trigger dementia.Frontotemporal dementiaFrontotemporal dementia is caused by two parts of the brain (the temporal lobe and the frontal lobe) sightly increasing ly damaged and then shrinking.In an estimated 40 to 50% of cases, people who develop frontotemporal dementia have inherited a genetic mutation (an modify gene) from their parents. These genetic mutations are thought tohave a negative effect on a protein known as the tau protein.All brain cells contain tau proteins. They help to keep the brain cells stable. However, if tau proteins stop working properly, they can damage brain cells.Ifno genetic mutationis found, the causes of frontotemporal dementiaremain unknown.Less common causes of dementiaDementia or dementia-like symptoms can have a number of less common causes, some of which are treatable. These includerepeatedinjury to the head,infections of the brain, such as meningitis or encephalitis,Huntingtons disease, a rare genetic condition that causes progressive brain damage,Creutzfeldt-Jakob disease (CJD), a rare and adipose tissueal condition that causes damage to the brain and noisome system,an overactive or underactive thyroid gland,dehydration,lack ofvitamin B in the diet,poisoning,for example from lead or pesticides,having a brain tumour, andcertain lung and heart conditions that interrupt the supply of blood and oxygen to the brain.Diagnosing dementiaConfirming a diagnosis of dementia can be difficult, particularly when the condition is in its primeval stages. This is because many of the symptoms of dementia can be caused by otherconditions.In orderfor dementia to bediagnosed correctly, you shouldhave a number of different tests and assessments includingAreview of your medical history.A estimable assessment of your mental abilities.A range oftests,including blood tests to rule out other possible causes of your symptoms, such as a vitamin B deficiency.Imaging examines, such as a magnetic resonance tomography (MRI) scan, which can provide information about the physical adduce and structure of your brain.Areview of any medication you may be taking, in case these are contributing to your symptoms.Some of these tests can be carried out by your GP. Others will be carried out by other specialists, such as a neurologist (an expert in treating conditions that affect the brain and neural system) or a psychiatrist with experience in treating dementia.Assessing your mental abilitiesThere are some questionnaires that can be used to helptest your mental abilities and how severe your symptoms are. One widely used questionnaire is theMini Mental State Examination (MMSE).The MMSE can be used to assess a number of different mental abilities including gip- and long-term memory,attention span,concentration,language and communication skills,ability to plan, andability to understand instructions.The MMSE is a series of questions, each carrying a score that can take for a maximum result of 30 points.Example questions includememorising a short list of objects and then repeat the list back,writing a short sentence that is grammatically correct, such as the dog sat on the floor, andcorrectly indent ifying the current day of the week, followed by the date, the month, the season and the year.While the MMSE cannot diagnosis dementia by itself, it isuseful for assessing the level of mental impairment that a person with dementia may have.Ascore of 25 or above is considered normal.Ascore of 18 to 24 indicates mild to moderate impairment.Ascore of 17 or below indicates serious impairment.Ruling out other conditionsThere arefurther tests that can be used to rule out other conditions that may be responsible for the patients symptoms. These tests are outlined below.A full blood countA full blood count can be used to assess your oecumenical health and check for a range of disorders, including anaemia and infection. A blood sample will usually be taken from a vein in your arm using a plague and syringe. The test will also check for other illnesses.Blood glucose testA blood glucose test can be used to determine whether your blood glucose level is normal, and can also determine whether yo u have diabetes. A blood sample is taken to rule out whether your symptoms might be caused by unknown diabetes.Urine analysisUrine analysis is used to diagnose diabetes or problems with your kidneys. During the test, you will be asked to pass a small sample of urine into a sterile container.Measurement of thyroid hormonesA measurement of your thyroid hormones may be taken in order to screen for thyroid disorders, including hypothyroidism (an underactive thyroid) and hyperthyroidism (an overactive thyroid).Measurement of vitamin B12 levelsYou may also have a test to checkwhether your symptoms are caused by a lack of vitamin B12. However, ifyou dohave a B12 deficiency, it is still possible that you may also have dementia.Imaging scansImaging scans can check if there are any underlying problems with your brain, such as a brain tumour, that couldhelp explainyour symptoms.Imaging scans can also identify changes in the appearance of the brain that may indicate dementia. Several types of imaging scans can be used in the diagnosis of dementia. These are described below.Magnetic resonance imagingA magnetic resonance imaging (MRI) scan is the opera hat way to rule out other brain problems, and to help diagnose the type of dementia.MRI scans help doctors determine whetherthere is any shrinkage to the outer layer of the brain,there is any evidence of changes to the blood vessels, orthere are any blood clots that might have resulted in vascular dementia.The test will also show whether other conditions, such as a brain tumour, are causing your symptoms.Computerised topographyA reckonerised topography (CT) scan can be used as an alternative to a MRI scan. A CT scan takes a series of X-ray images of your brain. The images are fed into a computer to build up a detailed3D image of the inside of your brain.Single photon-emission computed tomographyA single photon-emission computed tomography (SPECT) scan may be recommended if doctors are unsure whether you have Alzheimers di sease, frontotemporal dementia or vascular dementia.A SPECT scan is similar to a CT scan, but the scanner used for a SPECT scan is able to take moving pictures of the blood flow in your brain. The results show if the blood flow in your brain is abnormal, which can lots be used to help diagnose the type of dementia.Treating dementiaYour care planIf you are diagnosed with dementia, your coming(prenominal) health and social care needs will be assessed and a care plan will be drawn up. A care plan is a way of ensuring that you receive the right treatment for your needs.Examples of questions that couldcome upwhile drawing up your care plan are listed below.Doyou have a family member or friend willing to act as a carer?What support do you or your carer need for youto remain as independent as possible?Are thereany changes that need to be made to yourhome to make it easier to live in?Would you benefit from physical and occupational therapy?Doyou need additional treatment and advice to hel p you cope with symptoms of incontinence?Might you require residential care at some point in the future?It is important to remember that this is your care plan. You should ask as many questions as you want and make sure that your wishes are known.Patient consent and advanced guidingPatient consent means that you have to conduce express permission before any medical treatment can be carried out on you. Consent is needed for alltreatments, whether its a simple blood test or an organ donation.The onlytime when treatment can go ahead without yourpermission is if youare unable tomake a decision on your own, and thedoctors responsible for your care believe that treatment is in your best interests.There may be a time in the future when your symptoms mean that youare no longer ableto fail consent.Therefore, you may wish to draw up an advanced directive later on first receiving a diagnosis of dementia. An advanced directivemakes your treatment preferences known now, in case you are not ab le to do this later.Subjectscovered byan advanced directive can includewhat treatment you would consider having and in what circumstances,what types of treatment you would never wish to have, no matter what the circumstances,what type of end-of-life care you would wish to have, for example, whether you would want to be resuscitated by artificial means, such as having a breathing tube inserted into your neck if youhave lung failure, andwhether you would be willing to donate organs after your death.You cannot request anything illegal in your advanced directive, such as assisted suicide. Your care team will be able to provide you with more information and advice about advanced directives.You may wish to appoint a friend or family member to take care of your financial and legal affairs. This is known as granting power of attorney.SeeUseful linksfor information and advice about granting power of attorney.Psychological treatmentsThere are a number of different psychological treatments tha t can be used to help you copewith the symptoms of dementia and slow down thesymptoms. Theseare describedbelow.Cognitive stimulationCognitive stimulation involves taking part in activities and exercises that are designed to improve your memory, problem-solving skills and language ability.Itis provided by a trained carer, and usually consists of two 45-minute sessions a week. During these, you will be involved in discussions about a variety of topics, as well as taking part in word and memory games, and other activities, such as arduous to identify pictures of famous people.behavioural therapybehavioural therapy is used to help treat many of the behavioural problems that are associated with dementia, such as depression, aggression and delusional thinking.Behavioural therapy is usually provided by a carer, who can be a trained friend, relative or an employed carer. It issupervised bya health professional.Behavioural therapy uses a problem-solving approach where possible motivations a nd reasons for troublesome behaviour are identified. Different strategies are adopted to try to change that behaviour.For example, a person with dementia may have a history of wandering out of their home or care centre because they feel restless. Therefore, a strategy that involves encouraging them to take part in regular physical exercise maylessen their restlessness.Reality orientation therapyReality orientation therapy is a type of therapythat visitsfeelings of mental disorientation, memory loss and confusion, while improving feelings of self-esteem.Reality orientation therapy may involve group work in a classroom, in which a board prominently displays information such asthe current day and date,the location of the classroom, andthe names of the people in the group.The group members repeata series of tasks that are designed to make it mental stimulation. These tasks alsoreinforce information regarding the time, the placeand the people involved in the group.Multisensory stimulati onMultisensory stimulation is a way of stimulating the brainusing different elements. These includelighting, relaxing music and sounds, massage cushions, aromatherapy (scents) and different touch sensations.By stimulating different areas of the brain, multisensory stimulation aims to lessen feelings of confusion and restlessness, andimprove mood and language skills.However,this treatment is not suitablefor everyone with dementia, as some people find the effects of stimulation upsetting and unpleasant.Exercise therapyExercise therapy consists of either general fitness training or a structured fitness programme. It is designed to improve a persons physical mobility, as well as benefiting mental function and mood.MedicinesAcetylcholinesterase inhibitorsAcetylcholinesterase inhibitors (AIs) are widely used to treat Alzheimers disease. They are not usually recommended for other forms of dementia because the evidence for their effectiveness is limited and, in some cases, may make symptoms worse.One exception is for people living with dementia with Lewy bodies that have behavioural problems, such as delusions or hallucinations,which are causing them significant suffering or leading to challenging behaviour.AIswork by embarrassing the breakdown of the neurotransmitter acetylcholine, as low levels of acetylcholine have been linked to behavioural problems.Side effects includenausea,vomiting,diarrhoea,muscle cramps, gamyigue,loss of appetite,agitation,aggressive behaviour,dizziness and fainting,insomnia, andurinary incontinence.AntipsychoticsAntipsychotics are medicines that can be used to treat challenging and disruptive behaviour, such as aggression or agitation.However, antipsychotics are not usually recommended for the treatment of dementia becausethey can increase the risk of a person experiencing cardiovascular diseases, such as strokes, andthey can make the symptoms of dementia worse.Also, in people who have dementia with Lewy bodies there is evidence that antip sychotics can cause a range of serious side effects, such asrigidity,immobility,being unableto perform tasks,being unableto communicate and,possibly,sudden death.Antipsychotics are usually only used in cases where there are severe symptoms of challenging and disruptive behaviour that is judged to place you and/or others at risk of harm. They are only used if there is a full discussion between yourself and/or your carer and your care team about the benefits and risks of treatment.Antipsychotics will be prescribed at the lowest dosepossible, and for as short a time as possible. Your health will also need to be carefully monitoredif you are taking antipsychotics.Side effects of antipsychotics can includedrowsiness,shaking,trembling,muscle twitches,spasms,weight gain, fogged vision,constipation,lack of sex drive, anda dry mouth.Preventing DementiaPreventing vascular dementiaWhile it is not possible to prevent all cases of dementia, there are some measures thatcan helpprevent vascular de mentia, as well as cardiovascular diseases, such as strokes and heart attacks.As experts in treating dementia practically say, What is good for your heart is also good for your head.The best ways to prevent vascular dementia areEat a healthy diet.Maintain a healthy weight.Get sufficient and regular exercise.Drink alcohol in moderation.Dont smoke.DietTo help prevent dementia, a low-fat andhigh-fibre diet is recommended. This includes plenty of fresh harvest-tide and vegetables (five portions a day) and wholegrains.Limit the amount of salt that you eat to no more thansix gramsa day. Too much salt will increase your blood twinge, which puts you at risk of vascular dementia. One teaspoonful of salt is about six grams.Avoid eating foods that are high in saturated fat because this will increase your cholesterol level, which also puts you at risk of vascular dementia.Foods high in saturated fat includemeat pies,sausages and fatty cuts of meat,butter,ghee (clarified butter, often used i n Indian cooking),lard,cream,hard cheese,cakes and biscuits, andfoods that contain coconut or palm oil.Eating some foods that are high in unsaturated fat can decrease your cholesterol level. Foods high in unsaturated fat includeoily fish,avocados,nuts and seeds, andsunflower, rapeseed and olive oils.WeightBeing overweight can increase your blood pressure, which increases the risk of vascular dementia. Thisrisk is higher if you are obese.The most scientific way to measure your weight is to calculate your Body muss Index (BMI). This is your weight in kilograms divided by your height in metres, squared. In the UK, people with a BMI of between 25 and 30 are overweight, and those with an force above 30 areobese. People with a BMI of 40 or more are morbidly obese.The best way of tackling obesity is to reduce the amount of calories that you eat, and ensure that you take regular and sufficient exercise. Your GPcangive you further information and advice about how you can do this.http//www. nhs.uk/Tools/PublishingImages/bmi_tease.gifExerciseRegular exercise will make your heart and blood circulatory system more efficient. It will alsolower your cholesterol level andkeep your blood pressure at a healthy level, all of which will lower your risk of developing vascular dementia.For most people, 30 minutes of vigorous exercise a day, at least five times a week, is recommended. The exercise should be strenuous enough tomake your heart beat faster, and you should feel slightly out of breath afterwards. Examples of vigorous exercise include going for a tremendous walk or walking up a hill.AlcoholDrinking profuse amounts of alcohol will cause a rise in your blood pressure, and raise the cholesterol level in your blood.Sticking to the recommended limits for alcohol consumption is the best way to ensure that you reduce the risk of high blood pressure, cardiovascular disease and vascular dementia.The recommended daily levels of alcohol consumption arethree to 4units of alcohol for men, andtwo to threeunits for women. A unit of alcohol is fitted to about half a pint of normal strength lager, a small glass of wine or a pub measure (25ml) of spirits.http//www.nhs.uk/Tools/PublishingImages/do_you_drink_tease.gifSmokingSmoking can cause your arteries to narrow, which can lead to a rise in your blood pressure. It is also a major risk factor for developing cardiovascular diseases, cancer and vascular dementia.The NHS Smoking Helpline offers advice and encouragement to helpyou stop smoking. You can call on 0800 022 4332 or visit the NHS Go Smokefree website (see Useful links).Your GP or pharmacist will also be able to give you help and advice about giving up smoking.Preventing other types of dementiaThere is some evidence that rates of dementia are lower in people who remain as mentally and physically active as possible throughout their lives, and have a wide range of different activities and hobbies.Some activities that may reduce the risk of developing dementi a includereading,writing for pleasure,learning foreign languages, play musical instruments,taking part in adult education courses,playing tennis,playing golf,swimming,group sports, such as bowling, andwalking.There is no evidence that playing brain training computer games reduces the risk of dementia.Dementia (souce,Bupa)reventing vascular dementiaWhile it is not possible to prevent all cases of dementia, there are some measures thatcan helpprevent vascular dementia, as well as cardiovascular diseases, such as strokes and heart attacks.As experts in treating dementia often say, What is good for your heart is also good for your head.The best ways to prevent vascular dementia areEat a healthy diet.Maintain a healthy weight.Get sufficient and regular exercise.Drink alcohol in moderation.Dont smoke.DietTo help prevent dementia, a low-fat andhigh-fibre diet is recommended. This includes plenty of fresh fruit and vegetables (five portions a day) and wholegrains.Limit the amount of salt th at you eat to no more thansix gramsa day. Too much salt will increase your blood pressure, which puts you at risk of vascular dementia. One teaspoonful of salt is about six grams.Avoid eating foods that are high in saturated fat because this will increase your cholesterol level, which also puts you at risk of vascular dementia.Foods high in saturated fat includemeat pies,sausages and fatty cuts of meat,butter,ghee (clarified butter, often used in Indian cooking),lard,cream,hard cheese,cakes and biscuits, andfoods that contain coconut or palm oil.Eating some foods that are high in unsaturated fat can decrease your cholesterol level. Foods high in unsaturated fat includeoily fish,avocados,nuts and seeds, andsunflower, rapeseed and olive oils.WeightBeing overweight can increase your blood pressure, which increases the risk of vascular dementia. Thisrisk is higher if you are obese.The most scientific way to measure your weight is to calculate your Body Mass Index (BMI). This is your wei ght in kilograms divided by your height in metres, squared. In the UK, people with a BMI of between 25 and 30 are overweight, and those with an index above 30 areobese. People with a BMI of 40 or more are morbidly obese.The best way of tackling obesity is to reduce the amount of calories that you eat, and ensure that you take regular and sufficient exercise. Your GPcangive you further information and advice about how you can do this.http//www.nhs.uk/Tools/PublishingImages/bmi_tease.gifExerciseRegular exercise will make your heart and blood circulatory system more efficient. It will alsolower your cholesterol level andkeep your blood pressure at a healthy level, all of which will lower your risk of developing vascular dementia.For most people, 30 minutes of vigorous exercise a day, at least five times a week, is recommended. The exercise should be strenuous enough tomake your heart beat faster, and you should feel slightly out of breath afterwards. Examples of vigorous exercise inclu de going for a brisk walk or walking up a hill.AlcoholDrinking excessive amounts of alcohol will cause a rise in your blood pressure, and raise the cholesterol level in your blood.Sticking to the recommended limits for alcohol consumption is the best way to ensure that you reduce the risk of high blood pressure, cardiovascular disease and vascular dementia.The recommended daily levels of alcohol consumption arethree to fourunits of alcohol for men, andtwo to threeunits for women. A unit of alcohol is equal to about half a pint of normal strength lager, a small glass of wine or a pub measure (25ml) of spirits.http//www.nhs.uk/Tools/PublishingImages/do_you_drink_tease.gif