Memory Loss – The patient may forget his way back home from the shops. He may remember names and places. He may find it hard to remember what happened earlier on during the day.
Moodiness – The patient may become more and moodier as parts of the brain that control emotion becomes damaged. Moods may also be affected by fear and anxiety – the patient is frightened about what is happening to him.
Communicative Difficulties – The affected person finds it harder to talk read and write. As dementia progresses, the patient’s ability to carry out everyday tasks diminishes and he may not be able to look after himself.
Diseases that cause dementia
Alzheimer’s Disease – This is by far the most common cause of dementia. The chemistry and structure of the brain of a person with Alzheimer’s disease changes and his brain cells die prematurely.
Stroke (Vascular problems) – This means problems with blood vessels (veins and arteries). Our brain needs a good supply of oxygen-rich blood. If this supply is undermined in any way, our brain cells could die – causing symptoms of vascular dementia. Symptoms may appear suddenly, or gradually. A major stroke will cause symptoms to appear suddenly while a series of mini strokes will not.
Dementia with Lewy Bodies – Spherical structures develop inside nerve cells. Brain cells are nerve cells; they form part of our nervous system. These spherical structures in the brain can damage the brain tissue. The patient’s memory, concentration and ability to speak are affected. Dementia with Lewy bodies is sometimes mistaken for Parkinson’s Disease because the symptoms are somewhat similar.
Frontotemporal Dementia – This includes Pick’s disease. The front part of the brain is damaged. The patient’s behaviour and personality are affected first, later his memory changes.
Other Diseases – Progressive supranuclear palsy, Korsakoff’s syndrome, Binswanger’s disease, HIV and AIDS, and Creutzfeldt-Jakob disease (CJD). Dementia is also common among patients who have Parkinson’s disease, Huntington’s disease, Motor Neurone disease and Multiple Sclerosis. People who have AIDS sometimes go on to develop cognitive impairment.
There are two main categories of dementia. These are Cortical and Subcortical dementias.
Cortical Dementia – The cerebral cortex is affected. This is the outer layer of the brain. The cerebral cortex is vital for cognitive processes, such as language and memory. Alzheimer’s disease is a form of cortical dementia, as is CJD (Creutzfeldt-Jakob disease).
Subcortical Dementia – A part of the brain beneath the cortex (deeper inside) becomes affected or damaged. Language and memory are not usually affected. A patient with subcortical dementia will often experience changes in his personality, his thinking may slow down, and his attention span may be shortened. Dementias which sometimes result from Parkinson’s disease are subcortical dementias, as are those caused by AIDS and Huntington’s disease.
A patient with multi-infarct dementia will have both the cortical and subcortical parts of the brain affected or damaged.
Diagnosis of dementia
Although there are some brief tests, a more reliable diagnosis needs to be carried out by a specialist. The following tests are commonly used:
It is important that the patient’s score is interpreted in context with his socio-economic, educational and cultural background. The tester must also factor in the patient’s present physical and mental state – does the patient suffer from depression, is he in great pain?