Detailing leading forms of dementia
Often I hear family members of patients with memory loss state, “The doctor says he/she has dementia. Thank God it’s not Alzheimer’s Disease!” They are unaware that dementia is an umbrella term for specific types of dementia.
There are many forms of dementia, not just Alzheimer’s, which is the most popular and the most common type. There are as many as 50 other known causes of dementia, although most are very rare. Here are some of the more common ones.
∎ Alzheimer’s disease can strike at any age, although it becomes more common as we age. The most common early symptom is difficulty remembering newly formed information. As the disease progresses, symptoms get worse and include confusion, forgetfulness, paranoia, increased need for cueing for simple things.
∎ Vascular dementia is caused by coronary artery disease. Maybe someone has had a stroke or changes in the vascular structure of the brain that has interrupted effective blood and oxygen flow to the brain. The symptoms are very similar to Alzheimer’s disease; forgetfulness, repetitiveness, personality changes and/or paranoia.
∎ Lewy body dementia is caused by plaques forming in the brain called Lewy bodies. This type can be associated with Parkinson’s disease. It is very distressing to families and patients due to the visual hallucinations that are caused by the plaques. The visual hallucinations are the characteristic difference in the diagnosis from other forms of dementia.
∎ People with frontal lobe dementia have a hard time with social skills. They can be impulsive, exhibit poor judgment and insight. They lose their social skills and can be really hard to be around due to this. Their behavior can be interpreted as rude. People with frontal lobe dementia tend to say the things that people without dementia think.
I am sure you are now wondering how to treat these awful types of dementia. Caring for someone with dementia is one of the hardest things you can imagine. It takes time, energy and an amazing amount of patience. Care is very individualized to the person with the disease.
Of course, there are medications that can be used, isn’t there always? Cholinesterase inhibitors, such as Aricept (donepezil) or Exelon (rivastigmine), are recommended to be prescribed early in the stage of the disease. There is evidence it can slow the process of the above types of dementia, but only by about six months. It is not a cure. Namenda (memantine) can be added for moderate stage dementia. Its goal also is to improve memory, awareness and ability to perform daily functions, but only in moderate stage. Again, it is not a cure. It is common to prescribe both of these medications at the same time, as the disease progresses. There is a risk to stopping a cholinesterase inhibitor, symptoms can get worse and resuming it will not bring the person back to where they were when it was stopped.
Next month, I will discuss best ways to communicate with someone with dementia.
Peggy Dorson Abbott is certified as a gerontological nurse practitioner and an adult mental health nurse practitioner. She has been working with older adults for over 20 years and has advanced knowledge in treatment of dementia. She provides numerous seminars throughout New Hampshire for caregivers on communication with loved ones with dementia. She lives in Peterborough with her husband, Raymond.