Dementia Information Guide: Symptoms, Causes, and Diagnosis

Dementia is a general term for a decline in cognitive function. People with dementia may have problems with memory, language, thinking, problem solving, and other functions that affect daily living.

Dementia is not a normal part of aging. Certain disorders cause changes in the brain that trigger the symptoms associated with dementia. Alzheimer’s disease is the most common cause of dementia, accounting for up to 80% of senior dementia cases.

What are the signs and symptoms of dementia in the elderly?

Occasional forgetfulness is normal, but persistent memory loss that continues to worsen warrants a visit to the doctor. People with dementia rarely complain of memory loss or other problems associated with cognitive impairment. It’s much more common for family members and friends to notice signs and symptoms of dementia before their loved one does.

Talk to your parent’s doctor if you notice any of these signs and symptoms:

• Short-term memory loss or problems retaining new information
• Difficulty performing complex tasks, such as balancing a checkbook or learning new technology
• Trouble with language and speech, such as forgetting common words
• Disorientation, such as getting lost in familiar places or being confused about dates and people’s identities
• Difficulty with reasoning, such as dealing with unexpected events

Dementia is often progressive. This means that signs and symptoms of dementia continue to get worse over time.

What causes senior dementia?

Dementia is caused by diseases that affect the brain and damage brain cells. In people with dementia, brain cells gradually lose the capacity to communicate with each other appropriately. This affects thinking, behavior, and feelings.

There are several common causes — sometimes called types — of dementia.

• Alzheimer’s disease is the most common cause of dementia. Alzheimer’s progressively damages brain cells, hindering someone’s memory and their ability to think and carry out even basic daily living tasks in later stages of the disease. Alzheimer’s is caused by plaques and tangles in the brain that damage brain cells and fibers that connect them
• Vascular dementia is the second most common cause of dementia. This type of dementia is a result of damage to the vessels that supply blood to the brain. Vascular dementia is associated with stroke and other vascular brain injuries. Common symptoms of vascular dementia include problems with focus, organization, and decision-making skills. Symptoms may begin suddenly and continue to worsen, but may sometimes go away
• Lewy body dementia (LBD) affects more than one million people in the U.S. This type of dementia is associated with abnormal deposits of protein in the brain that cause changes in thinking, behavior, movement, and mood. Common symptoms include hallucinations, tremors, slowed movement, and problems with focus and attention
• Frontotemporal dementia affects brain cells in the frontal and temporal lobes in the brain. These areas of the brain are associated with behavior, personality, and language. Frontotemporal dementia causes changes in how people think, act, speak, move, and make decisions. This type of dementia is a common cause of early-onset dementia, often affecting people in their 60s
• Parkinson’s disease is associated with cognitive decline, accounting for about 4% of dementia cases. Memory loss isn’t a key symptom in this form of dementia, although it may occur. Common symptoms include disorientation, hallucinations, and problems with motor skills

Who’s at risk for dementia?

Older adults and people who have a family history of dementia are at increased risk. Age is the main risk factor for dementia and specifically Alzheimer’s disease. The risk of dementia increases with age and doubles every 10 years after age 60. In fact, nearly 85% of dementia cases occur in people 75 or older.

Family history is another key risk factor for dementia associated with Alzheimer’s disease and frontotemporal dementia. The risk doubles for people with a parent diagnosed with dementia before the age of 80.

However, researchers now believe there are other factors that increase the risk of dementia, and there are things you can do to help influence them. These factors include:

• High blood pressure
  Lifestyle changes, such as eating a healthy diet that’s low in salt and exercising, can help control blood pressure. Sometimes, medication is needed.
• Obesity
  In middle age, it is associated with a higher risk of dementia. Diet and physical activity are key to maintaining a healthy weight. The 2015-2020 Dietary Guidelines for Americans recommend older adults be as physically active as possible. If your aging loved one has chronic health conditions, it’s important to talk to the doctor before starting any type of exercise program.
• Diabetes
  It increases the risk for both Alzheimer’s disease and vascular dementia. If your loved one has diabetes, it’s important to manage it.
• Depression
  Later in life, it is associated with an increased risk of dementia. Occasional sadness is normal, but if your loved one is sad or anxious for several weeks, it’s important to talk to the doctor about getting your parent checked for depression.
• Smoking
  The connection between smoking and dementia is unclear, but there’s some evidence that older adults who smoke are at increased risk of Alzheimer’s, vascular dementia, and other forms of dementia.
• Inactive lifestyle
  Studies have found that even a low to moderate level of physical activity can decrease the risk of dementia by 35%. Gentle exercises such as chair yoga, tai chi, or a simple walk around the block may be good options to get your aging loved one moving.
• Social isolation
  There’s growing evidence that social isolation may be a risk factor for senior dementia. It also increases the risk of high blood pressure and depression — both risk factors for dementia.

How is dementia diagnosed?

No single test can solely and conclusively diagnose dementia. Doctors rely on various tools and tests to eliminate factors that may be contributing to memory loss and other dementia symptoms.

The doctor will review your parent’s medical and family history. They will also perform a physical exam and may ask for laboratory tests.

Bring a complete list of all medications your parent takes to the appointment. The doctor will want to review it to look for possible side effects or drug interactions that may be causing your loved one’s symptoms. Several medications can affect cognitive function, including certain antidepressants, cholesterol-lowering medications, and sleeping aids.

Some ways the doctor may check for dementia include:

• Interviewing your loved one to learn about their symptoms
• Asking a family member or friend about changes they’ve noticed in their loved one’s memory, thinking, and behavior
• Using cognitive assessment tools, such as the Mini-Mental State Exam (MMSE) or the Montreal Cognitive Assessment (MoCA) to test your loved one’s memory and cognitive skills

Your parent may also need to have brain scans. An MRI can look for signs of a stroke or tumor. A PET scan can check for proteins in the brain that may indicate Alzheimer’s disease.

The thought your loved one may have dementia can be scary, but it’s important to get them checked.  Many treatable conditions can also cause memory loss, including side effects of medications, thyroid issues, nutritional deficiencies, and infections.

What to expect after a dementia diagnosis

Dealing with a diagnosis of dementia can be stressful, overwhelming, and devastating. Seeking dementia information and learning about what to expect can help you get the support you need and plan to provide adequate care for your loved one.

As dementia progresses, your loved one may have difficulty performing simple tasks such as bathing, dressing, or using the toilet. They may demonstrate poor judgment as they become more disoriented. While some dementia behaviors may be as harmless as wearing inappropriate clothing for the current weather, others could be more serious.

It’s important to understand how you can keep your loved one safe. Certain medications can help with symptoms. Learning how to cope and manage dementia behaviors may improve quality of life.

If you need support planning for future dementia care or caring for a loved one with dementia, contact our Senior Living Advisors. Memory care communities include 24-hour supervision to prevent wandering, help with activities of daily living, and provide meal services and health care as needed.

Sources:

Larson, E.B. “Risk factors for cognitive decline and dementia.” https://www.uptodate.com/contents/risk-factors-for-cognitive-decline-and-dementia.

Larson, E.B. “Evaluation of cognitive impairment and dementia.” https://www.uptodate.com/contents/evaluation-of-cognitive-impairment-and-dementia.

National Institute on Aging. “What is dementia? Symptoms, types, and diagnosis.” https://www.nia.nih.gov/health/what-dementia-symptoms-types-and-diagnosis.