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Dementia

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Dementia

Written by Professor Marion McMurdo, honorary consultant in medicine for the elderly

What is dementia?

Dementia is an illness of the brain. When someone has dementia, brain cells are damaged and die faster than they would normally. Losing brain cells means that the brain does not work as well as it should, and gradually people lose the ability to do things.

Often, memory is affected first and people forget important facts such as the name of their husband or wife. Later, as the illness progresses, people get confused about things like where they are, what day it is or who other people are.

People with dementia may become listless and lose interest in activities that have previously been important to them. In the later stages, people lose the ability to look after themselves and may need help with washing, dressing and eating. Conversation becomes repetitive and the same question may be repeated over and over.

Facts about dementia

Most older people will never get dementia, although it is not a normal part of growing old; it affects about 5 per cent of people aged over 65 and 20 per cent of those over 80.

It is not caused by stress.

Dementia is not infectious.

It is not caused by too little or too much mental activity.

What types of dementia are there?

Alzheimer's disease Alzheimer's disease is the most common type of dementia, and is caused by a loss of brain cells. It is probably related to an imbalance in the chemicals in the brain.

Over time, more brain cells fail and the patient slowly and steadily declines mentally. About 60 per cent of people in the UK who have dementia have Alzheimer's disease.

Vascular dementias, including multi-infarct dementia

This is the next most common type of dementia, and is caused by poor circulation of blood to the brain. In multi-infarct dementia, lots of tiny strokes (or infarcts) occur which cut off the blood supply to part of the brain.

The progression of vascular dementia can happen in recognised steps. With this type of dementia, good control of blood pressure, good diabetic control and avoiding cigarettes may help to slow the progress.

Lewy body dementia

People with Lewy body dementia may be more prone to visual hallucinations ('seeing things'), unsteadiness, falls and spells of abnormal behaviour.

Patients with Lewy body dementia may also be very sensitive to the effects of some drugs used to control behaviour.

Alcohol-related dementia

Brain damage can be caused by drinking too much alcohol. It is important that people with this type of dementia give up drinking alcohol completely to stop the disease progressing.

What can you do?

In the early stages of the illness, there are practical ways to jog the memory. These include keeping a diary or using a notice board for reminders.

Thyroid problems, depression, infections and vitamin deficiencies can all be mistaken for dementia. If you are suffering any of the symptoms mentioned above, ask your GP to arrange for a full medical assessment. This may involve referral to a hospital specialist.

Caring for someone with dementia can be very difficult. Joining a carers' group can help. Dementia sufferers are often entitled to financial benefits such as attendance allowance.

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