What is dementia?

Dementia is a loss of mental skills that affects your daily life. It is different than the occasional trouble with memory that is part of aging. You may find it hard to remember things that you feel you should be able to remember. Or you may feel that your mind is just not working as well as usual.

Finding out that you have dementia is a shock. You may be afraid and worried about how the condition will change your life. Although there is no cure at this time, medicine may slow memory loss and improve thinking for a while. Other medicines may be able to help you sleep or cope with depression and behavior changes.

Dementia often gets worse slowly. But it can get worse quickly. As dementia gets worse, it may become harder to do common things that take planning, like making a list and going shopping. Over time, the disease may make it hard for you to take care of yourself. Some people with dementia need others to help care for them.

Dementia is different for everyone. You may be able to function well for a long time. In the early stage of the condition, you can do things at home to make life easier and safer. You also can keep doing your hobbies and other activities. Many people find comfort in planning now for their future needs.

How quickly dementia progresses depends on what is causing it and the area of the brain that is affected. Some types of dementia progress slowly over several years. Other types may progress more quickly.

The course of dementia varies greatly from one person to another. An early diagnosis and treatment with medicines may help for a while. Even without these medicines, some people remain stable for months or years, while others get worse quickly.

Many people with dementia aren't aware of their mental decline.

Over time, depending on the type of dementia, the way the person behaves may change. The person may become angry or agitated, or clingy and childlike. They may wander and become lost.

Even with the best care, people who have dementia tend to have a shorter life span than the average person their age.

Usually the first symptom of dementia is memory loss. Often the person who has the memory problem doesn't notice it, but family and friends do.

People who have dementia may have increasing trouble with:

• Recalling recent events. They may forget appointments or lose objects.
• Recognizing people and places.
• Keeping up with conversations and activity.
• Finding their way around familiar places, or driving to and from places they know well.
• Keeping up personal care such as grooming or bathing.
• Planning and carrying out routine tasks. They may have trouble following a recipe or writing a letter or email.

There are many types of dementia that get worse over time. The types are named by the disease or the changes in the brain that cause the dementia symptoms.

Alzheimer's disease.

This causes the loss of brain cells in many areas of the brain, and the brain shrinks.

Vascular dementia.

This is usually caused by several small strokes. In a stroke, blood supply to areas of the brain is cut off.

Dementia with Lewy bodies.

In this condition, abnormal structures called Lewy bodies form in the brain.

Parkinson's disease dementia.

This dementia may develop a year or more after problems with movement begin.

Frontotemporal dementia.

This is caused by a group of diseases in which certain areas of the brain shrink.

Medicines for dementia can slow it down for a while and make it easier to live with. Medicines can't cure it. But they may help improve mental function, mood, or behavior.

If a stroke caused the dementia, doing things to reduce the chance of another stroke may help. They include eating healthy foods, being active, staying at a healthy weight, and not smoking.

As dementia gets worse, a person may get depressed or angry and upset. An active social life, counseling, and sometimes medicine may help with changing emotions.

The goals of ongoing treatment are to keep the person safely at home as long as possible and to provide support and guidance to the caregivers.

The person will need routine follow-up visits. The doctor will monitor medicines and the person's level of functioning.

There is no single test for dementia. To diagnose dementia, your doctor will do a physical exam and ask questions about illnesses and life events. Your doctor may test your memory by asking you to tell what day and year it is, repeat a series of words, or draw a clock face.

Doctors use medicines to treat dementia by:

• Maintaining mental function for as long as possible.
• Managing mood or behavior problems. These include depression, insomnia, hallucinations, and agitation.
• Preventing more strokes in people who have dementia caused by stroke (vascular dementia).

Medicines to help maintain mental function

These medicines may include:

• Cholinesterase inhibitors. Examples are donepezil and galantamine.
• Memantine.

Medicines to help control mood or behavior problems

Many behavior problems can be managed without medicines.

In some cases, the doctor may prescribe:

• Antidepressants. Examples are citalopram and trazodone.
• Antipsychotic drugs. Examples are olanzapine and risperidone.

Medicines to prevent future strokes

The doctor may prescribe medicines for high blood pressure and high cholesterol. These drugs can't reverse existing dementia. But they may prevent future strokes and heart disease that can lead to more brain damage.

Take medicines for dementia as prescribed. Call your doctor if you think you're having a problem with your medicine. Eat lots of whole grains, fruits, and vegetables. If you aren't hungry, try snacks or nutritional drinks such as Boost, Ensure, or Sustacal. Try not to nap. Get regular exercise.

Dementia is caused by damage to or changes in the brain. Things that can cause dementia include:

• Alzheimer's disease. This is the most common cause.
• Strokes, tumors, or head injuries. This type of dementia is called vascular dementia.
• Diseases. These include Parkinson's disease, dementia with Lewy bodies, and frontotemporal dementia.

Some disorders that cause dementia can run in families. Doctors often suspect an inherited cause if someone younger than 50 has symptoms of dementia.

We all forget things as we get older. Many older people have a slight loss of memory that does not affect their daily lives. But memory loss that gets worse may mean that you have dementia.

Dementia is a loss of mental skills that affects your daily life. It can cause problems with memory, problem-solving, and learning. It also can cause problems with thinking and planning.

Dementia usually gets worse over time. But how quickly it gets worse is different for each person. Some people stay the same for years. Others lose skills quickly.

Your chances of having dementia rise as you get older. But this doesn't mean that everyone will get it.

If you are caring for someone who has dementia, you may need to make some extra changes to create a safe home. People with dementia have a loss of mental skills, such as memory, problem solving, and learning. So things that might not have been a danger to them before can cause safety problems now.

Here are some things to consider:

• Don't move furniture around. The person may become confused.
• Use locks on doors and cupboards. Lock up knives, scissors, medicines, cleaning supplies, and other dangerous items.
• Use hidden switches or controls for the stove, thermostat, water heater, and other appliances.
• If your loved one is still cooking, think about whether that is safe. It may be okay with some help, depending on your loved one's condition. But for people who have memory or thinking problems, it's best to avoid any activities that might not be safe.
• If the person tends to wander or to try to leave the home, install motion-sensor lights on all doors and windows.
• Have emergency numbers in a central area near a phone. Include 911 and numbers for the doctor and family members.
• Get medical alert jewelry for the person so you can be contacted if they wander away. If possible, provide a safe place for wandering, such as an enclosed yard or garden.