Dementia Who Is Most at Risk and How to Manage It

Have you noticed times when your loved one forgets about their typical television program or suddenly does not remember to pay their bills after years of doing so successfully? These can be common signs of dementia—a neurological condition that affects about 50 million people worldwide.

Dementia develops when a neurotoxic protein called beta-amyloid accumulates as we age, which causes nerve cells in the memory centers of the brain (such as the hippocampus and temporal lobe) to die. As a result, people begin experiencing symptoms including:

• Confusion
• Difficulty reasoning or problem-solving
• Limited social skills
• Memory loss

The most common risk factor for dementia is age, as dementia becomes more common as we get older. While it’s very rare to have the disease before the age of 60, seven percent of adults older than 60 do, and nearly 30 percent of those 85 and older do. Genetics also plays a role in the risk of developing dementia. Understanding its symptoms so your loved one can receive a diagnosis early can help protect them.

LISTEN: Dr. Torres discusses dementia in the Medical Intel podcast.

What Are the Types of Dementia?

Dementia is mostly made up of four different types, which include:

• Alzheimer’s disease: This is a neurodegenerative disease, meaning it occurs when brain cells continuously die over time. This is the most common type, making up about 60 to 80 percent of all cases.
• Vascular dementia: This is when people have a blockage tin blood flow to the brain, which deprives the brain of the vital oxygen and nutrients it needs. This occurs mostly in people at higher risk of stroke because of diabetes and hypertension. This is the second most common type, making up about 15 to 20 percent of all cases we see.
• Parkinson’s disease: This is a progressive central nervous system disorder that affects movement as well as cognition
• Lewy body dementia: This occurs when protein deposits, called Lewy bodies, develop in nerve cells in the brain that affect memory, thinking, behavior, and movement.

We’re also beginning to learn that brain trauma can predispose people to dementia later in life. In fact, we have seen chronic traumatic encephalopathy (CTE), a progressive degenerative disease of the brain that’s caused by concussions, in many individuals who play professional, high-contact sports.

To diagnose dementia, geriatric or primary care doctors typically do initial screenings that include blood tests and neurological imaging via a computed tomography (CT) or magnetic resonance imaging (MRI) scan. If further screening is needed, they will refer you to a neurologist.

Is Dementia Treatable?

Dementia unfortunately is irreversible at this time. Numerous researchers have attempted to identify treatments, but none have been successful. Medications are available, however, to slow down the progression of the disease. The most famous are donepezil, commonly known under the brand name Aricept; and memantine, commonly known under the brand name Namenda. Although these medications can work, people don’t automatically use them upon a dementia diagnosis. It is best to have a conversation with a doctor to decide whether the patient has reached the stage in which they would benefit from medication.

Some people benefit greatly from medication, while others see less of a benefit. But regardless, the effect of medication diminishes, and dementia begins to progress again. The biggest benefit from taking these medications is the ability to buy time.

Diagnosing dementia early on is important, as medications can slow it down, and there are even a few conditions that have dementia-like symptoms but are treatable. The most common is depression, as it can cause memory impairment and a loss of concentration.

While many theories and stories abound that substances such as herbal medications, anti-inflammatories, and vitamin supplements can help prevent the development of dementia, they have never been proven true scientifically. Two things that I recommend, however, are daily exercise and a healthy diet that prioritizes plant-based foods.

How We Can Help

We help educate caregivers and assist them in meeting the needs of their loved one through personalized, expert care at MedStar Washington Hospital Center. We sometimes see frustration and sadness in a caregiver and their loved one with dementia. We often implement behavioral techniques that prioritize patience to help ease this tension. Additionally, we can suggest home health care when it’s necessary to help individuals with dementia avoid unnecessary trips to the hospital or emergency department.

Dementia is a common disease among the elderly. If you notice your loved one experiencing symptoms, please consider scheduling an appointment with a geriatric or primary care doctor so they can undergo testing in order to receive treatment early on.