What is dementia?
Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with a person’s daily life. Several different diseases may cause dementia. Though dementia generally involves memory loss, memory loss has different causes (e.g, traumatic brain injuries, depression, etc).
Having memory loss alone does not necessarily equate to dementia.
Alzheimer's disease is the most common cause of progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms may be reversible (e.g, those that re due to nutritional deficiencies).
Signs and symptoms of dementia
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
Cognitive changes
- Memory loss, which is usually noticed by a spouse or someone else, Declining memory, especially short-term memory, is the most common early symptom of dementia.
- Difficulty communicating or finding words. Occasionally everyone has trouble finding the right word but a person with dementia often forgets simple words or substitutes unusual words, making speech or writing hard to understand.
- Difficulty performing familiar tasks. People with dementia often find it hard to complete everyday tasks that are so familiar we usually do not think about how to do them. A person with dementia may not know in what order to put clothes on or the steps for preparing a meal.
- Difficulty with visual and spatial abilities, such as getting lost while driving
- Difficulty reasoning or problem-solving
- Difficulty handling complex tasks
- Difficulty with planning and organizing
- Difficulty with coordination and motor functions
- Confusion and disorientation. We sometimes forget the day of the week or where we are going but people with dementia can become lost in familiar places such as the road they live in, forget where they are or how they got there, and not know how to get back home. A person with dementia may also confuse night and day.
- Poor or decreased judgement. People with dementia may dress inappropriately, wearing several layers of clothes on a warm day or very few on a cold day.
- Problems with keeping track of things. A person with dementia may find it difficult to follow a conversation or keep up with paying their bills.
- Misplacing things. Anyone can temporarily misplace his or her wallet or keys. A person with dementia may put things in unusual places such as an iron in the fridge or a rol of toilet paper in the washing machine.
Psychological changes
- Personality changes, e., becoming obstinate, irritable and temperamental
- Changes in mood or behaviour. Everyone can become sad or moody from time to time. A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Alternatively, a person with dementia may show less emotion than was usual previously.
- Depression
- Anxiety
- Inappropriate behaviour, e.g, touching people at the wrong places
- Paranoia, e.g, accusing people of stealing their things just because the person cannot find them
- Agitation and restlessness
- Hallucinations
- Withdrawal from work or social activities. At times everyone can become tired of work or social activities. A person with dementia may become very passive, sitting in front of the television for hours
Classifying dementia
In terms of severity of the condition, dementia can be classified into mild, moderate or severe.
Mild Dementia
In this early stage of dementia, an individual can still function rather independently, and often is still able to drive and maintain a social life. In the very early stage of dementia, symptoms that are seen may be attributed to the normal process of ageing. For instance, there might be slight lapses in memory, such as having difficulty finding the word for something or misplacing eyeglasses. Other difficulties may include issues with planning, organizing, concentrating on tasks, or accomplishing parts of employment, if the individual is still in the workforce. This early stage of dementia, on average, lasts between 2 and 4 years.
Moderate Dementia
In this middle stage of dementia, which in most cases is the longest stage of the disease, brain damage is extensive enough that a person has trouble expressing their thoughts, performing daily tasks, and has more severe memory issues than in the earlier stage. An individual in this stage might not remember their address, might be unable to recall their personal history, and may get confused as to their location. Communication becomes difficult and the individual may lose track of their thoughts, may be unable to follow conversations, and may have trouble understanding what others are trying to communicate. Mood and behaviour changes, such as aggressiveness, difficulty sleeping, depression, paranoia, repeating actions and/or words, hoarding, anger, wandering, incontinence, and frustration may be seen. This moderate stage of dementia, on average, lasts between 2 and 10 years.
Severe Dementia
In late-stage dementia, also known as advanced dementia, individuals have significant issues with communication, often using only words or expressions. At the very end, they may not verbally communicate at all. Memory also worsens and individuals may not be able to remember what they had for lunch, recall who family members are, or they may think they are in a different time period all together. For instance, they might revert back to their childhood days. Individuals may no longer be able to walk and will require extensive assistance with daily living activities, such as personal hygiene and eating. At the very end of this stage, the individual will most likely be bedridden. This severe stage of dementia lasts approximately 1 to 3 years.
