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Understanding Dementia

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Dementia is a clinical syndrome of decline in memory and other thinking abilities. It is caused by various diseases and conditions that result in damage to brain cells and lead to distinct symptom patterns and distinguishing brain abnormalities. Alzheimer’s disease is the most common form of dementia accounting for 70% of all causes of dementia, and vascular disease is the second most common cause, accounting for 17% of all dementing disorders. Other diseases and conditions, including Parkinson’s disease, Lewy body disease, frontotemporal dementia and normal pressure hydrocephalus, account for the remaining 13 percent.

To be classified as dementia, there must be decline in memory and impairment in at least one of the following cognitive abilities:

  • Ability to generate coherent speech and understand spoken or written language
  • Ability to recognize or identify objects, assuming intact sensory function
  • Ability to execute motor activities, assuming intact motor abilities, sensory function and comprehension of the required task
  • Ability to think abstractly, make sound judgments and plan and carry out complex tasks

The decline in cognitive abilities must be severe enough to interfere with daily life (e.g., tasks at work; functioning in social situations).

What is Alzheimer's Disease?

The most common cause of progressive memory loss in the elderly is Alzheimer’s Disease. Since there are now medications that may slow the decline, early recognition of symptoms is vital to beginning treatment and delaying the debilitating effects of Alzheimer’s Disease. In Alzheimer’s disease, as in other types of dementia, increasing numbers of nerve cells deteriorate and die. Scientists do not yet fully understand the processes that result in the catastrophic brain damage associated with Alzheimer’s disease.

Symptoms of Alzheimer's disease may include:

  • gradual and progressive memory loss
  • difficulty in following directions and performing routine tasks
  • impaired judgment, reasoning, concentration, and orientation
  • confusion and restlessness
  • personality changes
  • loss of the ability to care for one's self

Not all memory problems are due to Alzheimer's disease. Since many of the other memory problems can be improved or even cured, it is important to seek an accurate diagnosis.

Alzheimer’s disease can affect individuals differently, but the most common symptom pattern begins with gradually difficulty in remembering new information. This is because disruption of brain cells usually begins in regions involved in forming new memories. As damage spreads, individuals also experience confusion, disorganized thinking, impaired judgment, difficulty expressing themselves and disorientation to time, space and location. As the disease progresses, these symptoms may lead to wandering and difficulty with social interactions. In advanced Alzheimer’s, people need help with bathing, dressing, using the bathroom, eating and other daily activities. Those in the final stages of the disease lose their ability to communicate, fail to recognize loved ones and become bed-bound and reliant on 24/7 care. Alzheimer’s disease is ultimately fatal.

An estimated 75 percent of people living with Alzheimer’s are cared for at home. While families provide most of the care, some also use home and community-based resources like home care agencies, adult day care, and Caregiver Resource Centers. For many families there is a challenge for finding sufficient and affordable community resources to allow them to continue caring for their loved one with Alzheimer’s disease at home. In the later stages of the disease, as more assistance is needed than family caregivers can provide, caregivers may decide to move individuals with Alzheimer’s disease into a continuing care retirement community having multiple levels of care, a residential care facility for the elderly (assisted living, board and care) or a nursing home.

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