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What is dementia?

Dr. Martin Russo of North Ottawa Medical Group’s Family Medicine office answer’s your questions about dementia. 

What is dementia?

Dementia is a very serious problem that plagues many individuals in our families and community. It affects about one percent of people at age 60 and doubles approximately every five years. By age 85, it affects from 30-50%. About 10-20% of causes are potentially reversible.

Dementia usually presents as a gradual cognitive decline. The word “cognition” is a term referring to intellectual properties such as reasoning, judgment and memory. Problems often occur involving speaking and writing coherently or understanding what is spoken or written. One may have difficulties recognizing familiar surroundings, planning or carrying out multiple tasks. These problems interfere with the ability to remain independent (really interdependent) and the performance of one’s usual daily activities.

About 60-80% of the causes of dementia is Alzheimer’s disease producing the death of nerve cells in various parts of the brain. There is a deposition of a protein called “beta amyloid” and disorganized masses of protein fibers called “neurofibrillary tangles.” Other causes include “vascular dementia” which involves brain damage due to the blockage of small blood vessels clogged with blood clots or fatty deposits. Multiple small strokes may occur from increased risks such as poorly controlled high cholesterol, diabetes or high blood pressure. Parkinson’s disease and other causes make up a smaller group of causes of dementia.

What are risks for developing dementia?

  • Age – more common in people over 60.
  • Family history – more risk if a parent or sibling has had the disease (10-30% chance).
  • Other diseases – there is some link to other diseases such as high blood pressure, diabetes and smoking but the statistical relationship is still not clear.

What are the symptoms?

Early symptoms are usually seen by loved ones and close friends as the changes may be very subtle and gradual. Keep in mind however that there are normal age related changes in short term memory that are mild causing minor difficulties in one’s ability to learn and process information that does not lead to dementia. With AD (Alzheimer’s disease), one gradually sees a worsening of short term memory and with it, problems with concentration, reasoning, judgment, performing complex tasks such as balancing the check book, getting lost in familiar surroundings, difficulties with language (not finding the right words) and confusion.

Later symptoms of AD include changes in mood and personality, aggressive (or passive) behavior, hallucinations, inability to control one’s bowels or urine, disorientation and needing help with elementary tasks such as bathing, dressing and feeding oneself.

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