Dementia – What is it?

The word ‘dementia’ describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. These changes are often small to start with, but for someone with dementia, they become severe enough to affect daily life. A person with dementia may also experience changes in their mood, behaviour, personality and will lose the ability to look after themselves.

Frequency

There are currently around 850,000 people in the UK with dementia. It mainly affects people over the age of 65 (one in 14 people in this age group have dementia), and the likelihood of developing dementia increases significantly with age. However, dementia can affect younger people too. There are more than 42,000 people in the UK under 65 with dementia.

Cause and symptoms of it

Dementia is caused when the brain is damaged by diseases, such as Alzheimer’s disease or a series of strokes. Alzheimer’s disease is the most common cause of dementia, but not the only one. The specific symptoms that someone with dementia experiences will depend on the parts of the brain that are damaged and the disease that is causing the dementia.

There are many diseases that result in dementia. The most common types of dementia are outlined below:

• Alzheimer’s disease – This is the most common cause of dementia. In Alzheimer’s disease, an abnormal protein surrounds brain cells and another protein damages their internal structure.
• Vascular dementia – If the oxygen supply to the brain is reduced because of narrowing or blockage of blood vessels, some brain cells become damaged or die. The symptoms can occur suddenly, following one large stroke.
• Mixed dementia – This is when someone has more than one type of dementia, and a mixture of the symptoms of those types. It is common for someone to have both Alzheimer’s disease and vascular dementia together.
• Dementia with Lewy bodies – This type of dementia involves tiny abnormal structures (Lewy bodies) forming inside brain cells. They disrupt the chemistry of the brain and lead to the death of brain cells.
• Frontotemporal dementia (including Pick’s disease) – In frontotemporal dementia, the front and side parts of the brain are damaged. Clumps of abnormal proteins form inside brain cells, causing them to die.

Becoming a bit more forgetful does not necessarily mean that you have dementia. A person with dementia will have cognitive symptoms (thinking or memory). They will often have problems with some of the following:

• day-to-day memory – for example, difficulty recalling events that happened recently
• concentrating, planning or organising – for example, difficulties making decisions, solving problems or carrying out a sequence of tasks
• language – for example, difficulties following a conversation or finding the right word for something
• visuospatial skills – for example, problems judging distances (such as on stairs) and seeing objects in three dimensions
• orientation – for example, losing track of the day or date, or becoming confused about where they are.

Dementia is progressive, which means the symptoms gradually get worse over time. How quickly this happens varies greatly from person to person.

Treatments

The vast majority of causes of dementia cannot be cured, although research is continuing into developing drugs, vaccines and other medical treatments.

There is a lot that can be done to enable someone with dementia to live well with the condition. Care and support should be ‘person-centred’. This means it should be focused on that person and their individual needs and preferences.

Types of treatment include the following:

• Talking therapies, such as counselling, can help someone come to terms with their diagnosis or discuss their feelings.
• Cognitive behavioural therapy (CBT) may be offered if the person develops depression or anxiety.
• Cognitive stimulation therapy is a popular way to help keep someone’s mind active. It involves doing themed activity sessions over several weeks.
• Cognitive rehabilitation can enable an individual to retain skills for longer and cope better.
• Many people with dementia enjoy life story work, in which the person is encouraged to share their life experiences and memories.
• There are drugs that can help with the symptoms of dementia, or that in some cases may stop them progressing for a while.