Dementia (senile disease): symptoms, causes, and treatment

Definition of dementia

What is dementia?

The definition of dementia is a set of symptoms that affect the cognitive function of the brain in remembering (memory), thinking, behaving, and speaking (language).

In fact, dementia is not a real disease, but rather a term to describe a group of symptoms that interfere with brain function.

This condition has many other names, such as major neurocognitive disorder or dementia. Although, basically not all people who are senile (forgetful or often forgetful) have dementia.

Senility itself is a decrease in one's memory, which is generally caused by aging. However, people with dementia typically experience severe symptoms of dementia.

The severity of this condition can range from mild to severe. It is not even possible, conditions that affect brain function can change a person's personality.

This brain disease can also be progressive, which means that it can get worse over time. Some cases that result in dementia tend to be difficult to recover from.

The risk of developing dementia usually increases with age. However, it is important to understand that this condition is not actually a part of aging.

How common is this condition?

Dementia is a disease that commonly occurs in the elderly, to be precise people aged 65 years and over, both men and women.

In fact, the chances are higher once a person is over 85 years old. Genetic factors also contribute as a risk factor for this condition.

In Indonesia, in 2016 an estimated 1.2 million people have dementia. This figure will continue to increase over time with an estimated 2 million in 2030 and 4 million in 2050.

Types of dementia

Based on the National Institute of Aging website, there are several types of dementia (senile disease), including:

1. Alzheimer's disease

Alzheimer's disease is the most common type of dementia. Evidenced by about 60-80 percent of all cases of dementia are occupied by Alzheimer's disease, a small proportion of cases are related to gene mutations that are passed on from parent to child.

One of the genes that inherits the high risk of this disease is apolipoprotein E4 (APOE). While other cases may occur due to the presence of plaque (clumps of protein) in the brain.

2. Vascular dementia

Vascular dementia is a disorder of brain function caused by reduced blood flow to the brain. This condition can be caused by a buildup of plaque in the arteries.

Whereas normally, these blood vessels should serve as a blood supplier to the brain. Stroke or other disorders can be the cause of these blood vessel problems.

3. Lewy body dementia

Lewy body dementia is a condition characterized by the appearance of protein deposits in nerve cells in the brain. As a result, the function of the brain to deliver chemical signals throughout the body is inhibited.

That is why people who experience this usually have a decline in memory, and the response tends to be slow. Lewy body dementia is a fairly common type of progressive dementia.

4. Frontotemporal dementia

Frontotemporal dementia is a group of diseases characterized by the destruction of nerve cells in the frontal temporal lobe of the brain, which is the front. This part of the brain is generally responsible for regulating personality, behavior and speaking ability (language).

5. Combination of dementia

This dementia disease is a combination of two or more types of dementia, such as Alzheimer's disease, vascular dementia, and Lewy body disease.

Signs and symptoms of dementia

The following are the various signs, symptoms, and characteristics shown by people who have dementia (dementia):

Symptoms related to cognitive changes

• Loss of memory
• Difficulty speaking, communicating with other people, and doing daily activities.
• Experiencing disorientation or confusion over time and place.
• Difficulty thinking and digesting information.
• Often forget and wrong when placing an object.

Symptoms related to psychological changes

• Changes in behavior, personality, and mood that often occur suddenly.
• Loss of initiative or apathy in any matter, including in activities that have previously been engaged in.
• Difficulty doing daily activities.
• Have depression.
• Experiencing hallucinations.
• Experiencing paranoia.
• Feel restless.

As the patient ages, the symptoms of dementia in the late stages usually get worse. There may be signs and symptoms not listed above.

If you have concerns about a particular symptom, consult your doctor immediately.

When should I see a doctor?

If you or someone closest to you has one or more of the symptoms either above or other questions, please consult your doctor. The health condition of each person's body is different. Always consult a doctor in order to get the best treatment regarding your health condition.

Causes of dementia

There are various causes of dementia. But in general, this condition is caused by damage to brain cells (neurons) that can occur in several parts of the brain.

In addition, this condition can also be initiated due to disturbances in other parts of the body which then affect the function of these neurons.

Neurons or brain cells will gradually weaken and lose their function, until they eventually die.

This condition ultimately affects the connections between neurons, which are known as synapses. As a result, the message that should be delivered by the brain is cut off, resulting in various problems.

This in turn can inhibit brain cells from carrying out their functions in communicating with other people. In fact, it also influences the behavior and feelings of those who experience it.

Dementia can affect a person in different ways, depending on the area of ​​the brain that is problematic. The following are various conditions and things that can cause dementia (dementia).

• Disorders of brain structures, such as hydrocephalus and subdural hematoma or tumors and infections of the brain or Parkinson's disease.
• Disorders of the metabolic system, such as hypothyroidism, deficiency of vitamin B-12, potassium, sodium, low blood sugar levels (hypoglycemia), and kidney and liver problems.
• Exposure to chemicals that cause poisoning, such as lead, heavy metals, and pesticides.
• Anoxia, also known as hypoxia, which occurs when the body doesn't get enough oxygen. Anoxia can develop due to severe asthma, heart attacks, carbon monoxide poisoning, etc.
• Malnutrition. For example, due to lack of fluids (dehydration), vitamins, and other minerals that the body needs.

Dementia risk factors

There are many factors that can increase your risk of dementia, including:

Irreversible dementia risk factors

• Age. You are more susceptible to this condition after 65 years of age. However, it is possible to occur at a young age.
• Family history. Having a family member with this disease puts a person at a greater risk of experiencing it.
• Down syndrome. Many people with Down syndrome develop Alzheimer's disease in middle age.

Modifiable dementia risk factors

• Alcohol abuse. Often drinking large amounts of alcohol, can put you at a higher risk of developing this condition.
• Cardiovascular disease risk factors. Risk factors for high blood pressure (hypertension), high cholesterol, accumulation of fat on artery walls (atherosclerosis), and obesity. All of these things can increase the risk of developing this condition.
• Depression. Although not well understood, depression in the elderly may indicate the development of dementia.
• Diabetes. If you have diabetes, you have a higher risk of dementia, especially if it's not treated properly.
• Smoke. Increase the risk of dementia and other diseases such as vascular disease.
• Sleep apnea. People who frequently snore and stop breathing during sleep can experience a condition characterized by impaired cognitive function.

Dementia complications

Dementia that gets worse over time can cause complications, including:

• Nutritional deficiencies. The condition occurs because the patient forgets to eat well, or may not be able to swallow and chew.
• Pneumonia (inflammation of the lungs). Difficulty swallowing increases the risk of choking or sucking food into the lungs, which can block breathing and lead to pneumonia.
• Can't take care of myself. Inability to perform self-care, such as showering, dressing, brushing hair or teeth, using the toilet itself, and taking medication accurately.
• Dead. End-stage dementia causes coma and death, often due to infection.

Drugs & treatment of dementia

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

Conditions that affect the cognitive function of the brain usually do not involve just one type of examination. Your doctor may order a series of diagnostic tests for dementia, including:

1. Medical history

The doctor will ask about family history, illnesses, injuries, and surgeries that have been experienced. In addition, drugs that have been consumed, as well as chronic conditions will also be examined to find out the cause of this condition.

2. Physical examination

Hearing and vision tests, blood pressure, heart rate, and various other indicators will be checked. The goal is to detect whether your health condition is classified as acute or chronic.

3. Laboratory tests

Blood tests can be used to help detect physical problems that are affecting the brain's work. Whether it's due to a lack of vitamin B-12, or an underactive thyroid gland.

Sometimes, the spinal fluid is also checked for infection, inflammation, or signs of some degenerative disease.

4. Imaging tests

Electroencephalography (EEG), PET scan, and MRI, are other treatment options. However, this depends on your medical history and symptoms.

5. Neuropsychological tests

The doctor will usually ask the patient to remember words or name certain objects. This aims to determine the severity of the condition, track changes in the body's abilities, and assess the ability to function properly.

Overall, this examination is tasked with assessing various functions. Includes memory, language, vision, attention, problem solving, body movements, sensory systems, balance, to body reflexes.

6. Psychiatric evaluation

A mental health professional will usually assess whether depression or other mental health conditions are associated with this decreased brain function.

What are my treatment options for dementia?

Dementia can be treated using two ways, namely drugs and therapy:

1. Medicines

There are several drugs used to treat dementia, aka dementia, including:

Cholinesterase inhibitor drugs

These drugs work by increasing chemicals in the brain that are involved in memory and judgment. Examples of drugs used are donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne). The side effects of this drug are indigestion, slowed heart rate, and sleep disturbances.

Memantine medicine

Memantime works by regulating the activity of glutamate, another chemical messenger involved in brain function, namely learning and memory processing. The side effect of this drug is headache.

2. Dementia therapy

The way to treat and treat dementia other than drugs is by following therapy. This treatment aims to help patients have a better quality of life. Therapy generally includes:

• Occupational therapy. This treatment helps both the patient caregiver and the patient when symptoms appear. The goal is to prevent accidents or falls that can affect health.
• Environmental changes. An atmosphere that is far from noise and safe certainly helps dementia patients to focus more on carrying out activities. Families and caregivers will usually be asked to hide various objects that are dangerous, such as knives.
• Simplify daily tasks. Dementia patients easily find it difficult to carry out activities that are usually easy for normal people to do. Therefore, in this therapy, patients will be taught to focus more and follow easy steps in completing an activity.

Home dementia care

Almost all cases of dementia, cause someone to seek care at home because of the symptoms they experience. Therefore, patients need help from you and your family. Some of the things you can do to treat dementia patients are:

• You must help the patient follow the treatment recommended by the doctor. In fact, arrange a routine follow-up treatment schedule so that his body condition remains healthy.
• You need to help patients carry out self-care, such as preparing food and making sure that their diet is according to the doctor's recommendations, cleaning their bodies, and inviting them to do various activities that benefit their brain health, such as gardening or sports.
• Try to communicate with the patient in the right way, by using easy-to-understand word choices, not rushing things, and using body gestures to indicate something.
• Most important is how you can keep the patient's emotions stable. Avoid harsh speech, and don't ignore it.

Dementia prevention

There is no special way that can prevent someone from dementia. Even so, you can reduce your risk as a preventative measure for dementia in the future, including:

• Keep your mind active, such as reading, solving puzzles, or taking part in word guessing or memory sharpening games.
• Be active both physically and socially, namely by doing sports regularly and interacting with people around him, such as following the community.
• Quit smoking and avoid exposure to secondhand smoke.
• Follow treatment for any health problems you have, such as depression, hypertension, or high cholesterol.
• Fulfill the nutrients from a variety of healthy foods, especially from vitamin D, vitamin B complex, and vitamin C. You can get a variety of nutrients from vegetables, fruit, nuts, eggs, meat, and seeds.
• Maintain a healthy diet, so that your body weight remains ideal.
• Make sure you get enough rest. If you have sleep disorders, don't hesitate to consult a doctor.