Abstract
Dementia is a complex disorder that impairs an individual’s cognitive functions, limiting their ability to perform normal activities. It is characterized by poor memory, language problems, reduced attention, changes in mood, and disorientation. The disorder is prevalent among people over 65 years and in women compared to men. Dementia is diagnosed by evaluating a patient’s medical and family history. In addition, some cognitive and neurological examinations are also used to identify the illness. Some of these tests include brain scans such as magnetic resonance imaging and computed tomography. Other procedures for diagnosing dementia include genetic testing, cerebrospinal fluid analysis, and blood test. The DSM-5 diagnostic criteria stipulate that the presence of dementia should be evidenced by a significant cognitive deterioration in one or several cognitive areas. Even though there is no remedy for dementia, the use of drugs, therapies and some lifestyle modifications can help alleviate its symptoms.
Introduction
Dementia is the loss of an individual’s cognitive functioning to the extent that it interferes with their everyday lives and activities. The disorder affects a person’s memory, thinking, and language, adversely impacting their personality and behaviors. Research indicates that around 47 million individuals globally have dementia, with the number projected to reach 139 million by 2050 (Arvanitakis et al., 2019). In addition, the main risk factor for the disease is aging, which explains why 2 in every 100 individuals aged 65 years and above suffer from it. Other risk factors may include genetics and family history. Research also indicates that women have a higher incidence and prevalence of dementia than men (Sindi et al., 2021). Since women have an increased life expectancy compared to men, they are more predisposed to the disease. Even though dementia is fatal, early diagnosis can considerably improve its management and an individual’s survival chances. The adverse cognitive impairment caused by dementia can be remedied through a combination of medication, therapy, and lifestyle changes.
Diagnosis for Dementia
A thorough diagnosis can help determine whether or not an individual has dementia. The evaluation of probable dementia requires a short medical history and a mental status exam. Reviewing an individual’s family and medical history is a crucial diagnostic tool that should be obtained from the patient and corroborated by a close relative or friend. Through this information, a physician can identify the nature, severity, and course of the cognitive changes. In addition, a mental status exam is required to delineate the impairments in attention, language, memory, mood, and executive functioning. Some procedures for detecting dementia include cognitive and neurological tests such as the Mini-Mental State Examination (MMSE) (Arvanitakis et al., 2019). MMSE is a commonly used cognitive exam that evaluates an individual’s attention, memory, language, orientation, and visuospatial capabilities. In addition, Montreal Cognitive Assessment (MoCA) is another screening test that assesses language, visuospatial, and memory skills. It is more sensitive to mild cognitive impairment because it can identify cognitive deviations that may be overlooked by MMSE (Arvanitakis et al., 2019). The use of cognitive tests helps to understand the nature and intensity of the disease.
Another procedure for diagnosing dementia involves the use of brain scans. These examinations can help detect tumors, strokes, or other conditions that can trigger dementia. Scans include magnetic resonance imaging, computed tomography, and positron emission tomography (Arvanitakis et al., 2019). Similarly, since some types of dementia are stimulated by an individual’s genes, a physician may order a genetic test to determine whether the patient has the altered genes. Additionally, cerebrospinal fluid (CSF) tests may be used to assess the presence of dementia (Arvanitakis et al., 2019). This procedure involves measuring the protein levels or other constituents of CSF to detect if the individual has dementia. Most importantly, blood tests have been established as the most effective method to diagnose dementia. The blood test assists in assessing beta-amyloid levels, a protein that amasses abnormally in individuals with Alzheimer’s (Arvanitakis et al., 2019). However, although blood tests show great potential in detecting dementia, they cannot be used independently but alongside other diagnostic approaches. Thus, healthcare professionals may use a comprehensive approach to evaluate an individual’s cognitive function to determine whether they have dementia.
History of Dementia
The understanding of the pathogenesis, diagnosis, and epidemiology of dementia has greatly evolved over the decades due to advancements in the medical field. Although it is postulated that dementia existed in ancient times, there is insufficient information to support it. Therefore, the history of dementia can be traced back to the 20th century. In 1906, Alois Alzheimer, a German psychiatrist, made a groundbreaking discovery about a new form of dementia that affected younger populations and was characterized by tangles and plagues in the mind (Town & Hoffman, 2019). This type was later named Alzheimer’s disease (AD), the most widespread form of dementia. In the subsequent years, there was more progress in the research on the illness. During the 1960s and 1970s, scientists deduced that people with Down syndrome had a high propensity for developing AD (Town & Hoffman, 2019). In addition, the 1990s discovery that the apolipoprotein E (APOE) gene was linked to the disorder further increased the understanding of dementia (Town & Hoffman, 2019). This shows the evolution in understanding the origin of dementia.
Currently, due to advancements in science and technology, there is a wide range of information regarding dementia. Individuals are enlightened that the disease is triggered by damage to brain cells which negatively affects learning and memory, social cognition, executive function, and language (Arvanitakis et al., 2019). Additionally, people are informed that although AD is the most prevalent form of dementia, other types include frontotemporal, vascular, Lewy body, and mixed dementia (Arvanitakis et al., 2019). Advancements in medicine and evidence-based practices have significantly helped develop effective interventions to manage the condition (Town & Hoffman, 2019). Nevertheless, despite increased understanding and awareness about dementia, the disorder remains a major public health problem affecting millions of individuals, making it a burden to society (Town & Hoffman, 2019). Globally, scientists continue working to develop more effective treatment and prevention approaches to deal with the increasing cases of dementia.
DSM-5 Diagnostic Criteria for Dementia
The criteria for differentiating dementia from other medical or mental conditions involves thoroughly analyzing its symptoms. The common symptoms of dementia include disorientation, hallucinations, memory loss, decreased interest in daily activities, and problems with language and communication (Arvanitakis et al., 2019). Other signs are changes in mood and behavior, unusual sleep patterns, and poor judgment. Some patients may present mild symptoms, while others have severe episodes of the disease.
Based on the DSM-5 diagnostic criteria outlines an analysis to determine if a patient has dementia. In this case, for an individual to be diagnosed with a major neurocognitive disease, there should be evidence of a considerable cognitive decline in one or multiple cognitive areas (Busby-Whitehead et al., 2022). These domains include executive functions, language, social cognition, complex attention, and perceptual-motor. Another criterion dictates that there ought to be proof that cognitive deficiencies interfere with an individual’s independence in performing daily activities. Moreover, this standard requires that the presented symptoms not be attributable to other psychological disorders, such as schizophrenia or depression (Busby-Whitehead et al., 2022). Hence, the DSM-5 criteria should be used in all healthcare settings to establish the presence of dementia.
Treatment Techniques for Dementia
Although there is no known remedy for dementia, numerous treatment interventions can assist in managing the signs and slowing down the disorder’s progression. Common treatment techniques include the use of medication and therapies. In this case, cholinesterase inhibitors, including rivastigmine, galantamine, and donepezil, help to enhance memory, cognitive function, and behavior among individuals with mild to moderate dementia (Arvanitakis et al., 2019). In addition, memantine is a drug used to treat moderate to acute dementia. Similarly, several antipsychotic medications, such as olanzapine, aripiprazole, or quetiapine, can ease behavioral signs, including agitation, hallucinations, and aggression (Calsolaro et al., 2019). Thus, several drugs can be used to manage the signs of dementia.
The non-pharmacologic interventions have played a critical role in alleviating dementia’s signs. Cognitive stimulation therapy comprises reading, solving puzzles, memory games, playing music, or engaging in art (Arvanitakis et al., 2019). These activities are essential in helping dementia patients maintain cognitive function and social engagement. Equally, occupational therapy allows professional therapists to work with persons with dementia and assist them in retaining their ability to conduct daily tasks independently (Arvanitakis et al., 2019). Additionally, behavioral therapies, including validation, innovation, pet therapy, and cognitive behavioral therapy (CBT), can alleviate the disorder’s symptoms. Furthermore, lifestyle modifications such as regular exercise and proper diet can improve an individual’s physical and mental well-being, easing the signs of the disease (Arvanitakis et al., 2019). Therefore, the combination of medication, therapy, and lifestyle changes can help manage dementia.
Conclusion
In conclusion, dementia adversely affects an individual’s cognitive function, impairing their capability to perform daily activities. The disorder is characterized by poor thinking and memory, reduced attention and language skills, disorientation, and mood changes. It is most common among older adults, particularly those aged 65 years and above. The diagnosis of dementia is conducted by assessing a patient’s medical and family history of the disorder and performing other tests such as brain scans, CSF, and blood tests. The DSM-5 diagnostic criteria dictate that for a person to be diagnosed with dementia, there should be evidence of a cognitive decline in one or more cognitive domains. Although the disease has no cure, its signs can be alleviated using medications and therapies such as cognitive stimulation, CBT, pet, and validation. Additionally, lifestyle modifications, including regular exercise and a healthy diet, can improve an individual’s overall well-being, slowing down the progress of dementia. Healthcare practitioners should offer patient-centered treatment for dementia patients to improve their health outcomes.
References
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Busby-Whitehead, J., Durso, S. C., Arenson, C., Elon, R., Palmer, M. H., & Reichel, W. (Eds.). (2022). Reichel’s care of the elderly: Clinical aspects of aging. United Kingdom: Cambridge University Press.
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Sindi, S., Kåreholt, I., Ngandu, T., Rosenberg, A., Kulmala, J., Johansson, L., Wetterberg, H., Skoog, J., Sjöberg, L., Wang, H. X., Fratiglioni, L., Skoog, I., & Kivipelto, M. (2021). Sex differences in dementia and response to a lifestyle intervention: Evidence from Nordic population‐based studies and a prevention trial. Alzheimer’s & Dementia, 17(7), 1166–1178. Web.
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