There are a number of individuals who believe that dementia is a disease when in fact it is not. Dementia is actually a condition derived from a variety of diseases. "Many people equate dementia with Alzheimer's Disease, but they are not synonymous though Alzheimer's is one of dementia's major causes." (Levine 2006 p 6)
Dementia can be described as the loss of memory; short-term memory first, and then, over a period of time, the long-term memory as well, and the subsequent difficulties experienced by the individual with this condition. There is much speculation concerning the loss of these memories, and most experts agree that the memories are lost due to the loss of neuron cells in the brain. There are a variety of reasons why these cells die, though no one knows the exact reason why some people contract the diseases that cause dementia, and some people do not.
There is a criteria for diagnosing dementia and that criteria includes; "loss of memory, and one or more other cognitive abilities." It should also include "substantial impairment in social or occupational functioning" and last, but not least, "deficits that do not occur exclusively during the course of delirium." (Kawas 2003 p 1056)
Levine agrees with that assessment made by Kawas and states that cognitive testing is also very important in testing for dementia as compared to testing for Alzheimer's Disease.
Though the differences between the two (Alzheimer's and dementia) are slight, most medical personnel understand that the differences can mean a matter of the patient being able to conduct a normal lifestyle, or a patient that will be a huge burden to family, community and nation. This burden can be both financial and psychological, especially for the caregivers of those with either disease or condition. The key difference between the two is that patients with Alzheimer's lose short-term memory (as do dementia patients) but don't normally lose long-term memories until the disease becomes dementia.
The world's society is becoming much older, and many of those in the 'over 60 age group' know of someone who has dementia or Alzheimer's, therefore causing much angst and concern that they too can become affected by either of these two, or another form of dementia.
The figures and projections concerning this condition are frightening, especially with an aging population. Experts believe that with the world's population growing older, dementia will become a major headache for future generations. Some experts predict that 40-50% of the population over 65 years of age will contract a form of dementia. (Levine 2006)
As stated above, a major contributor to dementia is Alzheimer's Disease and the majority of patients that contract Alzheimer's usually degenerates into dementia at some point.
Another contributor to the onset of dementia is the presence of the APOE 4 gene.
Levine states, "The APOE 4 gene is a major determinant of risk for Alzheimer's disease, with carriers of APOE 4 having a significantly greater chance of getting Alzheimer's and getting it at an earlier age than noncarriers." (Levine 2006 p 15) Other factors that are considered precursors, or liabilities for individuals who have these conditions include; "smoking, hypertension, elevated cholesterol and diabetes at midlife" (Levine p 14). When diagnosing dementia the medical expert must take the patient's lifestyle, circumstances and environment under consideration and must also be careful not to misdiagnose dementia for Alzheimers Disease, since the two are often seen as going hand-in-hand.
"A diagnosis of AD can be made with reasonably high accuracy using a combination of clinical criteria, neuropsychologic testing, and conventional CT and MR imaging." (Husain 2005 p 767) These tests often show white spaces throughout the brain that portend the death of neuron brain cells that are harbingers of dementia. The reason why such a diagnosis is important is that the symptoms, especially early on, oftentimes mirrors other diseases, and treatments can be approached in dissimilar manners for the different conditions. The symptoms often start with the patient losing short-term memory, walking or moving slowly, depression, asking the same question over and over, getting lost while driving (even in familiar areas) and wandering around with no idea of who, or where they are. Because these symptoms are present does not necessarily mean the patient has dementia.
In fact, a number of other diseases and conditions could be diagnosed from these symptoms as well, including; normal aging, mild cognitive impairment and pseudo-dementia (fake symptoms). The number one symptom for dementia seems to be loss of memory. This can be confirmed with CT scans or an MRI and usually is visible as white space where normally neuron brain cells would be.
Replacing these brain cells could be a key to overcoming the crippling effects of neurological diseases, especially dementia. A number of different therapies and studies are currently being attempted in order to confirm this theory. Many of those therapies include trying to replace the dead cells, though one recent study is attempting to get the neuron cells to grow anew, instead of being replaced. "Long-term memory loss associated with dementia may be reversible," (Dorey 2007) What Dorey found was that (in mice) memory loss could be restored. If these results prove to be verifiable, then such a treatment could be what is needed to treat dementia.
"Current treatment for Alzheimer's tends to focus on the early stages, but the new research suggests HDAC inhibitors could be effective in patients suffering from severe dementia." (Dorey 2007) Other therapies have attempted to replace the lost brain cells, while Dorey's treatment is to get new terminals to grow, essentially allowing a rewiring of the brain.
"The fact that "lost" memories can be recovered suggests that the memories were not erased, but rather became inaccessible after neurodegeneration," (Dorey 2007)
Like many of the therapies being used to treat both Alzheimer's and dementia, Dorey's research is long-awaited, but it is also likely a long time in the future before the research translates into an effective treatment.
There are a wide variety of other therapies being used to treat dementia, some of these therapies sound like something directly out of a medical comic book, complete with heroes in the guise of researchers. One such therapy includes the use of good smells to calm the agitated patient in order to facilitate an environment in which the patient can recover.
"As pharmacological interventions may be limited by their potentially adverse effects, the use of complementary therapies for treatment of agitation has become more popular and aromatherapy is the fastest growing one." (Lin 2007 ab)
Aromatherapy may work at calming the agitated individual but it has not been shown, as of yet, to achieve any reversal in the neuron cells dying. There are a number of more mainstream therapies, many of them using single drugs, or a combination of drugs that are meant to work together. The problem with this approach is that it can lead to additional problems for the patient, especially if the patient is an elderly person. The treatment, or therapy, usually has to contend with other problems brought on by the aging process as well as the specific problem the therapy is being directed towards. One study was conducted to assess the problem of using a wide variety of drugs and how those drugs interacted with the nutrition value in the elderly.
The study showed that, "it is necessary to adequately diagnose the disease and often re-evaluate the chosen treatment, identify disease stages and the necessary therapies to minimize the number of drugs administered." (Akamine 2007 p 305) Another concern is not just the nutrients that those with dementia have or don't have, but whether the effects of the drugs will truly enhance the patient's way of living. Most experts believe that if an effective treatment can be found, it will save taxpayers billions of dollars in the long run. Such a treatment will not only save governments billions of dollars, but can also alleviate caregiver's misgivings and troubles in taking care of someone with dementia.
Many times the individual with dementia becomes just like a child with his/her needs. Older children are now taking care of their parents which can cause a huge psychological and financial burden on those caregivers. Many times the patient is not the only person who ends up becoming isolated, the caregiver does as well. Worrying over the well-being of a parent is much like worrying over a child. Since there are many couples who are waiting longer to have children, these individuals could end up taking care of their parents at the same time they are taking care of their children. This can lead to family conflicts and trouble. The stress of these situations can be overwhelming. Many times the stress will affect the caregivers even more than the patients affected by dementia. The caregivers can grow to believe that no one understands their particular problems which can affect the caregivers both mentally and physically. The question then becomes, 'who will care for the caregivers?'
Since some studies have shown…