Dementia

Published by Bupa’s Health Information Team, September 2011.

This factsheet is for people who have recently been diagnosed with dementia, or who would like information about it.

Dementia is a broad term that describes a set of symptoms caused by a gradual loss of brain function. The symptoms include memory loss, mood changes and problems with communication.

About dementia

Dementia describes a common set of symptoms that develop as a result of damage to your brain. The symptoms typically include memory loss, difficulty communicating and changes in mood. Dementia is a progressive disease, which means it gets worse over time. In the later stages, people with dementia become unable to do everyday things and will need increasing amounts of support.

There are about 750,000 people in the UK with dementia and this is expected to double over the next 40 years. It's more likely to affect people over 65, but can affect younger people.

The underlying causes of dementia aren't well understood at present. For some people, there may be a genetic link that increases their risk of developing dementia, but more research is needed.

Symptoms of dementia

If you have dementia, you may have some or all of the following symptoms.

• Memory loss, particularly of recent events. For example, you may not be able to remember a conversation that you had earlier in the day. You will probably find your forgetfulness is mild at first, but is likely to get worse over time. Your long-term memory will not be affected in the same way.
• Communication difficulties. You may have problems finding the right words for things, for example, you may describe how an item works instead of what it’s called.
• Mood changes. You may become depressed, frightened and angry about having dementia and what is happening to you.
• Disorientation and an inability to recognise familiar places. As dementia progresses, you may become confused about the time of day. This could cause you to get up in the middle of the night, wanting to go out.
• Poor judgement. For example, you may become unaware of dangerous situations.

If you have noticed problems with your memory, but you are managing your symptoms well, you may have a condition known as mild cognitive impairment. This is not dementia, but people who have this condition may be at increased risk.

Dementia affects everyone differently. Your symptoms may stay the same for some time and you can have a good quality of life for a number of years. But generally, the symptoms will become more severe over time. It's important to get support from social services, your GP, friends and family.

Causes of dementia

There are many different conditions and diseases that can lead to dementia. The following are some of the most common.

• Alzheimer's disease. This is the most common cause of dementia and develops as a result of changes in the structure of your brain.
• Vascular dementia. This is the second most common cause of dementia and happens when blood vessels become blocked in your brain, usually because of a stroke, or series of strokes.
• Mixed dementia. This is dementia that is caused by more than one disease at the same time. A common combination is Alzheimer's disease and vascular dementia.
• Dementia with Lewy bodies. This is caused by having an abnormal build-up of a particular protein in your brain.

There are also other diseases that can lead to dementia, but they are much rarer causes. They include the following.

• Creutzfeld-Jakob disease (CJD). This is a very rare disease that causes severe brain damage.
• Parkinson's disease. This disease affects the way the brain co-ordinates body movements. It happens when there is a shortage of a chemical called dopamine in the brain.
• AIDS (acquired immune deficiency syndrome). This is a term used to describe the point at which the immune system has been weakened so much by HIV (human immunodeficiency virus) that it can't fight certain life-threatening infections and illnesses.

Sometimes you might have an unrecognised medical condition that causes the symptoms of dementia. An underactive thyroid gland, vitamin B1 and B12 deficiencies and a build-up of pressure in the fluid that surrounds the brain can all cause dementia. If these problems are caught early enough, it’s usually possible to stop and reverse the progression of dementia.

Diagnosis of dementia

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP may do blood and urine tests to rule out the possibility of other conditions that could cause symptoms similar to dementia.

You may also have a mental test to assess your memory and thinking. There are several different tests that your GP may use to help find out if you have dementia. One that is often used is the 'mini mental state examination'. In this test, your GP will ask you some questions and test your attention and ability to remember words. How you score in this test indicates how severe your condition is.

If you have the signs of dementia, your GP will refer you to a specialist or memory assessment service for more detailed tests. This will help to determine what type of dementia you have. You may also be asked to have a brain scan, such as a CT scan.

Treatment of dementia

There isn't a cure for dementia. However, there are some medicines that can help with the symptoms. The treatment you're offered will depend on the cause of your condition.

Medicines

A specialist, such as a psychiatrist (a doctor who identifies and treats mental health conditions) may prescribe you a type of medicine known as an acetylcholinesterase inhibitor if you have mild or moderate Alzheimer's disease. These medicines, such as donepezil, galantamine and rivastigmine, work by increasing the level of an important chemical in your brain. They can help to slow the progression of dementia.

These medicines aren’t effective if you have dementia caused by something other than Alzheimer’s. If you have severe dementia, or if you have mild or moderate Alzheimer’s but can’t take any of these medicines for some reason, you may be prescribed memantine.

If you have vascular dementia and have had a stroke, your GP may prescribe you medicines to reduce your risk of having another stroke.

Your GP may also prescribe you other medicines if you have depression or anxiety, for example. If you have depression, you will usually be treated with antidepressant medicines called selective serotonin re-uptake inhibitors or a selective noradrenaline re-uptake inhibitor.

Talking therapies

Depending on their availability, your GP may suggest trying talking therapies, such as the following.

• Group activities and discussions. These aim to stimulate your mind and are sometimes referred to as cognitive stimulation therapy.
• Reminiscence therapy. This involves discussing past events in groups, usually using photos or familiar objects to jog your memory. However, there are conflicting opinions on whether this type of talking therapy is effective.

Complementary therapies

You may find aromatherapy helpful, but there is limited evidence to support this.

Help and support

It's important for you to get the help and support you need. As well as family and friends, emotional and practical support is available from a range of services including:

• your GP
• charities
• Admiral nurses (specialist dementia nurses)
• local voluntary groups

Health and social care staff can help you to maintain your independence. They can offer you advice on mobility and daily living, and on how to adapt and develop the skills you need to help you live with dementia.

You may be able to have a personal dementia adviser. He or she will help you to find the right information, care, support and advice. Ask your GP for more information about this service.

It's important that partners and children also receive plenty of help and support. Respite care, to give your family a break, can be an important part of looking after you, particularly as the disease progresses.
 

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.

Video

See our videos related to this topic:

• Depression in old age
• Helping elderly people live independently
• Life story

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.