Dementia

There are a number of types of Dementia which can be classified differently based on observed problems, such as memory, language, thinking, social behaviour, emotional state, and physical movement. Most individuals exhibit progressive loss over time which results from a degenerative disease process such as Alzheimer’s, while some types of brain injury (e.g., due to trauma or stroke) may result in symptoms that stay the same over time. Alzheimer’s disease is the most common form of dementia that accounts for 64 per cent of all dementias in Canada. Currently, over 500,000 Canadians have Alzheimer's disease or other forms of dementia. However there are other types such as Vascular Dementia, Dementia with Lewy Bodies and Frontotemporal Dementia. Researchers report most individuals with Alzheimer’s disease are over the age of 65. The likelihood of developing Alzheimer’s doubles every five years after that age but once an individual reaches 85 years, the risk reaches nearly 50 percent. The other most important risk factor is family history. Those who have a parent or sibling with Alzheimer’s are more likely to develop the disease. However research has also begun to reveal clues about other risk factors that we may be able to influence through lifestyle and wellness choices, and effective management of other health conditions. Statistics strongly suggest that significant numbers of individuals will be impacted in one way or another by Dementia. Family members or caregivers for a loved one with the disease often experience varying degrees of stress. Due to the progressive course of dementia, there are a wide range of emotions such a fear, frustration and ongoing loss that impact both the person with the disease and their loved ones. The presenter of the accompanying vignette is Loretta Tanner, Public Education Coordinator for Alzheimer Society Durham with over 30 years experience in the field of seniors’ mental health. She provides viewers with an insightful synopsis of Dementia and explains the value of early diagnosis. Ms. Tanner describes how individuals with this disease are impacted and illustrates the effects it has on caregivers. She provides supportive suggestions for crisis and distress line responders to use in communicating to individuals with Dementia or their loved ones. Questions for Further Consideration: What do you know about early signs of dementia? Will you recognize it when you are on the phone with a caller? Warning signs of Alzheimer’s: Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks at home or at work Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgement Withdrawal from work or social activities Changes in mood and personality A caller to the distress line shares and questions: “My mother has Dementia. She keeps crying and asking why she can't remember anything. How do we explain this to her? She was hospitalized recently and the trauma from this experience has made the dementia much worse. I just don’t know what to do”. How would you respond to this caller’s concerns? Remember your role is to be an empathetic listener. Acknowledge the caller’s fears, frustrations, and confusion. It would be helpful to guide the caller through problem solving strategies as to how (s)he can respond to her mother’s distress and address mother’s questions in a way she understands. The caller may benefit from referrals to community resources and should be reminded that helping her mother follow up with her primary care provider is also advisable. A woman calls the crisis/distress line reporting she has concerns that her father has dementia. She wants to know how to get him assessed and what supports she can get for him. What do you know about your community supports? In Ontario, the Community Care Access Centre (CCAC) connects clients with the care they need at home and in their community. They will assess the concerned individual and help coordinate supports to assist individuals remain longer in their home. Individuals who are seeking information and counselling regarding all forms of dementia can contact their local Alzheimer’s Society. Glossary: Alzheimer's disease: The most common form of dementia. Alzheimer's disease accounts for 50 to 80 percent of dementia cases. Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. The most common early symptom of Alzheimer's disease is difficulty remembering newly learned information because brain changes typically begin in the part of the brain that affects learning (i.e., temporal lobe). Early Onset Alzheimer’s: Early onset (also known as young-onset) Alzheimer's is an uncommon form of dementia that affects people younger than age 65. It has been known to develop between ages 30 and 40, but that’s very uncommon. It is more common to see someone in his/her 50s with the disease. Approximately 70,000 Canadians living with dementia are under age 65. Genetics seem to play a stronger role in the cause of this form of the disease. Vascular Dementia: Previously known as multi-infarct or post-stroke dementia. Vascular dementia is less common as a sole cause of dementia than is Alzheimer's disease. Impaired judgment or ability to make plans is more likely to be the initial symptom, as opposed to the memory loss often associated with the initial symptoms of Alzheimer's. Often it occurs because of brain injuries such as microscopic bleeding and blood vessel blockage. The location of the brain injury determines how the individual's thinking and physical functioning are affected. Dementia with Lewy Bodies: People with dementia with Lewy bodies have some of the symptoms common in Alzheimer's, but are more likely than people with Alzheimer's to have initial or early symptoms such as sleep disturbances, well-formed visual hallucinations, and muscle rigidity or other parkinsonian movement features. Frontotemporal Lobar Degeneration: Typical symptoms include changes in personality and behavior or difficulty with language. Nerve cells in the front and side regions of the brain are especially affected. Mixed Dementia: Recent studies suggest that mixed dementia is more common than previously thought. Brain changes are characterized by the hallmark abnormalities of Alzheimer's and another disease process —most commonly, vascular dementia, but also other types, such as Dementia with Lewy bodies. Creutzfeldt–Jakob Disease: This is a rare form of dementia with rapid onset; it is caused by infectious proteins called prions. Variant Creutzfeldt-Jakob disease, which affects primarily younger people, is extremely rare. It has been linked conclusively in humans to exposure to BSE (bovine spongiform encephalopathy). This is a rapidly fatal disorder that impairs memory and coordination and causes behaviour changes.