Dementia
What is dementia? Dementia is a reduced ability to remember, make decisions, or think that prevents someone from completing daily tasks. These changes occur gradually over time in most forms of dementia (2). https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRWRGO5ANOjp4yVAxpal4SPq7Z wl3YXl9yH8w&usqp=CAU Types of Dementia Alzheimer’s disease is the most common form of dementia. About 6 to 8 out of every 10 people with dementia have it. Vascular dementia is also a common type of dementia. About 1 out of every 10 people with dementia have it. Reversible dementia is a less common form of dementia, but is important because there are possible cures if it is caught early enough.
Changes in ability from old age With old age, sometimes people will occasionally forget a recent event/someone they just met, have difficulty finding a word for a while, or sometimes misplace things (2). Old memories and someone’s ability to speak a language should not change with old age (2). What are the signs of dementia? Having memory loss, such as frequently forgetting recents events, frequently repeating things, or having increased reliance on using things to help jog your memory (2). Having difficulty doing things that they had done for years, such as paying bills, cooking, driving, shopping, using a phone, or completing their job (2). Becoming regularly confused regarding the time of events or forgetting the date (2). Having difficulty navigating around home. Becoming increasingly clumsy (2). https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcShtpwpJuct84n-nypSmzYNS6MsnvTabnBHhcqVRAmI8B_pXIiD79GObGvnZoI192JNwto&usqp=CAU What are the signs of dementia? Having new difficulty with speaking, writing, difficulty finding words, or difficulty participating in a conversation (2). Frequently misplacing things and difficulty being able to retrace steps to find things (2). Having poor judgment, which could include making poor decisions managing money, not taking care of hygiene, or having trouble taking care of things that they were able to before (2). Becoming less involved in work, church, or activities that they would normally do (2). Having changes in mood, such as becoming paranoid or easily upset (2). What are risk factors for dementia? Older age, history of family members with dementia, head injuries, high cholesterol, high blood pressure, strokes, and smoking (2). There appears to be an increased risk of dementia in African American and Hispanic populations, which may be related to higher heart disease, diabetes, stress, and discrimination (2).
Dementia screening The American Academy of Neurology recommends that everyone 65 years of age and older should be screened yearly for dementia (1). If you notice any of the signs of dementia, then you should see a primary care physician or neurologist. Testing can be performed in the office to help determine if the problem is dementia and if so, the type, severity, and possible treatments.
Screening in the doctor’s office Montreal Cognitive Assessment (MOCA) Mini Mental Status Exam (MMSE) There is also more extensive testing, called neuropsychological testing that helps with detection and categorizing dementias. Basic blood tests that look at thyroid function and vitamin levels, such as B12 levels would be generally recommended. These are recommended in order to look for reversible causes of dementia. Screening for signs of depression would also be completed at the doctor’s office because sometimes depression can mimic dementia. Montreal Cognitive Assessment (MOCA) It is a 30 question test that helps with the detection of mild cognitive impairment and dementia. It takes about 10 minutes to complete. It tests abilities such as attention, concentration, short term recall, and language. A score of less than 26/30 suggests mild cognitive impairment. The average range for mild cognitive impairment is 19-25. A score of 16/30 is the average score for those with mild Alzheimers disease. The average range for Alzheimers disease is 11-21. Mini-Mental Status Examination (MMSE) It can help screen for dementia. It is not as useful as the MOCA for detecting early dementia, but more reliable for detecting more advanced dementia. It can be used for detecting progression of dementia. It is a 30 question and 30 point test that looks at abilities such as language, short term memory, and attention. It takes about 10-15 minutes to complete. A score of 24 or more is considered normal. 19-23 is generally consistent with mild dementia. 10-18 is generally consistent moderate dementia. 9 or less is generally consistent with severe dementia. Resources New York City Department for the Aging https://www1.nyc.gov/site/dfta/services/caregiving.page CDC https://www.cdc.gov/aging/index.html National Institute on Aging https://order.nia.nih.gov/ Administration for Community Resources https://acl.gov//aging-and-disability-networks AARP https://www.aarp.org/health/dementia/ Works Cited 1. AAN. “AAN RECOMMENDS PEOPLE 65+ BE SCREENED YEARLY FOR MEMORY PROBLEMS.” Www.Aan.Com, AAN, 18 Sept. 2019, https://www.aan.com/PressRoom/Home/PressRelease
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