What is Dementia? How Can I Reduce my Risk?

What is Dementia?

• Decline in memory and other cognitive functions (planning, organizing, problem solving) that are severe enough to affect activities of daily living and work functioning.
• The four A's of dementia diagnosis are amnesia, apraxia, aphasia, and agnosia. Amnesia is memory impairment. Apraxia is difficulty getting things done or not being able to do things you previously could do easily. Aphasia refers to difficulties with speech, such as problems with word finding. Agnosia is trouble recognizing the function of an object.
• For most dementias, the course of the illness is marked by gradual onset and continued decline.

What is Alzheimer's Dementia?

• Alzheimer's disease accounts for about 65% of dementia cases, while vascular dementia or mixed forms account for an additional 20%.
• Affects approximately 3 % of people at age 65 and increases to 50% of people over age 85
• In the elderly it is a leading cause of death in the U. S. after heart disease, cancer, and stroke.
• The average life expectancy is 8 to 15 years from time of onset of the illness, although most patients live about 10 years.
• By 2040, it is estimated that 14 million people in the U.S. will suffer from Alzheimer's dementia.

What are the Stages?

Stage 1

• GDRS is a common staging system
• No symptoms or deficits
• Normal mental status exam and no memory difficulties
• Some stages overlap in some patients

Stage 2

• Patient complains about memory problems, forgets where objects were placed, forgets names of people occasionally, word-finding trouble
• Not bad enough to affect work or social interactions, can mimic age related changes
• The patient is aware of the deficits and is concerned, lacks the denial seen later
• This stage looks like and is difficult to distinguish from normal aging.

Stage 3

• Earliest clear cut deficits appear
• Others notice the changes in memory/functioning
• May get lost in car, loses objects more often
• Word finding and name recall are more impaired and affect work
• Concentration and reading may be affected
• Some anxiety and denial of symptoms is common

Stage 4

• Decreased knowledge of recent events and personal history, orientation deficits
• Emotional range and speech constriction occur
• Decreased ability to handle travel, financial decisions, and inability to perform complex tasks
• Denial is more prominent and concentration deficits are more noticeable on testing
• Usually can still travel in familiar places, although driving becomes an issue as do VCR, remote, etc.

Stage 5

• Can no longer survive without assistance as medication, nutrition and safety issues arise
• Forgets more personal info such as address, and can't calculate well
• Can be disoriented to date or place or season but still retain a lot of remote personal history, still knows family members
• Can toilet and eat without help but needs help with clothing choices

Stage 6

• Personality and emotional changes worsen
• Can be paranoid, obsessive, anxious
• Diurnal rhythm disturbance, sleep reversal
• Unaware of recent events, personal history
• Forgets family members names
• Will become incontinent, wandering occurs

Stage 7

• All verbal abilities are lost over time
• Patient is incontinent, requires help with toileting and feeding and all activities of daily living
• Ability to walk is lost over about 1 year
• Patient may not be able to swallow well
• Weight loss worsens and infections can occur and are frequently the cause of death

Reduce Your risk

• Don't smoke
• Avoid saturated fat and “trans fats”
• Treat high blood pressure, diabetes, and high cholesterol
• Eat foods rich in antioxidants (berries, spinach, sprouts, colorful vegetables and salads) and eat plenty of whole grains
• Eat fish and salmon or flaxseed (for essential fatty acids)
• Exercise your body and stay as close to ideal body weight as you can, Exercise your mind and don't retire and become a couch potato.