RN, MSN, Chief Nursing Officer
Many times, individuals, family members, and healthcare workers fail to understand the relationship of neurological symptoms as they are related to different types of dementia.
It can be rather difficult to differentiate what is normal age-related memory loss versus early signs of dementia which may need further diagnosing and treatment.
Many of us tend to become more forgetful as we age, and may need a bit longer to remember things. Even though these changes are normal and typically occur during middle age, they can very well become a nuisance and even frustrating.
But, how can one know that these are normal and not an early symptom of dementia?
For most individuals, these changes are a normal result of aging, but it is important to understand the differences so diagnosis can be accurate and efficient in treating different types of dementia.
At one point or another in our lives, we have misplaced a set of keys, blanked on remembering someone’s name, forgot a phone number, or walked into a room to do or get something and began wondering what you went in there for.
Even though memory lapses can be frustrating, most likely they are not cause for concern. However, age-related memory changes are not the same issue as dementia.
As one grows older, there are various physiological changes that can cause variations in brain functions that one typically doesn’t even think about.
A few examples of these are the process of the longer duration to both learn and to recall information, not being as quick as he/she used to be, and an increased length of time to recall information. Memory lapses typically have little impact on one’s daily activities.
Dementia is marked by a persistent and often disabling decline in two or more intellectual abilities such as memory, judgement, language and abstract thinking.
Other symptoms of dementia include:
Studies have shown that 60-80% of people with dementia have this type of disease.
The individual presents with symptoms such as memory loss and difficulty planning and performing routine tasks.
The symptoms are mild at first but progressively worsen. Other symptoms noted may be confusion about person, place, and time, difficulty speaking and/or writing, losing things, poor judgment, and mood and personality changes.
Individuals with this type of dementia typically have had a stroke and symptoms depend on which part of the brain is affected by the stroke. The first signs noted with vascular dementia is typically poor judgment or difficulty planning, organizing, and making decisions.
Other noted symptoms are memory problems that disrupt the individual’s daily life, difficulty speaking and understanding speech, difficulty recognizing sights and sounds that used to be familiar, becoming confused or agitated easily, changes noted in mood and personality, and difficulty walking and having increased falls.
Lewy bodies consist of tiny microscopic deposits of a protein that form in some individual’s brains. The deposits of the protein develop and form in the part of the brain called the cortex and the symptoms include difficulty thinking clearly, making decisions, or paying attention.
The individual also has problems with memory, experiencing hallucinations, unusual sleepiness during the day, periods of “blanking out” or staring, difficulty with movement including slowness, and trouble walking, and the individual may have dreams where he/she acts out physically and may include walking, talking, and kicking.
Studies have shown that individuals with nervous system disorders experience this type of dementia at an estimated 50-80% of the time.
Typically, the symptoms of dementia develop approximately ten years after a person is first diagnosed with Parkinson’s. Individuals with Parkinson’s Disease have the same symptoms as dementia with Lewy Bodies and both conditions exemplify signs of Lewy bodies in his/her brains.
Individuals with this type of dementia have developed cell damage in areas of the brain that control judgement, planning, emotions, movement, and speech.
These individuals may also experience behavior and personality changes, sudden lack of inhibition in social and personal situations, problems thinking of the correct words when speaking, and movement problems such as shakiness, muscle spasms, and balance problems.
In this disease, it is caused by a genetic defect that is typically passed from one family member to another. The individual may have the gene for this disease at birth, but typically the symptoms do not usually start until the ages of 30-50.
The individual typically has difficulty with thinking and reasoning, memory, judgment, organizing, planning, and concentrating.
In this type of dementia, a protein called “prions” cause normal proteins in the brain to begin developing into abnormal shapes. This disease is a rare condition that leads to dementia symptoms that occur suddenly and quickly become worse.
The individual may experience memory and concentration problems, poor judgment, mood swings, confusion, sleep problems, depression, trouble walking, and twitching or jerking muscles.
A buildup of fluid in the brain is noted in this type of dementia and includes difficulty walking, concentrating, personality, and behavior changes.
In some cases, the extra fluid can be drained from the brain into the abdomen through a long, thin tube, called a shunt.
A severe shortage of thiamin (vitamin B-1) is noted in this type of dementia and is noted most commonly in individuals who are long-term heavy drinkers. The most common symptom noted is memory problems, but typically one’s problem-solving and thinking skills are not affected.
In a study conducted by a Dementia Research Group, information was collected regarding neurological symptoms using a NEUROEX assessment based on surveys of older adults living in low and middle-income countries.
Neurological symptoms were consistent with the areas of the frontal, cerebellar, extrapyramidal, and more generalized disturbances of gait were noted.
The pout reflex symptom is a common symptom seen in the frontal lobe and is associated with vascular dementia. Difficulties in fine finger movements are typically impairments related to cerebellar dysfunction. Tremor and rigidity are typically seen as extrapyramidal deficits that are related to Parkinson’s Disease. Gait ataxia which is a result of dysfunction of the frontal area of the brain was also noted and may include mixed types of symptoms with other symptoms of a non-neurological nature such as arthritis, respiratory, and vascular issues.
Due to certain other conditions that mimic dementia, many times normal age-related memory loss can be mistaken as a form of dementia.
It is imperative that proper assessment is completed by the nurse and/or physician to rule out any underlying causes for these symptoms that may not be true dementia.
Both small and large actions can be taken as a health advocate to obtain positive results. First, it is important for nurses to volunteer or assist in a facility that offers services to these individuals and to educate oneself on the facts surrounding different types of dementia.
Throughout the entire process of advocacy, these elements need to remain – confidentiality, purpose, equality, diversity, empowerment, and most importantly, empathy, compassion, and respect.
Education is the ongoing key to becoming more aware of proper care and treatment options for individuals with different types of dementia. Increased knowledge and expertise in this area and serving as an advocate for these individuals by listening and representing the individual’s views must be in place for this population to receive the necessary and adequate care they each deserve.
Different types of dementia show different signs and symptoms depending on which area of the brain is affected.
It is imperative to use a holistic approach with both the individual with dementia and the healthcare team, caregiver(s), and family to maintain open communication, empathy, and compassion while developing the best plan of action for the individual.
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