Dementia Explained

Author:
James Urquhart-Burton
Partner, Care Home Solicitor
Date:
03/01/2019

When you hear or see the word ‘dementia’, you’d be forgiven for thinking that this is one medical condition. But dementia is a set of symptoms which are closely linked to age, yet not an inevitable part of growing old, as often thought.

Dementia symptoms include problems with thinking, reasoning, learning, memory, language and difficulties with daily activities. These can get worse over time and often result in the sufferer being placed in residential care to meet their needs. And sadly, there is no cure.

Dementia is the result of diseases damaging the brain, and symptoms can be caused by a number of different underlying conditions, often referred to as different ‘types’ of dementia.

Once a person no longer has mental capacity to make their own decisions, they would not be permitted to put Lasting Powers of Attorney in place.

There are two types of Lasting Powers of Attorney. They are both legal documents which allow a person with mental capacity to choose one or more people who can make decisions for them, should they lose mental capacity; due to conditions such as dementia.

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The 4 Main Types of Dementia

1. Alzheimer’s Disease

Alzheimer’s is a physical disease that affects the brain and is the most common cause of dementia.

Our brains are made up of billions of nerve cells that connect to each other; when suffering from Alzheimer’s, the connections between these cells are lost.

Eventually the nerve cells die and brain tissue is lost.

Our brains also contain important chemicals that help to send signals between cells; people with Alzheimer’s have less of these chemicals in their brain so the signals are not passed on as well as they’d normally be.

Alzheimer’s is a progressive disease which means that over time, more parts of the brain are damaged. As this happens, more symptoms develop and continue to deteriorate.

2. Vascular Dementia

This is the second most common type of dementia and is caused by reduced blood supply to the brain due to blood vessels becoming diseased.

Our brain cells need a constant supply of blood to bring oxygen and nutrients. Our vascular system delivers the blood to our brains - if the vascular system becomes damaged, then blood cannot reach our brains and the cells will eventually die.

The death of brain cells causes problems with our memory, thinking and reasoning, which is known as our ‘Cognition’. When these cognitive issues are severe enough to have a significant impact on our daily life, this is known as Vascular Dementia.

There are different types of vascular dementia:

  • Stroke-related dementia - caused by the sufferer having a stroke
  • Post-stroke dementia - develops within the following 6 months after having a stroke
  • Single-infarct and multi-infarct dementia - caused by one or more smaller strokes
  • Subcortical dementia - caused by disease of the very small blood vessels that lie deep in the brain
  • Mixed dementia - this generally means that both Alzheimer’s disease and vascular dementia are thought to be the cause

3. Dementia with Lewy Bodies

Dementia with Lewy bodies shares symptoms of dementia with both Alzheimer’s and Parkinson’s disease.

Other names for Dementia with Lewy bodies (DLB) are Lewy body dementia, Lewy body variant of Alzheimer’s disease, diffuse Lewy body disease and cortical Lewy body disease. These all refer to the same condition.

The term ‘Lewy body’ can be confusing. When we speak of Lewy bodies, we’re referring to tiny deposits of protein that appear in our brain’s nerve cells. They cause DLB and Parkinson’s disease and deteriorate over time when the sufferer has developed one of these diseases.

If you suffer from Parkinson’s, you’re at high risk of developing dementia as the condition gradually progresses.

4. Frontotemporal Dementia

This is one of the less common types of dementia, often referred to as Pick’s Disease or Frontal Lobe dementia.

‘Frontotemporal’ describes lobes in the brain which are damaged. This type of dementia occurs when nerve cells in the lobes die; as more of the cells die, the brain tissue in the lobes will shrink. Symptoms include a change in personality and behaviour together with difficulty speaking. These are different from the memory loss symptoms associated with the more common types of dementia.

Under-65s are more likely to develop frontotemporal dementia - being diagnosed at a younger age is likely to cause a very different set of challenges, for example, if the sufferer has dependent children.

What Else Can Lead to Dementia?

There are other rarer diseases/conditions that can eventually lead to dementia or dementia-type symptoms. These include Creutzfeldt-Jakob disease, HIV-related cognitive impairment, Huntington’s disease, Parkinson’s disease and multiple sclerosis.

One particular and rarer type of dementia to note is Young-onset dementia, which is when symptoms begin before the age of 65. You may wonder why the age of 65 is used frequently - this is purely because 65 is the traditional retirement age.

Conclusion

The various types of dementia can be confusing and reading about their effects can be overwhelming. The important thing to remember is that if you or a loved one are suffering, you’re not alone. There are various treatments to help with the effects of dementia such as medications, therapies and person-centred care.

The support available varies depending on the severity of the disease - for instance, daily living support such as eating, drinking, washing and bathing may be needed in some cases. Alternatively, a care home may be required, or arrangements have to be made for carers to attend a person’s home.

But with the right support and treatment, sufferers are able to lead active and fulfilling lives.

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