Dementia, Symptoms, Cause and Treatment in Dubai

Dementia is not a specific disease but a general term describing a wide range of mental symptoms associated with a decline in memory, language, perception, judgment, and reasoning, as well as loss of emotional and behavioral control. The disorder affects the personality structure of the patient reducing his ability to solve problems and to perform his daily life activities. While the risk of developing dementia increases with age, it is not necessarily a normal way of aging. Brain cell death causes dementia. Toxic substances and several neurodegenerative can affect cells.

Symptoms

The first visible symptom of dementia is memory loss. Dementia usually affects short term memory first. The patient forgets what happened a few minutes ago, while still being able to remember far distant events. Later the disease will reduce the patient’s abilities to cope with daily routine, for example by misplacing things, not being able to find the way home etc. The disorder frequently leads to severe personality changes. The patients get irritable, suspicious, or fearful. They tend to lose initiative; their behaviour may be disorganized, restless or inappropriate.

Memory is fundamental to the formation of a sense of identity and consciousness. Dementia destroys this foundation. The person affected by severe amnesia (memory los) is detached socially, is losing his biography, and is being forced to live as a person with no life history.

Causes

While the risk of developing dementia increases with age, it is not necessarily a normal way of aging. Brain cell death causes dementia. Toxic substances and several neurodegenerative can affect cells.

Alzheimer dementia

The most common dementia in elderly people is the Alzheimer’s disease. It affects the neurocognitive brain functions such as memory, concentration, rational judgment, abstract thinking, and speed of thinking. Although the underlying cause is still not precisely known, the most likely hypothesis (the amyloid hypothesis) postulates that extracellular beta-amyloid deposits leading to the cell malfunction and death.

There is strong evidence that depression is a triggering factor for Alzheimer’s disease.

MRI comparison of brain changes in older people (around 80 years old): 01. An older cognitively normal, 02. Moderately Alzheimer’s changes with mild cognitive impairment, 03. Progressed Alzheimer’s disease with sever cognitive impairment

Dementia caused by organic factors

The other cause of brain cell death happens in brain damage trough injury, strokes (Vascular Dementia), infections, hereditary or secondary disorders like Parkinson’s disease and Multiple Sclerosis.

Korsakoff’s Syndrome

Alcohol consumption has a toxic effect on the brain damaging neurons. Excessive and long-lasting alcohol consumption results in an irreversible brain damage appearing as Wernicke’s encephalopathy. The dementia caused by Wernicke’s encephalopathy is called Korsakoff’s Syndrome. Korsakoff’s syndrome is a severe neuropsychiatric disorder creating such symptoms as:  mental confusion, amnesia (loss of memory), hallucinations, confabulations (making up stories) and frequently loss of muscle coordination.  

MRI, 01: Brain image of multi-infarct dementia, 02: Major brain infarction with severe neurocognitive impairment, 03 Wernicke’s encephalopathy causing the Korsakoff’s dementia

Diagnostics

Psychiatric and psychological evaluations methods are needed to diagnose dementia. The medical evaluation consists of taking family history, physical and neurological examination and blood tests, EEG (Electroencephalogram), CT (Computer Tomography) or MRI (Magnetic Resonance Imaging). Psychometric testing can quantify the dimension of the neurocognitive impairment.

The cognitive functions such as memory, concentration, and speed of thinking can be affected by organic diseases such as hypothyroidism, brain tumor, intoxication and more. Treating the organic disorder can reduce the symptoms.

In the case of a depressive “pseudo dementia” the treatment of depression restores the neurocognitive functions.

Treatment

Any treatment of a dementia depends on its cause and needs a profound diagnostic investigation, involving experienced physicians and psychologists. In the case of the most progressive dementias, including Alzheimer’s disease, the treatment concentrates on slowing down the illness which includes a psychopharmacological (medication) and psychological treatment. Both approaches focus on the increase of the neurocognitive skills of the patient to improve the patient’s life quality.