A type is a category or kind to which something belongs: robins, pigeons and eagles are types of birds. Hats, pants and shirts are types of clothing.
Once you get a diagnosis of dementia, your life can change on a dime – but that shouldn’t mean the end of an ordinary life. There are certain kinds of dementia that can be slowed down and even reversed if identified early enough.
Alzheimer’s Disease
Alzheimer’s disease is the most common form of dementia, which impairs memory, reasoning and language. Alzheimer’s manifests when aggregations of protein (amyloid plaques) and twisted fibrils of proteins (neurofibrillary tau tangles) accumulate in the brain health. and cause the death of cells leading to decline in cognitive function. Alzheimer’s symptoms develop over time and get worse.
But first symptoms are mild – forgetting a name, perhaps, or where you put the keys. Eventually there are more serious problems: the need for help to accomplish daily tasks, a simple confusion about day of the week or season; perhaps difficulty with eating or drinking or a change in personality.
Alzheimer’s symptoms are not a normal part of ageing, but there is some evidence that a healthy diet, regular exercise and social activity can take the edge off the disease. Some kinds of dementia can be treated; some cannot. A FDG-PET scan will pick up on brain activity; how much glucose the brain uses. A MRI or CT scan can show signs of dementia.
Vascular Dementia
In this disease, small blood vessels that deliver your brain’s blood supply and associated oxygen and nutrients are damaged, leading to reduced blood flow and cell death. The symptoms that patients experience start out as vague changes in thinking – an increased absent-mindedness, or a kind of ‘tip of the tongue’ forgetfulness that gets mistaken for ‘senior moments’ – and then progress to a more significant degree of impairment, with a more dramatic and swift decline in day-to-day functioning that makes life miserable.
Vascular dementia tends to come on after a stroke or other problem blocking major blood vessels to your brain, or from tiny strokes accumulating through the years and causing your brain to silently die cell by cell.
Some of the risk factors for vascular dementia are also preventable, including high blood pressure. Changing lifestyle habits such as diet and exercise can reduce your risk, as can medications such as cholinesterase inhibitors, which can help slow down progression. Life expectancy of people with vascular dementia is shortened but, as is the case with other forms of dementia, a person with vascular dementia can die of other causes. A person with vascular dementia could die of a fall, pneumonia or even a blood clot in the lung, and not necessarily from the vascular dementia.
Lewy Body Dementia
Lewy Body Dementia (LBD) happens when clumps of a distinctive protein called alpha-synuclein form in brain tissue, damaging the nerve cells. This is still in the family with Parkinson’s disease, which is another reason why it is often misdiagnosed.
LBD sufferers exhibit early memory problems and later encounter difficulty in moving, as well as the changes in thinking and behaviour common to dementia. Some sufferers become belligerent to the point that they need to be restrained. Others have a form of LBD that is characterised by visual hallucinations. Yet others suffer from tremors and a shuffling gait, bringing to mind those diagnosed with Parkinson’s, whose symptoms can also be caused by LBD.
Symptoms appear gradually and usually begin in middle age. They gradually increase over years; LBD patients need more care as they age due to the cognitive and motor decline they experience. There is work underway to develop better in vivo means of diagnosing the condition during life. These could include use of fluorodeoxyglucose PET and single-photon emission computed tomography brain scans that show reduced dopamine transporter uptake. More future techniques could involve lumbar puncture (spinal tap) or skin biopsy testing to measure specific proteins.
Frontotemporal Dementia
Unlike Alzheimer’s, frontotemporal dementia (FTD) causes problems with behaviour, language and movement. FTD is less common than Alzheimer’s disease, and usually begins much earlier, in middle age. It most commonly affects people between the ages of 45 and 65. Doctors still don’t know what causes this disease. But in the brain, abnormal proteins accumulate in the front and temporal lobes. These are the parts of the brain that control personality and judgement, and help us plan, organise and solve problems.
With behavioural variant FTD you can lose your inhibitions and become inappropriately flamboyant or aggressive. You could start to repeat phrases, struggle to find the right word, or become obsessed with sticking to routines. You could start stuttering or slurring your speech but you usually retain the ability to understand others and read.
There is no treatment for frontotemporal dementia. It’s a new condition, and its rarity presents challenges. There are few centres that treat it, so moving doesn’t always guarantee better care. Cattani continues: ‘Next, psychotropic drugs can help reduce symptoms and make you easier to take care of. With a diagnosis, a doctor familiar with these disorders can determine which ones to prescribe, if any.