Chapter 4-1 What Is Dementia?

• Jurisdiction: United States

4-1 What Is Dementia?

Dementia is the name given to a group of symptoms including memory loss, reduced ability to reason, impaired judgment, and progressive loss of the ability to understand either spoken or written language.¹ One could liken dementia to a fever: a "fever" is not a disease; it is merely a symptom that someone is suffering from a thus-far unidentified disease. In the same manner, dementia serves as an indication that someone is suffering from some form of impaired judgment.

This, though, is where the similarities end. In the final analysis, fevers and dementia manifest themselves in quite dissimilar ways. If we consider the manifestations as points along a spectrum, on one end of the spectrum, we find someone who may be "burning up with a fever." The person may be delirious and may say things he or she does not mean or does not remember after the fever has abated. On the other end of the spectrum, we find someone suffering from dementia. Generally, the person behaves in ways others may find irrational.² He or she suffers from severe mood or personality changes, is physically aggressive, becomes easily agitated, and suffers from altered perceptions such as hallucinations, misperceptions, and delusions.³ As time passes by and the disease settles in "for the long haul," the person may become disoriented in time (i.e., not knowing what day of the week, day of the month, or month of the year it is), place (not knowing where he or she is), and person (not knowing who he or she is—or who anybody else is, for that matter).⁴

4-1:1 Diagnosing Dementia

The Alzheimer's Association reports that disorders grouped under the general term "dementia" are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings, and relationships.⁵ Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. But many other conditions can also cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.⁶ Symptoms of dementia can vary greatly. Examples include:

• problems with short-term memory,

• keeping track of a purse or wallet,

• paying bills,

• planning and preparing meals,

• remembering appointments, and

• traveling out of the neighborhood.⁷

No single test exists to determine whether someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior...