Symptoms of dementia

introduction

Dementia is a neurological disease in which mental abilities are lost over time. As a result, those affected lose the ability to find their way in everyday life. Depending on the type of dementia, the symptoms are slightly different. The memory disorders are usually in the foreground. The ability to remember and remember is significantly impaired.

This plays at Alzheimer's disease and the vascular dementia already plays a major role in the early stages. In frontotemporal dementia (Pick's disease) the personality changes first, the patients are easily irritable and aggressive. The above-mentioned memory disorders only develop over time.

Forgetfulness as a symptom of dementia

A decline in memory performance and increasing forgetfulness can have many causes; from normal absent-mindedness to stress and dementia.

In the early stages it is therefore important to find out whether the cause is harmless, temporary (e.g. stress, sleep disorder, dehydration) or a treatable cause (e.g. depression).
Treating depression often improves cognitive performance. If these possibilities have been excluded, one can think of the onset of dementia.

A reduced ability to think and remember is the classic symptom. Everyone forgets a name or an appointment. However, if these incidents accumulate and states of confusion also occur, this is a warning symptom for dementia. There are also orientation problems. Those affected can suddenly no longer find their way around well-known places. Complex activities such as driving a car, shopping or using public transport are also difficult for patients. Ultimately, this is an important point when it comes to determining whether memory impairment is a sign of dementia.

Loss of orientation as a symptom of dementia

It can happen to everyone that one or the other day of the week is mixed up during stress or that one gets lost in a strange environment. This is not always a cause for concern.

In the case of patients with the onset of dementia, however, the difference is that they can often no longer find their way around places they are familiar with, that they no longer know where they are in their own street or cannot tell how they got home. These spatial and temporal orientation problems are classic dementia symptoms.

As the disease progresses, those affected can no longer say which year, month or day it is. The patients can no longer find their way around their own apartment.

In the final stage, the patient forgets important biographical information such as their own name and date of birth. He can't remember if he has kids or where he worked. This orientation towards oneself is the last thing to be lost. In the initial stage, the patient can usually still access this memory content.

Is a change in personality a symptom of dementia?

Changes in personality in the context of dementia are a common phenomenon and are often experienced as very stressful by the relatives of those affected. Many patients show severe behavioral disorders as the disease progresses. This ranges from sudden mood swings to distrust of loved ones to aggressive behavior and loss of control. Especially for the relatives it is terrible to see how a loved one changes so.

As a relative, you have to be aware that a person's personality is also stored in their brain. If the nerve cells in the corresponding brain regions die or are damaged, the personality changes. It's an organic process.
That has been researched quite well with the clinical picture Pick's disease or the fronto-temporal dementia. Changes in personality are the typical symptom here. The memory often stays intact longer. However, the patients are easily irritable, quickly aggressive, and behave very tactlessly towards their relatives. However, this is due to the changes in the brain caused by dementia.

Changes in personality are also an expression of the disease in Alzheimer's dementia.

Is a malicious character a symptom of dementia?

Character is the essence of a person. Dementia continuously destroys nerve cells in the brain. If brain regions that are responsible for personality and character are affected by the decay, the disease leads to a change in personality.

Therefore, the behavior of people with dementia (even when dementia begins) cannot be measured against the standards of healthy people. The character and personality traits slowly disappear with the disease.
This means that behavior that is often experienced as malicious by relatives does not necessarily have to correspond to the character of the patient, but is often seen as an expression of the illness.

Depression as a symptom of dementia

Dementia and depression are two diseases that are closely related. Both increase with age. Both diseases also lead to mental impairment.

In contrast to dementia, depression can often be treated very well. So-called antidepressants are used to improve mood. If pure depression is the cause of reduced memory, memory performance can increase significantly again after treatment of the depression.

Also read: How do you treat depression?

Unfortunately, dementia is more of a continuously deteriorating process. Especially in the early stages, patients notice that they are changing, that they can no longer cope with everyday problems. This can often lead to a feeling of depression. In this respect, depression is often an accompanying symptom of dementia.
The concentration of neurotransmitters in the brain can also be changed by dementia, so antidepressants that influence the concentration of neurotransmitters in the brain are also useful in the early stages of dementia. The choice of antidepressant should be carefully considered, as there are classes of drugs that worsen dementia by their effects.

Is Incontinence a Symptom of Dementia?

Incontinence is the involuntary evacuation of urine or stool. Those affected can no longer arbitrarily control their excretions. This often goes hand in hand with dementia.
Approx. 70-80% of dementia patients also suffer from incontinence. This is because the region in the brain that controls bladder function has often been destroyed by dementia. The course can often be moderated with medication, but complete continence can rarely be achieved in dementia patients.

Pyschosis as a symptom of dementia

Delusions and hallucinations are characteristic of psychosis. Ultimately, psychotic symptoms can also occur in all forms of dementia. They are typical for them Lewy body dementia (the second most common neurodegenerative disease after Alzheimer's disease). Optical hallucinations in particular play a role here. Sometimes patients see people in the room and talk to them. Some can distance themselves from it in retrospect and know that the people are not present. About a third of those affected by dementia have at least a few psychotic episodes. One then speaks of one paranoid dementia.

Paranoia

Paranoid is a mental illness in which the patient believes he is being watched or followed. In connection with a dementia, one speaks of paranoid dementia.
In addition to memory and orientation disorders, these psychiatric abnormalities unfortunately often also belong to the classic symptoms of dementia. Relatives in particular experience this as an enormous burden.

Medicinal treatment options are neuroleptics, but the paranoia can unfortunately only be influenced to a limited extent by drugs.

Hallucinations as a symptom of dementia

Hallucinations are unfortunately not uncommon in people with dementia. Those affected often see things that are not really there.
Acoustic hallucinations (such as hearing voices) are not as common in dementia. Basically, however, any form of hallucination can lead to fearful and / or aggressive behavior or intensify existing behavioral disorders. Drug therapy is often necessary. The drug of choice is risperidone. If possible, it should only be prescribed for a short time and in the lowest possible dose.

Epilepsy and dementia

Epilepsy is the tendency to have seizures (epileptic fits). Epilepsy as a symptom of dementia is rather unusual or it depends very much on the cause of the dementia. With the most common cause of dementia, Alzheimer's disease, epileptic seizures are the exception.

In the late stages, generalized seizures have occasionally occurred in patients. In the vascular dementia the situation is different. Circulatory disorders in the brain (e.g. stroke) lead to more generalized seizures over time.

Tremors and aggressiveness in dementia

Dementia is a neurodegenerative disease in which the nerve cells in the brain are gradually destroyed. Since the character and personality of a person are also stored in the brain, changes in personality occur as the disease progresses. Often this is characterized by aloof behavior and aggressiveness. This is often very difficult for relatives to process. Ultimately, like forgetfulness, this must be seen as a symptom of the disease. Movement disorders in the form of tremors are particularly common in Parkinson's dementia. Trembling is not so typical for the other forms of dementia.