Dementia is a condition where the number of functioning brain cells rapidly decreases due to progressive atrophy. The most common type of dementia is Alzheimer’s disease, mostly found in elderly people over 65 years old. However, dementia can also occur at a younger age, often caused by genetic diseases, cerebrovascular diseases, brain infections, exposure to toxins, and so on. When brain cells atrophy, it results in problems with memory, thinking, emotions, and personality changes from the original state.
Causes of Dementia
- Alzheimer’s disease is the most common type of dementia compared to all types. It is caused by the death of certain brain cells, leading to reduced neurotransmitter transmission. Patients with this disease lose memory and learning ability. Over time, symptoms progressively worsen due to increased brain cell death beyond the normal aging process. There is no cure. Treatment focuses on symptom relief and supporting the patient’s comfort.
- Cerebrovascular disease occurs due to blockage of brain blood vessels, reducing blood supply to brain cells, or rupture of brain blood vessels causing bleeding in the brain, compressing brain tissue, resulting in partial brain cell death and reduced brain function. Besides symptoms like limb weakness, poor balance, and unclear speech, dementia may develop over time. Preventable risk factors include high blood pressure, diabetes, high blood cholesterol, stress, smoking, and heavy alcohol consumption.
- Other causes of dementia include:
- Brain infections such as AIDS virus, syphilis
- Thyroid gland dysfunction
- Vitamin B12 deficiency, often found in cases with absorption problems
- Exposure to toxins or drugs
- Enlarged brain ventricles
- Brain tumors
- Chronic brain trauma or history of severe brain injury
- Chronic liver or kidney disorders, etc.
Risk Factors for Dementia
- Increasing age, with higher rates of dementia found in older individuals
- Genetics, if there is a family history of dementia, the risk is higher than average
- Having chronic diseases such as high blood pressure, diabetes, high blood cholesterol, chronic liver or kidney disease
- Heavy alcohol consumption and smoking
- Exposure to toxins from the environment or drugs
- Thyroid or parathyroid gland dysfunction
- Infections such as AIDS or syphilis
- Brain trauma from accidents or occupations such as boxing
- Nutritional deficiencies such as vitamin B12
- Enlarged brain ventricles or brain tumors
Symptoms of Dementia
- Memory impairment and reduced ability to learn new things, such as inability to remember recent events. In severe cases, past events, familiar people, and even close relatives may not be recognized.
- Language difficulties, such as inability to find words, incorrect word usage, impaired writing and reading, or inability to perform these tasks
- Inability to perform daily activities as before, reduced self-care ability such as eating, bathing, and toileting, either unable to do or doing incorrectly
- Changes in mood and personality, which may include irritability, aggression, depression, apathy, or emotional numbness
- Insomnia, hallucinations, paranoia, and anxiety
Diagnosis requires doctors to identify the cause and differentiate diseases to plan appropriate treatment. Diagnostic methods include:
- Physical examination, medical history, neurological examination, and mental status tests assessing memory, learning, language use, calculation, orientation to time and place, and planning ability
- Blood tests to evaluate thyroid, liver, kidney function, and electrolyte levels that may cause symptoms
- Magnetic resonance imaging (MRI Brain) or electroencephalogram (EEG) to assist in treatment planning
- Possible lumbar puncture for cerebrospinal fluid analysis in suspected brain infections
Treatment Approaches
- Doctors focus on treating the underlying cause in diseases that can be cured, such as cerebrovascular disease, brain infections, thyroid dysfunction, enlarged brain ventricles, brain tumors, folate deficiency, vitamin B12 deficiency, and drug overdose. If treated correctly and timely, with minimal brain damage, patients may return to normal. Delayed treatment may result in significant disability.
- Focus on symptomatic and supportive treatment for conditions that cannot be cured, such as Alzheimer’s disease, advanced brain cancer, brain infections in some AIDS patients. Medication may only relieve symptoms but cannot stop brain degeneration. Good care and family understanding help patients live longer and importantly improve the quality of life for both patients and their families.
