Signs of dementia symptoms and when not to worry

DEMENTIA is a topic that can be the butt of jokes but for people sliding into it and their loved ones, it is no laughing matter.

Of course, those people already deep into dementia are the least distressed and are often looked after by people committed to making their lives as comfortable as possible.

What is sad is when people start the long, slippery slide into dementia and are aware of their deterioration and the distress it is causing their loved ones.

My father, at 82, first started to show dementia symptoms about five to six years ago and my mother was becoming quite distressed.

But my sister and I could not see how much he was deteriorating as when we sat down with him, he was still able to have normal conversations.

He could still talk about current affairs, and seemed interested in the wider world. As we were not living with him, we could not see how bad he was.

My sister, who was dying of breast cancer, and I became impatient with our mother as we felt she was trying to shift the focus away from her own deteriorating psychological health.

She was depressed over my sister's illness and ended up dying a few months after my dear sister passed. She had drunk herself to death over the last few years of her life.

I now realise that my father's dementia symptoms were immensely worrying to my mother and I feel so guilty about not supporting her more.

Today, after having a stroke, dad is in a nursing home and his dementia symptoms are very obvious, although he still knows who I am and can still talk a bit about the past.

As my father's dementia symptoms were quite subtle in the beginning, I thought I would look into ways of recognising those symptoms in the early stages and also show the difference between normal memory lapses and dementia - because we middle aged people worry - often unnecessarily - about any sign that we may be losing our faculties.

The message here is, if someone close to a potential sufferer of dementia calls out for help, listen and offer support. Only people living with those in the early stages of dementia will see the signs. However, sometimes we can mistake those signs which may really be normal memory lapses or some form of stress.

Dementia is not an inevitable part of the ageing process, even if our parents and grandparents had it. But it is a growing problem as the ageing population of the developed world grows with the large baby boomer generation living longer. However, while we are living longer than our forebears, we are not necessarily healthier - we are exercising less and eating more high fat, high sugar, high salt foods.

One newspaper report I read stated that in the next few years, we would have an ``avalanche of dementia''.

So, let's look at dementia symptoms, the different types of dementia and how to separate normal memory lapses from early dementia symptoms.

As a newspaper health reporter, I have access to doctors and other health professionals as well as experts at the Alzheimer's Association of NSW.

I also have the ability to sift through information from other sources such as the American Alzheimer's Association and bring it to people in an easily-understood format. That is what journalists do, after all. The information is out there but often written in complicated medical lingo or at least a long-winded fashion.

There are three main types of dementia

Vascular dementia

A common form of dementia, it develops when there is impaired blood flow to parts of the brain, depriving cells of food and oxygen.

It can often strike after a major stroke blocks a large blood vessel to a significant portion of the brain.

It can also come after a series of very small strokes, or infarcts, block small blood vessels and cause damage over time.

With vascular dementia, symptoms include impaired memory, confusion, difficulty concentrating and following instructions, inability to carry out everyday activities and often physical weakness or permanent impairment.

Sometimes, the person loses the ability to speak or to comprehend the written word.

Alzheimer's

This is the cruelest form, the one most feared. Some people think this is the only form of dementia as it is the one most talked about and the one with the most dire outcome.

It also is the form of dementia most likely to be inherited and the one form which is less responsive to preventative treatment, although onset can still be lessened if general physical and mental health have been maintained.

One of the most common signs of Alzheimer's, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, relying on memory prompts such as reminder notes.

People with Alzheimer's may forget names and appointments but remember them later.

Some may start to have difficulty working with numbers or following a familiar recipe or paying bills.

The afflicted have trouble understanding something that is not happening right away or forget familiar places or people they do not see everyday. Eventually they may forget familiar people, including their nearest and dearest. That is why it is such a cruel and feared disease.

Just as frightening is the changes in mood and personality of the person with Alzheimer's. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
With this form of dementia, changes to the person are more evident than with vascular dementia.

Mixed dementia

Mixed dementia is a condition in which Alzheimer's disease and vascular dementia occur at the same time. Many experts believe mixed dementia occurs more often than was previously realized and that it becomes increasingly common in advanced age.

Experts recommend suspecting mixed dementia whenever a person has both evidence of cardiovascular disease and dementia symptoms that get worse slowly.


When to worry and when to relax

Worry: Poor judgment and decision making; Relax: Making a bad decision once in a while

Worry: Inability to manage a budget; Relax: Missing a monthly payment

Worry: Losing track of the date or the season; Relax: Forgetting which day it is and remembering later

Worry: Difficulty having a conversation; Relax: Sometimes forgetting which word to use

Worry: Misplacing things and being unable to retrace steps to find them; Relax: Losing things from time to time


But self-diagnosis has its limits in any area of health. The point is, if you are concerned you or a loved one may be losing faculties, consult a doctor and insist on proper tests to see the state of that person's mind. It is amazing how brain detioration can be mapped with medical equipment.