Dementia is a progressive disorder that affects how the brain works and in particular the ability to remember, think and reason.
As they get older, some people notice the brain is not as agile and the memory not as sharp as it used to be. It's a common observation, but many of us wonder if these memory problems could be an early sign of dementia.
Here we look at what is known about dementia, symptoms that could suggest you should seek further advice, steps to reaching a diagnosis, and where you or your family can go for more specialist information about dementia treatment and support.
Dementia is predominantly a condition that affects older people although it affects people under 65 too. In Northern Ireland approximately 19,000 people are living with dementia, a number projected to rise to almost 60,000 by 2051, the fastest expected rate of increase in the UK (DHSSPS 2010).
If dementia is diagnosed early enough there are lots of things that can be done to help you live well with dementia.
What is dementia?
Dementia is not a disease in itself - but a group of symptoms that may accompany conditions that affect your brain.
The most common of these is Alzheimer’s disease. Another is vascular dementia which can develop following a stroke or if there is blood vessel damage that interrupts the supply of blood to your brain. Dementia is not a normal consequence of growing old.
Recognising symptoms of Dementia
In most cases, the symptoms that characterise dementia come on gradually and get worse over time, often over a number of years. They can vary according to the condition causing them and from person to person but the symptoms of dementia include:
- Struggling to remember things that happened recently, even though you can easily remember things from longer ago.
- Struggling to follow conversations, particularly in groups.
- Forgetting the names of people or things.
- Struggling to follow a story on television or in a book, or understand magazine and newspaper articles.
- Having trouble remembering the day or date.
- Having trouble remembering where you put something, or where things are kept.
- Repeating yourself or losing the thread of what you are saying.
- Finding your thinking is fuzzy.
- Struggling to do things you used to find easy.
- Feeling confused even in a familiar place.
- Having problems controlling your mood, or controlling your emotions.
Both the person with dementia and those around them may not even notice the signs or take them seriously for quite some time.
Seeking further advice
If problems like this start to affect your daily life, it is worth sharing your concerns and making an appointment to discuss them with to your GP.
If you are worried about someone else’s memory, try to encourage them to see their GP and offer to go with them for support if they seem a bit reluctant.
Could you be at risk?
There does not appear to be a single cause of dementia. Research to date suggests a combination of factors affect your overall risk of developing it.
You cannot do anything about factors such as your age or genetics but you can make changes to your lifestyle.
This is the most significant risk factor and chances of developing dementia increase with age.
This seems to be more significant if you develop dementia under the age of 65. In the majority of cases the significance of inheritance seems small. If a parent or other relative develops it, your own chances are only a little higher than if there were no cases in your family.
People who follow a healthy lifestyle that protects their heart and blood vessels and who enjoy active and fulfilling lives have been shown to have a lower risk of dementia. Therefore aim to:
- eat a varied diet with plenty of fruit and vegetables
- eat less salty and fatty foods, particularly avoiding those high in saturated fat
- drink alcohol in moderation
- stop smoking
- take regular exercise
- enjoy and active life with plenty of outside interests that exercise body and mind
- ask your GP to check your blood pressure and cholesterol
Diagnosis and treatment
Memory problems can have many underlying causes and are associated with some physical illnesses. These include thyroid problems, urinary tract infections and constipation. They can also be a side-effect of medication or due to stress, tiredness or depression. If your GP considers these but rules them out, there are a number of ways to assess your symptoms further.
As a first step, your GP will chat to you to find out more about you and your symptoms. This can include exploring how they are affecting your daily life. Your GP may carry out some recognised tests to check your thinking and memory. If a family member or someone who knows you well can be there too, it can be helpful for moral support and to support what you are saying.
Your GP may feel able to make a decision based on their findings but is likely to refer you for a fuller assessment to a memory clinic or consultant with more specialist knowledge. If you believe this would be helpful but the GP does not suggest it, ask if you can be referred as you have a right to ask for a second opinion.
Staff at the memory clinic may want to carry out further tests, including a brain scan, to get a clearer picture that will help them reach a diagnosis.
Difficulty of diagnosis
Making a diagnosis of dementia and confirming which type you have can be difficult, particularly in the early stages. Each person will experience it in their own way and their condition will progress at a different rate.
If you would like more specialist information, the Alzheimer’s Society and Alzheimer’s Research UK provide information on all types of dementia and have helplines that you can call for advice and support. There is also information about dementia in the health A-Z section of the NHS Choices website.
Your consultant should explain their findings, discuss next steps with you and answer any questions you may have. You can choose not to know your diagnosis. You can also choose who else can know about your diagnosis.
If you receive a diagnosis, it is important to know who will be responsible for managing your care in the short and longer term and who you can contact with any questions or worries. You may find it helpful to download our free guide Living with early-stage dementia
There are drug treatments and non-drug treatments that can either help slow down progression of the dementia or help with some of the symptoms.
The National Institute for Health and Care Excellence (NICE) has issued guidance on supporting people with dementia and their carers. This includes information about the types of medication that can help some people with Alzheimer’s disease. These medications address symptoms that affect memory and thinking and can slow their rate of progression.
The NICE guidance also discusses the role of non-drug treatments such as cognitive stimulation therapy. This can help people who have mild or moderate dementia with symptoms that affect their thinking or memory. It involves doing activities that require some thought and problem-solving but in a fun way and can be provided by health or social care staff who have had appropriate training.
Other non-drug treatments can help with help with symptoms that affect mood or behaviour, such as reminiscence therapy, massage, music and other therapies. These treatments can foster a sense of wellbeing in many people with dementia.
Everyone experiences dementia in their own way. The key is to understand the individual and their life history and see if this understanding can help you identify triggers for particular types of behaviour.
NICE has also developed a Quality Standard for Dementia Care. It describes standards that the NHS should be working towards when developing services for people with dementia and their carers.
You can also find out about treatment and support on the NHS Choices website.
Help and support
The nature of dementia means your condition will change over time. It is important that the health professional responsible for your care tells you about the range of local services that can help you and family members who care for you.
This includes social services should you need help with personal care and day-to-day activities or regular respite care and voluntary groups that can provide both practical and emotional support to you and your family.
Caring is a very demanding job, so if you care for someone with dementia it is important you know where you can go for help and support and if respite breaks are available though social services.
You can find more about help available through social services by calling our Advice Line on freephone 0808 808 7575.
If you have difficulty managing personal care or day-to-day tasks or need watching over to make sure you are all right, you may be able to claim a non means-tested benefit – Disability Living Allowance or PIP if you are under 65 years old or Attendance Allowance if you are aged 65 and over. You can find out more about these and other benefits you may be entitled to by calling our Advice Line on freephone 0808 808 7575.
Powers of Attorney
There may be a time in the future when your symptoms mean you are no longer able to make decisions about your financial affairs or about medical treatment. One option is to draw up, in advance, separate Lasting Powers of Attorney – one to cover financial decisions and one to cover health and welfare decisions. This involves appointing someone you trust to act on your behalf should this happen.