Dementia

Older Adults and Dementia
by Dr. Saba Habis 
Published in The Carthage Press Senior tabloid edition
November 2009

Dementia is not a specific disease but rather describes a group of symptoms affecting one’s social and cognitive abilities enough to interfere with daily functions. Different types of dementia, depending on the cause, include:

  • Alzheimer’s disease – the most common cause of dementia, occurring in five percent of adults age 65-74; occurs in approximately 50 percent of those over age 85.
  • Vascular dementia – overall function and cognitive impairments caused by blood circulation problems in the brain.
  • Lewy body dementia – shares characteristics of both Alzheimer’s disease and Parkinson’s.
  • Frontotemporal dementia – primarily affects the areas of the brain associated with personality, behavior, and language; patient may undergo dramatic changes in personality and may act inappropriately in social settings.

Other types of dementia:

  • Multiple sclerosis
  • Pick’s disease         
  • Normal pressure hydrocephalus
  • Parkinson’s disease
  • Huntington’s disease     
  • Alcoholism or drug abuse      
  • AIDS
  • Creutzfeldt-Jakob disease
  • Progressive supranuclear palsy
  • Reversible dementia  

Common Signs of Dementia
With dementia, many symptoms are possible. At the beginning, symptoms may be mild. However, as time passes, adults may have more than one of the following symptoms:       

  • Memory problems – including trouble remembering recent events or trouble remembering people, places, times, and dates
  • Poor judgment and not being able to understand the results of their actions
  • Decline in thinking ability – for example, not being able to figure out the correct order in which to put clothing on
  • Trouble following instructions or staying on task; problems paying bills, fixing meals, shopping or taking medications
  • Lack of emotion, lack of interest in what is going on around them, less participation in activities enjoyed previously, or withdrawal from others                                               
  • Loss of interest in food and less concern with looking neat and personal hygiene
  • Irritability, agitation, and a tendency to overreact
  • Wandering away from home or getting lost
  • Believing that someone is taking money or belongings from them or that family members are not who they say they are

As the disease worsens, it may cause problems with control of the body. These include:

  • Inability to control bowel or bladder
  • Unsteadiness while walking, leading to falls and the eventual inability to walk
  • Forgetfulness about how to eat or having trouble chewing and swallowing
  • Difficulty speaking and thinking of the right words, eventually becoming unable to speak

Complications
Dementia can affect the ability to carry out day-to-day tasks, which may include the following:

  • Difficulty taking medications – because those experiencing dementia have some memory loss, remembering to take the correct dosage of medications at the right time presents a challenge.
  • Inadequate nutrition – often times those with dementia will reduce food or fluid intake or stop eating and drinking altogether. This decreased interest in food and losing the feeling of hunger or the desire to eat will result in an overall lack of adequate nutrition. 
  • Emotional and mental health – dementia may lead to depression, confusion, frustration, anxiety, disorientation, and other emotional challenges, resulting in a change of personality.
  • Problems sleeping – disruption of the normal sleep cycle such as staying up at night and sleeping during the day, as well as insomnia, is very common among those with dementia.
  • Difficulty communicating – communication can be affected at various levels whether it’s communicating feelings or wants, or just remembering people’s names.
  • Reduced hygiene – even in moderate stages of dementia, one may loose the ability to independently complete daily living tasks such as bathing, dressing, or brushing one’s hair or teeth and require assistance accomplishing even small tasks.

What you can do 

  • See a doctor when symptoms arise so the doctor can determine the underlying cause. It’s important to receive an early diagnosis in order for treatment to begin.
  • Treatments can help slow or minimize the development of dementia symptoms. In addition, treatment of the underlying causes of dementia can also help slow its progression.
  • To reduce your risk of dementia, lower your levels of LDL cholesterol, limit alcohol consumption, stop smoking, control your diabetes, and keep your mind, body, and social  life active.

Tests and diagnosis

  • Physicians specializing in geriatric medicine will ask about your medical history and family history. In addition, a physical exam will include urine or blood samples, your blood pressure, and a review of your current medications. 
  • Cognitive evaluation will measure a variety of skills, memory, reasoning, and judgment. 
  • Family history and age are both contributing factors in determining one’s risk of developing dementia. With age, the risk of developing dementia increases. Furthermore, a family history of dementia may increase one’s chances of developing certain types of dementia.

Healthcare for seniors
Freeman Center for Geriatric Medicine, the only one of its kind in the region, provides multiple specialists and important services with easy access and convenience for patients, families, and caregivers. Two board-certified geriatricians specializing in health issues affecting older adults, perform a thorough medical assessment summarizing all the evaluations and recommendations of the center’s specialists. The center focuses on maintaining and improving the quality of life of seniors by providing early intervention for health risks and comprehensive treatment. Freeman Center for Geriatric Medicine works directly with a variety of healthcare specialists, including the patient’s primary care physician, or can serve as a medical home for those without a primary care physician.

Supported by a number of resources only a hospital based provider can supply, Freeman has made an unprecedented commitment to the health of older adults, at a level never seen before in this area of the Four States. For more information or an appointment call 417.347.4374. 

About Dr. Saba A. Habis:
Dr. Saba A. Habis received his medical degree from Damascus University Hospital, completed his fellowship in Geriatric Medicine at University of Illinois College of Medicine, Peoria, Illinois and is board-certified in internal medicine and geriatric medicine. Dr. Habis serves as Clinical Associate Professor of Geriatrics, Kansas City University of Medicine and Biosciences, and Medical Director, Freeman Center for Geriatric Medicine, 931 E. 32nd Street, Joplin.