What is dementia?

Dementia is a complex and often misunderstood condition that can cause great distress to families. Roughly 850,000 people suffer from dementia in the UK, with 1 in 6 people over the age of 80 suffering from some form of the condition.

These numbers are expected to rise to over 1 million people with the condition come 2025, and 2 million by 2051. Approximately 40,000 under the age of 65 suffer from the condition, and 25,000 victims come from black and minority ethnic backgrounds. This article explains what dementia is, and what causes it.

What is dementia?

Dementia is a persistent intellectual impairment. Its symptoms include problems such as memory loss, language difficulties, problem-solving, and coherent thinking. Caused by damage to the brain, dementia presents itself in two forms: degenerative and non-degenerative dementia.

Degenerative dementia is caused by problems with the nervous system and the person's condition generally worsens over time. An example of degenerative dementia is Alzheimer's disease.

Non-degenerative dementia is caused by cardiovascular issues resulting in a lack of oxygen and/or blood to the brain, such as in the case of a stroke, which can lead to vascular dementia. The specifics of any individual’s dementia depends entirely on which part(s) of the brain is damaged.

What are the symptoms of dementia?

As mentioned above, the symptoms present in any case of dementia depend on which dementia is suffered. Dementia is a progressive illness, meaning any symptoms that are suffered will start off relatively minute and then become worse over time. A list of symptoms associated with dementia follows:

Lack of orientation - Sufferers often become confused about their location, or have difficulties recalling the time or date.

Language difficulties - Struggling to follow a conversation and frequently failing to recall the right word, are common problems for those with dementia.

Poor visuospatial skills - People with dementia often struggle to perceive objects correctly, such as with depth perception or misjudging distance on stairs.

Declining daily memory - A commonly known symptom of dementia, its victims often have difficulties recalling what has recently occurred.

Poor planning, concentrating, and organisational ability - Sufferers often have problems with following sequences, such as the steps required to cook a meal, and may take a long while to make decisions.

What causes dementia?

As already suggested, the causes of dementia point to damage to the brain, arising in degenerative or non-degenerative forms. However, within this, each specific sub-category of dementia has its own causes based on which part of the brain is damaged.

Alzheimer’s makes up 65% of all dementias, so is by far the most common kind. It is degenerative dementia that is caused due to atrophy (shrinking) of the cerebral cortex. Changes in the hippocampus, such as the increases in amyloid plaques, cause damage to brain cells, which results in an inability for neurons to communicate with each other, leading to the symptoms of Alzheimer’s.

Vascular dementia is a type of non-degenerative dementia caused by a single, strong stroke, or a series of smaller strokes. Thinning of the blood vessels in the brain, caused by the strokes, leads to a lack of oxygen reaching the brain, bringing about the death of brain cells. A related type of dementia is known as subcortical vascular dementia, which occurs when a disease disrupts blood flow to the deep regions of the brain.

Mixed dementia occurs when one suffers from multiple kinds of dementia, the most common combination of which is Alzheimer’s and vascular dementia.

What is dementia with Lewy Bodies?

Dementia with Lewy Bodies is a type of dementia caused by the development of Lewy Bodies inside the brain’s neurons. These bodies disrupt the balance of the cells, altering their chemical makeup and leading to their eventual deaths. This type of dementia is often associated with Parkinson’s disease since it disrupts the motor cortex and also features hallucinations.

Frontotemporal dementia occurs when the frontal and temporal lobes of the brain are affected by dementia. Clumps of proteins begin to build up inside the neurons in these brain regions, which lead to their eventual deaths. As the frontal lobe is the part of the brain associated with higher cognitive processes, there are often changes in behaviour or personality with this type of dementia. Likewise, if the damage in the temporal lobe includes damage to the Broca’s area, then there will also be difficulties with language production.

There are rarer causes of dementia, too, such as HIV infections and Creutzfeldt-Jakob disease, but altogether these make up only 5% of diseases. A more common example is Parkinson’s disease, where there is a loss of cells within the basal ganglia in the brain. Since this is brain damage, it can result in dementia as the condition progresses.

There is also a genetic factor involved with the illness. Whilst it doesn’t directly cause dementia, the ApoE4 gene is inherited from our parents, and the more copies of it there are, the higher the chance of developing dementia. For example, 6% of over-75-year-olds with no copies of ApoE4 will suffer dementia, whereas 11% and 18% of over-75s with one or two copies of the gene, respectively, will suffer dementia. That said, only 2% of people inherit two copies of the gene, and most research suggests it is epigenetic - that is, the expression of the gene is affected by the environment, i.e lifestyle choices.

Dementia-related training

At Flexebee, we offer a number of courses relating to dementia and Alzheimer's. To learn more about dementia, try our Dementia Awareness course. Also, our Specialist Care training page offers more care-specialist online courses, including modules on Stroke Awareness and Epilepsy Awareness.