An Overview of Dementia and Aging

Myths, Realities, Symptoms, and Questions – An Overview of Dementia and Aging

By DEBORAH S. ALLEN, BS, MSW, CDP

It is important to understand the definitions of dementia and aging and to explore their connections.

Dementia is irreversible brain failure/brain death.

Aging is the process of becoming older. It is the sequential or progressive change in an actual organism that leads to an increased risk of debility, disease, and death.

Below are some common myths and realities regarding dementia and aging.

Myth 1: Only Alzheimer’s causes dementia.

Reality: Dementia is caused by over 80 different illnesses and conditions, including, but not limited to: Alzheimer’s disease, Parkinson’s disease, strokes, severe brain damage, and mixed dementias. (Alzheimer’s disease is the most common cause of dementia, accounting for 60% to 80% of cases.)

Myth 2: Extreme memory loss is a natural part of aging.

Reality: As people age, it’s normal to have occasional memory problems (“senior moments”). Because older individuals have many, many years of memories, memory retrieval may take longer.

Usually, older adults will work on remembering names and experiences they have temporarily forgotten. Someone with dementia-related memory loss usually doesn’t try to retrieve memories. Their memory loss is more obvious and frequent.

Myth 3: Only older people get dementia.

Reality: Dementia can affect people in their 20s, 30s, 40s, or even 50s. However, dementia-related illnesses are more common in older adults.

Myth 4: Dementia is not fatal.

Reality: Dementia has no survivors. It destroys brain cells. Eventually this leads to the loss of key body functions and death.

Myth 5: There are vaccines or treatments available to cure dementia.

Reality: Current available medications do not cure dementia. These medications may assist with treating some of the symptoms. Extensive research and testing are focused on finding a viable cure for dementia and are ongoing.

Myth 6: Persons with dementia have minimal interest in intimacy.

Reality: When the mind, behavior, and physical abilities are altered by dementia and age, the need for companionship, affection/ intimacy, and sexual desire may exist well after other capacities have declined.

There are multiple symptoms of dementia:

Memory Loss – Memory loss tends to be the symptom most commonly associated with dementia. It can be pervasive and, with disease progression, the loss of memories shortens. For example, an individual with dementia can ask a question and forget the response a few moments later.

Memory loss works in a backward progression. Recent memories fade more quickly, but past, long-term memories can be retained for longer time periods.

Repetition – Someone with dementia may constantly repeat stories and questions.

Loss of interest/focus – Persons with dementia may have a shorter attention span. Focusing on a lengthy, more complex book or program may be impossible.

Poor judgment –All individuals have instances where their judgment may not have been the best. For individuals with dementia, poor judgment is often more extreme. For example, leaving an indoor location in the middle of winter without a coat or footwear or wandering away from home without a known destination show extremely poor judgment.

Falling – Falls may occur because of altered senses of balance and spatial awareness that can occur with dementia.

Inability to complete simple tasks – Those with dementia may develop the inability to effectively complete ADLs (activities of daily living, such as bathing, dressing, eating) without assistance.

Communication – Persons with dementia have difficulties with word finding. This inability to communicate may result in further shutting down verbal communication. They appear to be withdrawn. They may reach the point where they cannot verbally express their needs/wants.

The field of dementia-related illness/conditions raises numerous questions and concerns. Some key questions are:

What is Mild Cognitive Impairment (MCI)?

MCI is memory loss that is more pronounced than typical age-related forgetfulness, but it has not progressed to a level considered to be dementia. The Alzheimer’s Association indicates that 12% to 18% of persons older than age 60 are living with MCI. Every year it is estimated that 10% to 15% of these individuals will develop full-blown dementia.

What are risk factors for MCI?

Risk factors include: diabetes, inadequate sleep, smoking, high blood pressure, high LDL cholesterol, obesity, depression, and inactivity.

How can MCI be prevented?

Strategies include: good nutrition, better sleep habits, ongoing learning, exercise, improved stress responses, and regular socialization. Following these suggestions may help to prevent the development of full-blown dementia.

When is the best time to seek professional help?

“As early as possible” is the best answer. Obtaining evaluations from an organization that includes multiple disciplines — geriatricians, psychiatrists, neurologists, psychologists, and social workers — helps get a thorough picture of what may be occurring.

These results help provide a baseline for future comparisons. In addition, these evaluations may recommend medications, treatments, and activities that could provide optimum results in the future.

What is the relationship of behavior and communication?

Behavior = communication. With a decline in verbal skills and physical abilities, nonverbal communication may emerge as the primary method of communication.

Individuals with dementia may experience many unmet needs: physical, social, and emotional. For individuals with dementia, pay attention to their actions, gestures, facial expressions, aggressiveness — their behaviors. For example, if a nonverbal individual begins pacing and starts to remove his/her clothing, this may be communicating the need to use the bathroom.

Other behavior-related communications:

Wandering = Boredom, feeling lost Calling out = Loneliness Anxiousness = Fear of the unknown Grabbing = Fear of pain Agitation = Overstimulation Withdrawn = Understimulation

It is important to remember that all behavior has meaning.

How can caregivers effectively communicate and engage with persons with dementia? Some suggestions:

• Do not correct; instead, redirect

• Use gestures • Be positive; do not judge • Listen and note voice tone and behaviors

• Learn about the person: their interest areas, profession, family, etc. • Use music to help engage the individual • Maintain good eye contact; keep facial expressions pleasant • Give compliments and praise

• Always remember: relate as one adult to another adult • Continue to explore other resources

Treat everyone with dignity and respect!

Deborah Allen is the executive director at PennCares Support Services, serving south-central Pennsylvania. PennCares is a communitybased nonprofit organization that provides children’s early intervention services; employment services (PennWorks); inhome, nonmedical care services for individuals who are elderly and people with physical and intellectual disabilities; as well as professional, educational trainings for caregivers and professionals. Please check website for upcoming webinars at penncares.org.

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