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Research Paper with at least 10 References.

The paper must be a professional scholarly paper about your topic and follow APA style. Each student will compile all of the Essays from the previous weeks and add to the research by ensuring the research paper is at least 50 pages. The student should also be aware that a minimum of 10 References must be included in the 50 pages.  The topic is Depression in the Elderly..

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Depression in Older Adults
Florida National University
Professor Mireidy Fernandez
Adaimi Mojena
Capstone
07/10/2022
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Depression in Older Adults
Introduction
Because of its devastating and severe consequences, late-life depression has become a
vital public health issue. It is directly associated with factors such as increased suicide risk,
decreased physical and cognitive functioning, self-regret and social functioning impairments, all
of which are associated with increased mortality rates. Contrary to people’s perceptions,
however, major depression is less frequent a problem among older adults, exacerbated by other
factors such as pre-existing medical conditions, which will be discussed later on in this paper. It
is essential to understand that depression in older adults differs in both obvious and subtle ways
from depression in younger adults (Cahoon, 2012). This increases its complexity, necessitating
research and analysis to identify how older adults suffering from this condition can be helped.
Knowledge of the way age affects the concept of depression is necessary for the development of
treatments that are both effective and suited to the needs of older adults. In this paper,
depression in older adults will be discussed. Different factors pertaining to the topic will be
analyzed, with special focus being given to the factors that influence its development and the
available treatment options.
Body
Depression in older adults is commonly referred to as a geriatric depression. Geriatric
depression is both an emotional and mental health disorder that affects a significant number of
older adults. In the United States alone, the Centers for Disease Control and Prevention (CDC)
estimate that approximately 7 million Americans over the age of sixty-five experience depression
each year. It is manifested by feelings of sadness and the occasional blue moods that alter the
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behaviour and actions of this population. One important factor to understand is that older adults
are more likely to suffer from sub-syndromal depression. Subsyndromal depression is
characterized as a type of depression that does not meet the full criteria for major depression.
However, if left untreated, it can quickly lead to major depression, further imposing on the
overall health and wellness of these individuals.
The question of what influences the development of depression in older adults is most
often raised by late-onset depression. When it comes to depression in older adults, there are two
types, including early-onset depression and late-onset depression. In early-onset depression, the
older adult is said to have experienced depression while young, which in this case, influences
their susceptibility to depression (Kok & Reynolds, 2017). When it comes to late-onset
depression, the depressive symptoms manifest for the first time when the individual is above the
age of sixty-five. To answer this question and provide factors that influence the development of
depression in older adults, most scholars are currently focusing on the structural changes in the
brain. Through their research, it has been ascertained that older adults with late onset depression
are more susceptible to vascular risk factors including a history of a cerebrovascular condition
Although this conclusion has been majorly critiqued, it sets the foundation for the discovery and
establishment of factors that influence the development of late-onset depression in older adults.
Researchers have directly drawn a correlation between late-onset depression and concomitant
cognitive deficits and dementia. Many studies, but not all, have established that concomitant
cognitive deficits can be directly associated with late-onset depression in older adults, especially
in the context of executive functioning. White matter hyperintensities from neurological
findings are reported to be more common in late-onset depression while less common in early-
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onset depression. One important factor to understand is that these parts are strongly involved
with mood regulation and therefore influence the manifestation of symptoms such as sadness.
It is necessary to understand that depression in older adults results from a large number of
factors, including social, psychological, spiritual and personality-wise. Biologically, depression
in older adults is associated with factors such as cardiovascular disease, hip fractures,
Parkinson’s disease and dementia. According to research, 20% of all patients diagnosed with
Parkinson’s disease meet the criteria for major late-onset depression, while 21% of these patients
meet the criteria for minor depression (Wilkinson et al., 2018). Depression is also directly
associated with pain in institutionalized elderly patients and is also largely common among
homebound elders with urinary incontinence. Healthcare providers establish that both major
depression and alcohol depression increase susceptibility for the development of another disorder
at a one-year follow-up.
Psychologically, depression in older adults is directly associated with cognitive,
psychodynamic and behavioural aberrations. To understand how these factors relate, it is
necessary to draw from research and theories that have been developed over time in an attempt
of understanding the behaviours and actions of people. For instance, the behaviour of learned
helplessness, first used to describe the increasingly passive behaviours of dogs, has been
expanded to analyze depressive symptoms throughout the life cycle. It suggests that the causes
of depression can be directly associated with initiating actions in a continually stressful
environment that essentially makes them futile and void. This direct association of depression
with negative and bad consequences could be interpreted in response to continued adverse
stressors. For example, researchers have argued that childhood abuse increases the susceptibility
to late-onset depression. In this case, children who have experienced emotional and physical
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abuse are more likely to develop depression at older ages. It is necessary to understand that
psychologically, depression is analyzed from the adverse negative effects it inflicts on the
cognitive and emotional range. While these symptoms may manifest when the child is also
young, they become more common in old age, especially in the context of an environment that is
full of turmoil or isolation.
Researchers have also established that social factors play a significant role in influencing
depression in older adults. In a community study, impaired social support was directly
associated with depression with factors such as the social contact frequency, the network
composition, the network size and the levels of emotional support being analyzed. Drawing
from the results obtained from this study, it can be argued that social factors play a critical role in
influencing the development of depression in older adults (Fiske et al., 2009). For example,
older individuals that experience no emotional or physical support are most likely to be
depressed, feeling isolated and lonely. Nursing homes have recorded high rates of depressed
older adults, with isolation from family and friends leading to feelings of sadness and
worthlessness. In understanding how social factors influence the development of depression in
older adults, it is also necessary to consider the factors of race, gender and income. According to
research, minority communities are more likely to experience depression both at a young and old
age. This can be directly associated with factors such as discrimination and prejudice, leading to
the destruction of the self-identity of these populations and imposing on their self-image
negatively. Gender-wise, the results are somewhat skewed, with different factors affecting how
both genders experience and perceive depression.
One important factor to understand is that depression, even severe depression, can be
treated. As a result, it is often advised that individuals close to older adults experiencing this
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condition should ensure that they seek treatment as possible to increase their chances and
likelihood of recovery. When diagnosing depression, healthcare providers are advised to be
increasingly careful as these symptoms can sometimes mimic the symptoms of other conditions.
This can, however, be ruled out through a physical examination. If it is ascertained that there is
no medical condition inherent, the healthcare provider may suggest a psychological evaluation,
referring the individual to mental health professionals such as psychologists. It can be argued
that treating depression necessitates holistic and patient-centred care. In this case, collaboration
and cooperation between different healthcare professionals is necessary, each recommending
treatments that can prove effective in these cases. Common types of treatments include:
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Psychotherapy, talk therapy and counselling- Psychotherapy involves talking with
a psychiatrist or psychologist, in which the client is provided with an opportunity
to talk about their troubling thoughts, emotions and behaviour. To treat
depression, psychotherapy can prove effective, providing this population with an
opportunity of expressing themselves, their emotions and thoughts.
•
Anti-depressants (Medications for depression)- When it comes to treating
depression in older adults, hormonal medicines that affect mood, such as
serotonin, may also be prescribed. It is necessary to understand that depending on
the depressive symptoms exhibited, different types of anti-depressants may be
prescribed.
•
Electroconvulsive Therapy (ECT)- This type of treatment involves placing
electrodes on an individual’s head to enable mild and safe electric currents to pass
through and reach the brain. It is often recommended when one has not shown
any signs of improvement from previous treatments.
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Repetitive transcranial magnetic stimulation- This treatment involves the use of
magnets to activate the brain. It is considered safe with doctors often given the
go-ahead to operate even without the use of an anesthesia. One important factor to
understand is that it targets specific parts of the brain, aiding in the reduction of
common side effects including fatigue, memory loss and nausea.
Conclusion
Late-life depression affects approximately six million Americans aged sixty-five and older.
However, only 10% of this number gets treatment, with the complexity of identifying depressive
signs and symptoms increasing with age. With the negative and adverse effects associated with
depression, it is necessary to identify practical and effective metrics that can be used to identify
depression in older adults.
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References
Cahoon, C. G. (2012). Depression in older adults. AJN The American Journal of
Nursing, 112(11), 22-30.
https://journals.lww.com/ajnonline/Abstract/2012/11000/Depression_in_Older_Adults.21.aspx
Fiske, A., Wetherell, J. L., & Gatz, M. (2009). Depression in older adults. Annual review of
clinical psychology, 5, 363.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852580/
Kok, R. M., & Reynolds, C. F. (2017). Management of depression in older adults: a
review. Jama, 317(20), 2114-2122.
https://jamanetwork.com/journals/jama/article-abstract/2627976
Wilkinson, P., Ruane, C., & Tempest, K. (2018). Depression in older adults. bmj, 363.
https://www.bmj.com/content/363/bmj.k4922
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Depression in Older Adults
Adaimi Mojena
Florida National University
Capstone
Professor Mireidy Fernandez
07/24/2022
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Introduction
As age progresses, individuals several changes such as stressful life events, retirement,
death of loved ones, or medical problems. These transitions aggregate to situations where one
feels uneasy. However, this feeling dissolves after some time, and older adults feel well again
when they adjust to the situation. Due to this reason, there is a misconception that depression is
normal and inevitable as one grows old. When older persons portray specific depressive
symptoms such as fatigue, anorexia, and insomnia, they perceive these conditions as normal
aging aspects and regard them as acceptable responses to life stress. According to a 2017 report,
the prevalence of depression in the globe reached 28.3% rate in older adults, with WHO
projecting that the figure of older adults will increase to over 1.3 billion by 2030 (Padayachey et
al., 2017). This sentiment means that depression in older adults is a fundamental health concern.
A better understanding of depression in older adults would improve their quality of life from a
public health and clinical perspective. The paper thus highlights the types of depression
experienced by older adults, risk factors, signs and symptoms of depression, treatment, and
social responsibility to ensure the issue is clarified.
Types of Depression
Studies indicate that depression in older adults can take several forms. The most common
forms of depression include substance-induced depressive disorder, major depressive disorder,
and persistent depressive disorder. Major depressive disorder (MDD) interferes with an
individual’s ability to perform daily tasks, and its symptoms last at least half a month. These
symptoms disrupt an individual’s life since the ability to eat, concentrate, work, and sleep are all
affected. MDD affects over 300 million individuals around the globe; thus, it is a
multidimensional disorder that is chronic and disabling in society (Zuckerman et al., 2018). A
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common symptom that can be used to identify MDD is cognitive dysfunction. When an
individual has MDD, the learning, executive function, concentration, attention, and processing
speed domains are impaired, thus leading to poor psychosocial outcomes. Since MDD affects the
mood and core domains associated with quality life, individuals with MDD have reduced
workplace productivity and functionality.
Persistent Depressive Disorder is also called Dysthymia. PDD is very different from
MDD. While individuals with MDD fail to perform their daily tasks, those with PDD can still
perform these tasks. PDD is a mild depression where individuals have a dark mood that may last
for two years or more. Clinical and epidemiological evidence suggests that individuals with PDD
have stressors such as bereavement and loss of social support. While there is no empirical
evidence of what causes PDD, scientists relate the disorder to low serotonin levels. Serotonin is a
natural hormone that influences other body functions. The hormone controls the feelings of wellbeing and emotions among individuals. Dysthymic disorder in older adults aggregates disability
which leads to poor medical outcomes. As a result, elderly patients remain in primary care where
the PDD identification and treatment are inadequate. Medical experts require collaborative care
and treatment to ensure PDD is optimally treated.
Substance-induced depressive disorder is associated with substance use such as alcohol,
medications, or drugs. Unlike transient moods of sadness that every individual experiences and
resume well-being, when substance-induced depressive disorder progresses, individuals feel
considerably worse for longer periods. It entails the complete loss of enjoyment or interest in life
for some individuals. The substance-induced depressive disorder begins at the onset of
intoxication. This sentiment means that whenever the person is high on the drug, a depressive
episode commences. Depression after taking a drug can also be induced at the withdrawal stage.
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The irony behind this form of depression is that elderly adults take drugs to feel better without
knowing that the same drugs yield worse feelings. For instance, elderly adults associate alcohol
with positive emotions without understanding that the drug plays a part in their present feeling,
which involves losing interest in life. After retirement, elderly adults may find themselves caught
up in substance abuse to fight loneliness. However, this only intensifies the situation and leads to
depression.
Risk Factors
In clinical practice, a risk factor amplifies the chance of developing an ailment. In this
regard, depression in older adults comprises several risk factors. However, it is important to
understand that these factors do not necessarily cause depression. Common risk factors include:
•
Medical conditions such as Cancer
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Loneliness and social isolation
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Lack of physical activity
•
Sleep problems
Out of these risk factors, social isolation proves to be a significant threat. When elderly
adults complete the parenting process, they are left at home with little activities to perform,
affecting their mental status. In addition, those that retire and come back to their families have
difficulty adjusting to the environment since they are used to a vibrant workplace where they
relate with colleagues. Taylor et al. (2018) regard social isolation as related to depressive
symptoms. Therefore, extended family members and friends are a unique ground for combating
psychological distress and depressive symptoms in older adults.
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Signs and Symptoms
Depression in older adults manifests in different ways. Since the elderly population has
underlying illnesses, depression symptoms are also symptomatic, and this complicates the
recognition of depression. Common symptoms that older people may present include:
•
Reduced attention and concentration
•
Decreased energy or fatigue
•
Difficulty in sleeping
•
Loss of interest in activities they used to enjoy, including sex
•
Suicidal thoughts or suicidal attempts
Essentially, people experience depression differently. As a result, other symptoms may be
excluded from the list. In 2019, the National Institute of Mental Health in the U.S indicated that
suicide was among the top ten causes of death. A study performed in 2018 to examine the risk
factors in older adults indicates that suicidal rates in the U.S increased among older white men
and have a rate of 47 per 100,000 (Conejero et al., 2018). Suicidal behavior is thus common in
older adults for many reasons. The top reason is loneliness. Many elders live alone and
are housebound. If their partner has recently died and there are no family or friends nearby, they
may be lacking in the social ties they require to thrive. Secondly, chronic illnesses also
precipitate suicidal thoughts. Seniors are more likely to suffer from long-term illnesses like high
blood pressure, CVD, diabetes, and arthritis. These disorders can cause discomfort and
movement difficulties, lowering one’s quality of life. Seniors may also have visual and hearing
loss, making it more difficult to accomplish the things they enjoy. Together, these illnesses lead
to feelings of hopelessness. As a result, suicidal thoughts are common in seniors and can be used
to recognize depression.
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Treatment
Counseling and medication are the two most common methods that benefit depressed
persons. Depression symptoms are reduced through medication prescribed by a psychiatrist or
physician in charge of the patient. Nonetheless, psychiatrist or psychologist visits largely benefit
a huge number of depressed individuals. These forms of treatment are highlighted below.
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Medications- The psychiatrist or healthcare practitioner prescribes various
antidepressants that regulate hormones that affect moods and emotions. Selective
serotonin reuptake inhibitors (SSRIs) regulate serotonin levels in the older person’s body.
They are considered safer than other antidepressants since they have fewer side effects.
However, if SSRIs are used without improvement, Tricyclic antidepressants can be
prescribed. These antidepressants are very effective but tend to bring severe side effects
to the patient. Doctors may also combine two antidepressants to improve their effects.
Mood stabilizers can also be offered as an additional medication.
•
Psychotherapy or talk therapy- This refers to the process in which psychological and
verbal techniques are used to treat mental distress and psychological disorders. During
the process, the psychiatrist assists the client in tackling the source of stress and other
general or specific problems. Talk therapy develops a therapeutic relationship where a
dialogue is created to ensure clients communicate their problematic emotions, behavior,
and thoughts. Munder et al. (2019) dictate that psychotherapy is more effective for adults
with depression.
Social Responsibility
Despite the need for treatment, older adults require support from their friends and family.
In the coming years, the number of adults aged 65 years and above will increase. As a sensitive
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group to social isolation, the population will require care since they have arrived at a stage in life
where health detriment and bereavement are common experiences (Malcolm et al., 2019).
Therefore, friends and family members need to provide company to such individuals by
increasing their frequency of contact. As indicated earlier, social isolation and loneliness
cultivate suicidal ideation. Therefore, families and friends should encourage depressed adults to
seek medication and stick to treatment plans created by their healthcare providers. Likewise, they
can also engage the persons in activities they love to increase physical activity.
Conclusion
Depression in older adults is not a normal thing as most people perceive. Older persons
with specific depressive symptoms such as fatigue, anorexia, and insomnia should seek medical
attention. Healthcare practitioners will diagnose to determine whether the affected persons suffer
from depression. Even though most symptoms are hard to recognize due to underlying physical
illnesses, older adults should visit healthcare providers for further examination. Patients
diagnosed with depression require support from their friends and families. This support creates a
positive relationship with the patient to help them combat suicidal thoughts brought by
loneliness.
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References
Conejero, I., Olié, E., Courtet, P., & Calati, R. (2018). Suicide in older adults: current
perspectives. Clinical interventions in aging, 13, 691.
Malcolm, M., Frost, H., & Cowie, J. (2019). Loneliness and social isolation causal association
with health-related lifestyle risk in older adults: a systematic review and meta-analysis
protocol. Systematic reviews, 8(1), 1-8.
Munder, T., Flückiger, C., Leichsenring, F., Abbass, A. A., Hilsenroth, M. J., Luyten, P., … &
Wampold, B. E. (2019). Is psychotherapy effective? A re-analysis of treatments for
depression. Epidemiology and Psychiatric Sciences, 28(3), 268-274.
Padayachey, U., Ramlall, S., & Chipps, J. (2017). Depression in older adults: prevalence and risk
factors in a primary health care sample. South African family practice, 59(2), 61-66.
Taylor, H. O., Taylor, R. J., Nguyen, A. W., & Chatters, L. (2018). Social isolation, depression,
and psychological distress among older adults. Journal of aging and health, 30(2), 229246.
Zuckerman, H., Pan, Z., Park, C., Brietzke, E., Musial, N., Shariq, A. S., … & McIntyre, R. S.
(2018). Recognition and treatment of cognitive dysfunction in major depressive
disorder. Frontiers in psychiatry, 9, 655.
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Depression in Older Adults
Adaimi Mojena
Florida National University
Capstone
Professor Mireidy Fernandez
08/01/2022
2
Introduction
Late-life depression (LLD) affects older adults in society that are above 60 years
(Blackburn et al., 2017). These individuals have underlying medical conditions which make it
challenging to notice LLD. In addition, most people perceive that as one age, stressful factors
such as retirement and death of loved ones, and bereavement affect an individual’s life, especially
in old age. As a result, there is a misconception that depression is inevitable as one age. This
belief has led to severe depressive symptoms such as insomnia and fatigue being ignored. In case
an older adult portrays these traits, there is a need for physical examination.
Background
Depression is a common mental disorder among elderly individuals. Due to greater rates
of illness prevalence, disease recurrence, and diversity of symptom manifestations, the aged need
specialized treatment. This indicates that understanding grief in the elderly requires a psychiatric
and a social perspective. Accepting dependence, shifting roles, and preparing for death are
symptoms and themes that represent the social, physical, and emotional losses associated with
aging in senior persons (Mener et al., 2013). A thorough treatment plan must include care for the
patient’s physical, social, and emotional wellness. This study explores older adults’ psychological
and psychosocial responses to depression to determine how sensitive they are to the difficulties
of aging and how successful they are as a prophylactic measure to reduce depression
susceptibility. In contrast to affective symptoms, somatic symptoms, cognitive impairments, and
a lack of interest are more prevalent in older depressed individuals than in younger depressed
individuals. Possible risk factors for developing late-life depression include cognitive diathesis,
age-related neurobiological changes, genetic vulnerabilities, and stressful life events.
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According to a study, depression symptoms may manifest in several ways among seniors.
The three most prevalent forms of depression in the general population are substance-induced
major depressive disorder, depressive disorder, and persistent depressive disorder. The
symptoms of major depressive disorder (MDD) persist for at least one month and make it
difficult to perform daily tasks. These symptoms impede a person’s ability to live a regular life
by making it difficult for them to eat, focus, work, and sleep. As a result, lack of sleep is an
unrecognized risk factor for depression in later life. It has also been suggested that reducing
everyday activities may be a frequent way for older individuals to develop depression, regardless
of whether other risk factors are more significant. The loop of self-criticism that commonly
accompanies depression may aggravate and prolong the condition. Increases in psychological
resilience associated with age mitigate the frequent rise of certain risk factors.
Additionally, a higher socioeconomic status, active engagement in beneficial activities,
and a strong religious or spiritual commitment are protective variables. Underutilized therapies
for older adults include behavioral therapy, cognitive behavioral therapy, cognitive
bibliotherapy, problem-solving therapy, short-term psychodynamic therapy, and life review or
memory therapy. In addition, monies have been set aside to promote preventative activities, such
as group support, life reviews, cognitive restructuring, behavioral activation, and education, for
people with chronic conditions.
History
It is unknown which brain chemistry and function alterations contribute to late-life
depression. It is commonly known that stress caused by specific life events, such as illness,
childbirth, the loss of a loved one, life transitions (such as retirement), interpersonal disputes, and
social isolation, affects the brain (Iaboni & Flint, 2013). The events of a person’s life and how
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they are perceived and handled may raise their likelihood of experiencing depression as an adult.
Medical issues, the death of a daughter, son, or another close relative, handicap, dwindling social
support, trauma, and grief are the most major life events that put older individuals at risk for
depression and alter how they react to treatment. Moreover, these life experiences may reduce a
senior’s desire to undergo treatment. This raises the notion that older individuals’ grieving may
result from a cascade of circumstances, including those listed above and others. The results of
the research also imply that risk factors such as psychodynamic, behavioral, and gloomy
interpretations of life’s events may significantly influence the development of depression in
adulthood.
Populations afflicted
Most senior citizens belong to one or more risk categories for depressive illnesses.
However, there are further subgroups of the elderly who experience late-life depression and these
include.
Black older adults
Due to geographical disparities, older African Americans frequently experience emotions
of powerlessness, isolation, and loneliness (Taylor et al., 2018). Compared to older African
Americans residing in other regions of the nation, individuals in the South had a decreased
chance of acquiring any form of late-life or lifetime drug use problem and any total lifetime
disorder. It is essential to note that loneliness and a sense of social isolation are significant risk
factors for mental health issues and depression in older Africans.
Aged low-income earners and the minority groups
People will feel helpless and depressed, particularly if they watch their loved ones or
other members of their race being subjected to discrimination. It is essential to recognize that
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racial and ethnic prejudice raises the risk of depression in old age among certain races. Research
shows that Hispanics have a higher probability than whites of having depressive disorders later
in life, especially among races in which the bulk of low-income individuals are black.
Aged women
Depression is also strongly impacted by an individual’s gender. Data obtained in the great
majority of the world’s nations were used to compile the results of several studies that studied
how gender affects the occurrence of depression in later life. According to the data, older women
are more likely to suffer from late-life depression than older males of the same age. An extensive
study has been conducted on the indications of late-life depression in both men and women, in
various cultural situations, and in the same way. According to some estimates, approximately
twice as many women as men are diagnosed with late-life depression.
Older GLBT group members
Other studies have sought to demonstrate a connection between a person’s sexual
orientation and the likelihood of developing depression in adulthood. Even if older adults are
more likely to have poor sexual performance, research indicates that a person’s sexual orientation
significantly influences how much pain they experience. Moreover, despite the lack of research
in this area, the elderly are substantially more likely to identify as lesbians than any other age
group. It is illogical to expect homosexuals and lesbians to move from homosexuality to
heterosexuality as they mature. Lesbians of the same age have larger degrees of sadness than
their heterosexual counterparts.
Lesbians and gays confront the same lack of empathy, especially within the healthcare
business. These care providers do not acknowledge lesbians and do not care that being gay or
lesbian is a lifestyle choice that should not be used to justify discrimination against anyone.
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Those who rely exclusively on others for food and medical care are particularly vulnerable.
Consequently, older heterosexuals have garnered the most advantages from the healthcare
systems of most nations, especially the United States.
Diagnosis
Diagnosis is a medical practice that recognizes a disease based on signs and
symptoms. With this in mind, it is essential to highlight some signs and symptoms of depression
in older adults. The signs and symptoms highlighted are common symptoms noted among older
adults. As a result, other individuals may portray different signs and symptoms from those stated
here. These signs and symptoms include:
•
Insomnia
•
Fatigue
•
Decreased concentration and attention
•
Suicidal attempts or Suicidal ideation
•
Loss of interest in pleasurable activities such as sex
Once the caregivers notice these symptoms, the following action is to consult a healthcare
provider. Healthcare providers must be consulted because depression may also reveal symptoms
similar to underlying medical conditions. Therefore, the healthcare providers are in the first line
of consultation because they can note symptoms of depression since they have been treating the
patient for a long time. If the healthcare provider finds out that there is no existing medical
condition, they may prefer a psychological assessment. Psychological evaluation involves
qualified mental health professionals like psychologists. Psychologists use tests and other
evaluation tools to observe and measure a client’s behavior to ensure they reach a diagnosis and
guide treatment.
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Psychological evaluation occurs in a private office, medical center, or mental health facility.
A complete and in-depth psychological evaluation may include several visits to the
psychologist’s office, where one session would take several hours. A common evaluation method
is clinical interviews. A clinical interview entails a conversation between the client and the
psychologist. The psychologist can observe the client’s behavior, thought process, and interaction
with others by speaking to them about their history and concerns. A psychological evaluation
may also entail interviewing individuals close to the client. The client’s medical history should
also be provided to the psychologist to determine if the disorder is hereditary. Psychologists use
information from clinical interviews and tests to determine a diagnosis, provide referrals or
develop a treatment plan for the client.
LLD is easily detected when mental health experts consider risk factors. Risk factors linked
with LLD include change of residence, recent bereavement, adverse life events such as financial
crisis and separation, problematic substance abuse, and physical disabling illnesses. Blackburn et
al. (2017) state that these risk factors and symptoms indicated earlier can be diagnosed using
tools such as the Cornell Scale for Depression in Dementia (CSDD) and the Geriatric Depression
Scale (GDS). The latter exists in long-form and short-form. Short-form GDSs are widely
preferred since they take a shorter time to fill. However, GDS is not practical for individuals with
high cognitive impairment. CSDD can thus be adopted since it entails interviewing the patient
with their caregiver to ensure depressive symptoms are recognized efficiently.
Treatment
LLD can be managed once it has been diagnosed. The two most common treatment methods
include psychotherapy and pharmacotherapy. Psychotherapy can be combined with medications
to improve LDD symptoms (Voineskos et al., 2020). There are several forms of psychotherapy
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used to treat LLD. They include problem-solving, cognitive behavioral therapy, and
interpersonal therapy (IPT).
•
Cognitive behavioral therapy (CBT) emphasizes training patients to be their therapists.
CBT trains the patients to recognize distortions that alter their mood and behavior and
work towards changing their problematic thinking and behavior.
•
Problem-solving therapy assists the patient in finding possible solutions to their problems
and ensures they implement these solutions to change their behavior and thinking
patterns.
•
IPT is a structured technique that focuses on interpersonal relationships. This is because
when LLD occurs within an interpersonal context, it affects people’s roles within those
relationships. IPT thus focuses on ensuring depressed individuals learn to stand alone and
improve their social adjustment.
Pharmacotherapy comprises medications that treat LLD. Antidepressants used to treat LLD
include Tricyclic antidepressants (TCAs) and Selective serotonin reuptake inhibitors (SSRIs).
SSRIs are well tolerated by older adults and control the serotonin hormone, which is responsible
for the change in one’s mood. Side effects of SSRIs include sexual dysfunction, constipation,
diarrhea, and nausea (Hirsch & Birnbaum, 2020). TCAs are recommended as the first-line agents
for treating LLD because of side effects like postural hypotension and cardiac conduction
abnormalities. As a result, they are prescribed if SSRIs are used without improvement.
Prognosis
In medical practice, prognosis refers to the practitioner’s opinion on a patient’s recovery.
Novick et al. (2017) indicate that patients are likely to recover if they adhere to treatment and
have fewer clinical depression symptoms and higher levels of education. In LLD prognosis, the
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course of depression is amplified depending on LLD’s development. Individuals with milder
LLD have high chances of recovery and require psychotherapy alone. However, medications can
be provided if needed. Moderate severity of LLD includes antidepressants as the recommended
course of action, while talk therapy can be added if required. Antidepressant treatment and
referral to mental health facilities are crucial in managing severe LLD. Severe LLD is
determined based on the reaction to antidepressants. An individual who encounters more than
two episodes of LLD and fails to tolerate antidepressants possesses severe LLD. Without
antidepressants, the chances of recovery are diminished. LLD prognosis is also determined based
on the presence of triggering factors. If a patient still precipitates suicidal ideation, increased
substance use, and other risk factors after a long treatment period, they are likely to live with the
disorder.
Conclusion
LLD is a considerable threat to global health. While individuals view the disorder as a usual
thing in old age, it is essential to consult a physician in case depressive symptoms are seen.
Physicians will diagnose the depression to determine the severity of the disorder. It is important
to remain honest during psychological evaluations to ensure accurate results are obtained. As
mental health experts seek antidepressants as a treatment option, it is essential to consider other
medical conditions within the patient. This is because specific agents have adverse side effects
that worsen existing medical conditions.
10
References
Blackburn, P., Wilkins-Ho, M., & Wiese, B. S. (2017). Depression in older adults: Diagnosis and
management. BC Med J, 59(3), 171-177.
Hirsch, M., & Birnbaum, R. J. (2020). Selective serotonin reuptake inhibitors: Pharmacology,
administration, and side effects. Waltham, MA: UpToDate.
Iaboni, A., & Flint, A. J. (2013). The complex interplay of depression and falls in older adults: a
clinical review. The American Journal of Geriatric Psychiatry, 21(5), 484-492.
Mener, D. J., Betz, J., Genther, D. J., Chen, D., & Lin, F. R. (2013). Hearing loss and depression
in older adults. Journal of the American Geriatrics Society, 61(9), 1627.
Novick, D., Montgomery, W., Vorstenbosch, E., Moneta, M. V., Dueñas, H., & Haro, J. M.
(2017). Recovery in patients with major depressive disorder (MDD): results of a 6-month
multinational, observational study. Patient preference and adherence, 11, 1859.
Taylor, H. O., Taylor, R. J., Nguyen, A. W., & Chatters, L. (2018). Social isolation, depression,
and psychological distress among older adults. Journal of aging and health, 30(2), 229246.
Voineskos, D., Daskalakis, Z. J., & Blumberger, D. M. (2020). Management of treatmentresistant depression: challenges and strategies. Neuropsychiatric disease and
treatment, 16, 221.
DEMENTIA
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Dementia
Student Name
Florida National University
Capstone
Dr. Mireidy Fernandez
October 17, 2021
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Dementia
Dementia is often considered to be a disease, but it is important to note that it is
not a specific disease but can be described as a general term for the impairment of the
mind and the person’s inability to think, remember, as well as make decisions properly.
Many people also tend to think that dementia is a part of normal aging but that is not so,
even though it mostly affects older adults who are over 65 years of age. When a person
suffers from dementia, it is something that is manifested as a set of related symptoms.
The thing to note is that these symptoms become appearing long after the brain has
already been damaged, which is why it can be difficult to treat it. The main symptoms
include progressive impairments to the thinking, memory, as well as behavior of the
person and this results in the person being negatively impacted with regards to his or her
functioning as well as to carry out daily routines and activities. Even though memory
issues as well as the disruption in the thought patterns of the person are the most common
symptoms, there are other symptoms that can manifest, such as the person having
emotional problems, not being able to speak and write easily, as well as the person losing
motivation to live and to do his or her daily chores, including lack of interest in hobbies
and things that the person used to enjoy.
Dementia can be caused by a number of different factors. For instance, it can be a
result of stroke, or a host of other kinds of diseases that tend to damage the brain.
Dementia can also be a result of some kind of injury to the brain. The most common form
of disease that is associated with dementia is Alzheimer’s disease, which is the cause of
dementia in about 60-80% of the dementia cases. Moreover, more than 95% of the
patients who have Alzheimer’s disease tend to have dementia. The Diagnostic and
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Statistical Manual of Mental Disorders Fifth Edition (DSM-5) describes dementia as a
major neurocognitive disorder that can have many different levels of severity as well as
causative subtypes. At the same time, the International Classification of Diseases (ICD10) depicts that dementia is an organically situated disorder that can manifest in both
mental as well as behavioral aspects of the patient and one that also has several subclassifications. It has also been noted that Causative subtypes of dementia that have been
confirmed to have a potential known cause dementia. This can include diseases like
Parkinson’s disease, Huntington’s disease, as well as HIV infection. At the same time,
mixed dementia can also occur in certain patients.
The history of the patient as well as cognitive testing that is done with imaging
can be done to conclusively diagnose dementia (Arvanitakis, Shah & Bennet, 2019). It is
important to note that there can be various other illnesses, such as an underactive thyroid,
can also cause dementia-like symptoms and this is something that can be ruled out by a
simple blood test. One of the cognitive tests that is administered for dementia incudes the
Mini-Mental State Examination, which works to find out the progress of the state of the
person’s mind. Many risk factors have been identified, including increasing age.
However, it is important to note that age alone does not contribute to dementia. Smoking,
obesity, as well as various other risk factors that are preventable are going to be discussed
later in this paper as well.
Dementia does not have a known cure. However, several medications, such as
acetylcholinesterase inhibitors, can be used to treat mild to moderate dementia.
Nevertheless, the quality of life of the patients can be greatly improved if the patient as
well as the caregivers can make various lifestyle changes. This can include various types
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of cognitive and behavioral interventions. It is extremely important to educate and
provide the necessary emotional support to the caregivers as well as the patients (Cheng,
2017). The patients can also benefit from various exercise and physical activity programs.
With regards to the epidemiology of the disease, it is depicted that as many as 50 million
people around the world have dementia. This is something that has increased quite a lot
over the past several years, as it was about 20.2 in 1990. The number of cases is said to
be increasing by around 10 million people annually. About 10% of the people in the
world develop dementia at some point in their lives, which is mostly a result of aging.
However, the most common age group for people who have dementia remains the elderly
over 75 years of age. Dementia has also been listed as one of the top ten causes of death
around the world. This is because of how people are living longer lives because of the
marvel of science and health care. It has become one of the most common forms of
disability in the older people. Nevertheless, it is extremely important to note that younger
people also get affected even though it is rare. This form of dementia is known as EarlyOnset Dementia (EOD) or Presenile Dementia.
History of Dementia
Dementia was a much broader concept until the end of the 19th century. The
physicians at the time included various types of mental illnesses as well as various other
incapacities of the psychosocial nature, which included several reversible conditions.
During this time, dementia was used for a person who had lost the ability to reason, and it
was depicted that it was mostly because of age as well as because of such illnesses as
syphilis. Yet, it is interesting to note that dementia is something that has been referred to
in various medical texts since antiquity. For instance, the 7th-century BC Greek
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philosopher Pythagoras alluded to dementia. Pythagoras described the human lifespan as
being made up of six distinct phases and the last two of them were ages 63-79 (old age)
as well as 80 onwards (advanced age). He described the last two stages as being the
“senium,” which means a period of mental and physical decay. He depicted that during
these stages, the individual becomes like an imbecile and his mind goes back to infancy
(Fymat, 2018). In a similar manner, Athenian statesman and poet Solon argued in 550 BC
that if a man lost his ability to judge properly because of advanced age then his will
cannot be validated. Interestingly enough, this condition was also mentioned in ancient
Chinese medical texts where a person with dementia was described as a foolish old
person.”
The famous philosophers Aristotle and Plato also wrote about mental decay as
being part of advanced age. They viewed it as an inevitable process that affected all old
men and that there was nothing that could be done to prevent that. According to Plato, the
elderly would not be able to have any position of responsibility because of how he
believed that the acumen that they had in their younger years was completely gone in that
they had lost their imagination, power of reasoning, as well as memory. Roman statesman
Cicero was able to gain better insights into the idea of dementia, as he depicted that the
loss of mental function was not something that was inevitable in all old people, as it
would only affect those that had weak wills. He talked about how people who were able
to remain mentally active and eager to learn new things would be able to stave off
dementia. These ideas, however, were largely ignored because of how most of the people
were following Aristotle’s medical writings. When the physicians of the Roman Empire,
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including Celsus and Galen, talked about medical aspects, they would repeat what
Aristotle had written earlier.
Dementia was also reported in Byzantine history, as at least seven emperors
whose lifespan exceeded 70 years of age displayed signs of cognitive decline.
Constantinople also recorded several hospitals that were specifically designed for those
that had been diagnosed with mental health decline, including dementia and insanity. Yet
even though this was the case, no mention of dementia exists in the Western medical
texts for the past 1,700 years. The first reference can be found in Roger Bacon – a 13thcentury friar – who depicted that old age was a divine punishment for the original sin. He
was also in the same boat as Aristotle, as he depicted that dementia was something
inevitable, but was able to make the assertion that it was not the heart that was the center
of memory and thought rather it was the brain. Several writers, poets, and playwrights
also mentioned loss of mental health with age. For example, William Shakespeare wrote
about it in his plays like Hamlet and King Lear (Sheehan, 2021).
By the 19th century, the doctors had started to come to an understanding that
dementia in the elderly was because of cerebral atherosclerosis. Even though this was the
case, the doctors continued to debate whether this was because of major arteries being
blocked and blood supply being throttled or because of smaller strokes that would occur
within the vessels of the cerebral cortex. Alzheimer’s disease was first described in 1907.
This was when researchers looked at the brain under a microscope and found some
microscopic changes that had been occurring. The researchers, however, continued to see
this is a very rare disease of middle age because the first person who was diagnosed with
it was a 50-year-old woman. Doctors continued to believe that this was the case until the
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1960s when it was determined that there was a link between age-related cognitive decline
as well as neurodegenerative diseases was established. The medical community was able
to confirm that vascular dementia was something that was quite rare and that it was
Alzheimer’s disease that caused most of the dementia cases in patients. Robert Katzman,
a neurologist, suggested in 1976 that a link exists between senile dementia and
Alzheimer’s disease, and it was depicted that senile dementia in patients that occur after
they are 65 is quite similar to Alzheimer’s disease in patients who were younger than 65.
This is how he was able to establish that Alzheimer’s disease was very common in people
over 65 and not as rare as previously believed (Rodgers, 2020).
Terminology of Dementia
The term dementia comes from dementia praecox, which means premature
dementia or precocious madness. This was a psychiatric diagnosis that has not become
antiquated. This was originally used to describe a chronic and deteriorating psychotic
disorder in which there was rapid cognitive disintegration, which began in the late teens
or early childhood. Dementia praecox was eventually removed from the vernacular, and it
was replaced by schizophrenia, which is still used as a diagnosis. The term dementia
praecox was first used in 1891 when Arnold Pick – a professor of psychiatry at Charles
University in Prague – described a person who had a psychotic disorder as something that
was similar to schizophrenia. In this regard, it was Emil Kraepelin – a German
psychiatrist – who popularized the term dementia praecox when he wrote a detailed
textbook describing a condition that was eventually known as schizophrenia (Kendler,
2018). The reason for that is that dementia praecox was depicted as having a disruption in
the cognitive as well as mental functioning and this was described to affect memory,
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attention, as well as goal-directed behavior. This was something that was compared with
manic depressive episodes, and it was concluded that this type of psychosis was quite
different from each other.
Main Reason
The main reason why I chose this topic is that my grandmother was diagnosed
with vascular dementia last year, and it has been extremely difficult for me and my
family to watch her condition decline over the past and recent years. Her diagnosis not
only has left her debilitated and affected her daily living skills but also has had a
devastating effect on our family emotionally. Therefore, I wanted to do my research on
dementia and learn more about it.
Impact of a Diagnosis
A diagnosis of dementia can have extremely negative impacts on the patient who
has been diagnosed as well as on the family and caregivers of the patient. The patient can
end up becoming depressed after hearing the diagnosis and this is something that can lead
to more mental health and emotional issues for the patient (Elahi & Miller, 2017). At the
same time, it must be noted that informal caregivers, such as the family members of the
patient, end up spending on an average about 5 hours a day caring for the patient. This is
something that can be quite overwhelming for the caregivers and can lead to a lot of
stress for them. It has been noted that almost half of the global cost of dementia is
attributed to informal care.
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How Life Changes
The life of the patient with dementia changes drastically. This is because it is a
progressive disorder that leads to complete loss of control over the body. Initially, the
patient can become quite depressed and can have a difficult time in processing what has
occurred. Other than that, it starts off with the patient not remembering minor things but
then it becomes so problematic that the patient is unable to complete normal and routine
tasks, such as eating and changing his or her clothes. This is something that can be quite
problematic especially if the person lives alone. The patient starts to get increasingly
dependent on the caregiver for such actions as eating and going to the bathroom, etc.
Types/Causes, Symptoms, Treatments, Stages
Dementia refers to a decline in a person’s cognitive functions. For the disorder to
be considered dementia, it is important that at least two brain functions are affected.
Dementia tends to affect the way a person speaks, his or her behaviors, memory, as well
as thinking and judgment. Dementia itself is not a disease and many different types of
illnesses, as well as injuries, can cause it. It can be mild to moderate to severe, with some
types of dementia being progressive.
Most of the cases of dementia occur because of an illness. The most common type
of dementia is Alzheimer’s disease, which makes up about 60 to 80 percent of the
dementia cases. Another type of dementia is vascular dementia that occurs because of
reduced blood flow in the brain. This can be because of a stroke or if there is plaque
buildup in the arteries that go to the brain (Hachinski et al., 2019). When protein gets
deposited in the nerve cells, it can prevent the brain from sending chemical signals, which
can lead to Lewy body dementia. Parkinson’s disease is another disease that can lead to
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dementia. People with such type of dementia can have problems with their reasoning as
well as judgment and can also have depression, paranoia, and irritability. Some people
can also have frontotemporal dementia, which can be because of changes that occur to
the front and side parts of the brain. This can also be because of injuries to the brain, such
as after a car accident.
The main cause of dementia has been noted to be damage or loss of nerve cells as
well as their connections that occur in the brain. Dementia affects people differently
based on the area of the brain that is damaged. This is something that can lead to different
symptoms as well. Other than that, the different types of dementia are often grouped with
what they have in common, such as whether they are caused by the protein or protein
deposits in the brain or the part of the brain that gets affected. There can be some other
diseases that might appear to look like dementia, but they are related to reactions to
medications or deficiencies of some kind. Such diseases can be reversed with treatment
(James & Bennett, 2019).
There are several types of progressive dementias, which include Alzheimer’s
disease, which is the most common cause of dementia. The causes for Alzheimer’s
disease are not all known, yet it is depicted that there are mutations of three genes that are
passed down to children from parents that cause a small percentage of Alzheimer’s cases.
Other than that, it is depicted that the reason why Alzheimer’s disease occurs is because
of plaques and tangles that exist in the brains of the patients. These tend to be made out
of a protein known as beta-amyloid. Other than that, tau proteins make up the fibrous
tangles. When these clumps occur, they result in a lot of damage to the healthy neurons
and fibers that connect them.
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Another type of progressive dementia is vascular dementia. This is when the
vessels that supply the blood to the brain are damaged, causing a lack of flow of blood to
the brain. This is where the fibers in the white matter of the brain are damaged, and they
can cause symptoms of dementia. More than memory-loss, patients of vascular dementia
tend to have issues with regards to not being able to solve problems as well as lack of
focus and organization. Lewy body dementia is another type of progressive dementia in
which large balloon-like clumps of protein is found in the brains of the people. This can
lead to visual hallucinations as well as the patients having problems with regards to their
sleep and focusing on tasks at hand. This is something that can also cause problems with
attention and focus.
Frontotemporal dementia is another type of dementia in which the nerve cells and
their connections tend to breakdown. These connections were supposedly for the frontal
as well as the temporal lobes of the brain. When this occurs, there tend to be various
changes in the person’s behaviors, as well as issues with language and personality.
Furthermore, people can also have mixed dementia, which is when they can have a
combination of Alzheimer’s, vascular dementia, as well as Lewy body dementia. This
can be because of various types of illnesses as well as because of some kind of injury or
another. There are also various disorders that are not dementia but are linked to dementia.
For example, Huntington’s disease, which is caused by a genetic mutation, has signs and
symptoms in which the person’s cognitive skills start to decline. Other than that, if a
person has traumatic brain injury, it can also lead to dementia. Some of the athletes, such
as football players and boxers, who repeatedly get concussions or head trauma, are at a
very high risk of this kind of dementia. The part of the brain that is injured is known to
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show what the signs and symptoms might be. Some people suffer from depression, while
others have impaired speech and loss of memory. Traumatic brain injuries can also cause
parkinsonism. It is unlikely that the signs and symptoms of the trauma appear
immediately, as it can take many years for them to occur.
Alzheimer’s Disease. This is the most common forms of dementia and as many
as 80% of the people who have dementia have Alzheimer’s disease. There are several
symptoms specific to Alzheimer’s, which include being confused about where the person
is; the person can also forget what day it is or what year it is; the patient can also have
problems with regards to reading, speaking, and writing; the patient normally loses things
and is unable to find them; the patient shows lack of judgment; patients can also
experience mood and personality changes (Mahendra, Hikey & Bourgeois, 2018). The
thing to note about this disease is that it is a neurodegenerative disease that starts slowly
and then worsens progressively. As noted earlier, it is the leading cause of dementia in
patients. If a person has Alzheimer’s disease, the early symptoms include not being able
to remember recent events. As the diseases progresses, symptoms can include the person
not being able to speak properly, being disoriented with regards to where the person is or
what he or she is doing, getting lost easily, having mood swings, not having enough
motivation, not being able to take care of his or her daily routine, forgetting to eat, as well
as having behavioral issues. The patients start to withdraw from their families and society
as the case progresses and this is something that can be quite problematic as well.
Patients usually live for three to nine years after being diagnosed because of how the
progression of the disease is different for everyone.
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Looking at the causes of the disease, it can be said that it is not exactly clear as to what
causes the illness. This is because several of the risks that have been identified include
genetic issues as well as environmental risks. The main genetic risk comes from the allele
of the gene APOE. There can be many other risk factors, such as the person having head
injury, clinical depression, as well as high blood pressure. The main reason for the
Alzheimer’s disease is depicted to be amyloid plaques as well as tau protein tangles.
There is no blood test that can be conducted to find out if a patient has Alzheimer’s
disease. This is why the diagnosis is made using history as well as cognitive testing.
Blood tests, however, are performed to rule out other possible causes that might be there.
The thing to note is that initial symptoms of the patients might be mistaken for normal
cognitive decline. The only way to confirm diagnosis is to examine the brain tissues but
this can only be done after death. People in the general population can take many actions
that they can use to help prevent and delay the onset of Alzheimer’s disease. These
include eating a healthy diet, as well as exercising regularly (Livingston et al., 2017). In
recent times, it has also been found that engaging socially with others can have good
benefits as well.
As noted earlier, there are no treatments to stop or reverse the progression of
Alzheimer’s disease. However, there are several medications and treatment options can be
used to help improve the symptoms. Those that have dementia with regards to
Alzheimer’s disease tend to require a lot of assistance, which is something that can be a
great burden on the caregiver. There can be several pressures that can be there with
respect to the patient and their diagnosis, which include social, psychological, physical,
as well as economic aspects. In this regard, it has been noted that an exercise program can
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be beneficial with respect to the activities of the person’s daily life. This is something that
can help to improve the outcomes as well. Some of the behavioral problems that might
occur because of dementia related to Alzheimer’s disease can be treated with
antipsychotics but this is not normally done nor is it recommended. This is because these
medications can cause early death.
Looking at the epidemiology of Alzheimer’s disease, it can be said that almost 30
million people in the world have Alzheimer’s disease and the total number of people with
dementia is 50 million. Alzheimer’s disease usually starts in older age, and it begins with
people who are over 65 years old. However, there can be some cases in which the onset
occurs earlier, such as between when the person is 30 and 60 years old. Alzheimer’s
disease tends to affect women more often than men. About 6% of the people who are 65
years old tend to be affected. With regards to the financial aspects of the disease, it can be
said that it is a significant financial burden with as much as $200 billions of annual costs
(Taylor et al., 2017).
Vascular Dementia. Vascular dementia is another type of dementia, and it is
usually caused by a stroke. This stroke can be one major stroke, or it can be a series of
smaller strokes that might be silent, meaning that the person does not feel any signs and
symptoms of the strokes. The symptoms of vascular dementia depend on the part of the
brain that gets affected. Vascular dementia’s initial symptoms include a person exhibiting
poor judgment, and they can also have trouble planning, organization skills, as well as
making their decisions. There can be various other symptoms, such as not being able to
speak and understanding words; they can also have memory problems that can cause
problems in their daily routines; they can also have issues recognizing sights and sounds
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that were familiar to them; vascular dementia can also cause a lot of confusion and
agitation in the person; it can also lead to change in the mood and personality of the
patient; it can also result in more instances of patient falls and can cause problems with
walking (Kalaria, 2018).
As noted earlier, vascular dementia occurs when the patient has issues with
regards to the supply of blood to the brain. The main reason for that is that the patient has
several mini strokes that tend to reduce the blood levels to the brain. This is something
that tend to worsen the cognitive abilities of the patient. The decline tends to occur on a
step-by-step pattern, as it progressively gets worse. The thing to note is that there can be a
complex interaction that occurs with regards to the cerebrovascular disease and risk
factors, and these can lead to various changes in the brain structures. This is mostly
because of strokes and lesions that occur in the brain, which in turn lead to changes in the
cognition (Kalaria, 2018). With regards to the signs and symptoms of vascular dementia,
it is important to note that it can be difficult to differentiate between the symptoms of
vascular dementia and Alzheimer’s disease.
Individuals who have vascular dementia can present with progressive cognitive
impairment and this is something that can be either acute or sub-acute. Patients who have
vascular dementia tend to have these aspects in terms of them occurring step by step and
this is mostly because of how they undergo several strokes. In some patients, there are
periods of improvement that occurs between the strokes but then they start to decline
after further strokes that they get. If the patient starts to deteriorate quicker, it can lead to
death because of a larger stroke, infection, or heart disease. It is interesting to note that
vascular dementia can be depicted as being both a behavioral disorder as well as a mental
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disorder as per the ICD-10. The signs and symptoms appear to be motor as well as
cognitive, and they can also translate into behavioral ones as well. The changes start to
occur over a period of 5-10 years. Even though the signs are similar to those with other
forms of dementia but the main way to discern vascular dementia is because of cognitive
decline and memory impairment. This has to be conducted with regards to a lot of
severity that tends to occur (Kalaria, 2018).
The causes of vascular dementia include ischemic or hemorrhaging infarcts that
tend to affect many different areas of the brain. Some of the affected areas include
anterior cerebral artery as well as the parietal lobes, as well as cingulate gyrus. In some of
the rarer cases, it has been noted that the thalamus or the hippocampus can also be
affected, and this is what causes the dementia. If a patient has a history of stroke or
strokes, it increases his or her risk of dementia by more than 70% (Kalaria, 2018). Other
than that, if the risk was recent, it can increase the risk by as much as 120% (Kalaria,
2018). The thing to note is that diffuse cerebrovascular diseases, such as small vessel
disease, can also result in brain vascular lesions, which results in vascular dementia.
There are several risk factors that have been identified for vascular dementia.
These include increasing age, smoking, hypertension, high cholesterol levels, diabetes
type 2, cerebrovascular diseases, as well as cardiovascular diseases. The patient’s
genetics, as well as geographic origins can also present some risk factors. In certain
patients, cerebral amyloid angiopathy can trigger vascular dementia. This is when the
beta amyloid plaques that reside in the walls of the cerebral arteries result in the
breakdown and rupture of the vessels. This is interesting because amyloid plaques are the
cause of Alzheimer’s disease and in this regard, vascular dementia can also affect those
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that have Alzheimer’s disease. Other than that, in some cases, this type of angiopathy can
also occur in those that have no history of previous dementia. Moreover, some
connections have also been found between celiac disease and vascular dementia
(Lebwohl et al., 2016).
With regards to the diagnosis of vascular dementia, it must be noted that the
DSM-5 as well as the ICD-10 both provide very specific diagnostic criteria that can be
used to diagnose it. When physicians suspect that vascular dementia might be present,
they can order several tests, which include blood tests to rule out other causes of
dementia (such as vitamin deficiency, infection, or other conditions), as well as chest Xray, ECG, and neuroimaging. In some cases, single photon emission computed
tomography (SPECT) is also used in case it is available. Positron emission tomography
(PET) neuroimaging can also be used to confirm the diagnosis of dementia that is
conducted alongside mental status examination to confirm the diagnosis. In this regard, it
is depicted that there is no single test that can be conducted, and the physicians require a
battery of different tests, as well as mental and cognitive evaluation to come to a proper
diagnosis of vascular dementia. As noted earlier, the signs and symptoms of vascular
dementia tend to overlap with those of Alzheimer’s disease and this is something that can
result in various difficulties in coming to a proper diagnosis (Kalaria, 2018).
There is no treatment for vascular dementia, which is why prevention is
something that is most of the physicians focus on. In this regard, it is extremely important
to have early detection of the illness and for there to be an accurate diagnosis as well.
This is because vascular dementia is partially preventable. If there are ischemic changes
in the brain, they can be reversed. The thing to note is that stroke is an essential part of
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vascular dementia, and this is why it is important to prevent further strokes from
happening. This is something that can be done by helping to reduce hypertension, as well
as reducing cholesterol and controlling the patient’s diabetes. It has been noted that
medications that reduce high blood pressure have been found to be quite effective in
reducing the risks for strokes and therefore for vascular dementia. Other than that,
individuals can also be encouraged to indulge in more regular physical exercise so that
they can have better blood sugar control as well as better blood pressure. Many of the
patients are also prescribed low-dose aspirin to be taken on a regular basis to help prevent
strokes. Other interventions include ensuring that the patients stop smoking if they are
smokers. Eating a healthy diet, such as eating more fish and vegetables and reducing red
meats and carbohydrates have also been found to be effective as preventative measures.
(Kalaria, 2018)
As noted earlier, there are no medications that can prevent or treat vascular
dementia. Moreover, the medications that are used to treat Alzheimer’s disease show
small improvements of cognition in patients with vascular dementia. This is why even
though some of the doctors tend to prescribe the same medications to patients with
vascular dementia that they do for Alzheimer’s disease patients, it is important to note
that other doctors tend to disagree, and they do not prescribe the same medications.
Moreover, as noted earlier, some of the patients of celiac disease tend to be more
susceptible to vascular dementia, which is why putting the patients on a strict no-gluten
diet has been found to relieve the symptoms of mild cognitive impairment. Such a diet
must be started as soon as possible, as it is likely to have an impact in the early stages of
the disease rather than when the disease has progressed to more moderate or severe
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symptoms and cognitive impairment (Lebwohl et al., 2016). Other than that, the general
management of dementia is something that can also be applied to the treatment and
management of vascular dementia, such as providing community services and support, as
well as ensuring that the daily routines of the individuals are simple.
It is important to consider the prognosis for dementia. Even though several studies
have been conducted, they have all been depicted as being small, limited, and
inconclusive. This is because there tends to be a lot of contradictions in the studies as
well. Nevertheless, it has been found that vascular dementia’s prognosis is not very good,
as people who have vascular dementia are more likely to die compared to those with
Alzheimer’s disease after being diagnosed. Other than that, it has also been found that if
the patient had to be hospitalized because of vascular dementia, such a patient was even
more likely to die compared to if the patient was hospitalized for cardiovascular disease.
Moreover, it has also been noted that in Alzheimer’s disease, the patients tend to get
weak, and this can result in the patients having various infections, like pneumonia, which
can cause death. On the other hand, in patients of vascular dementia, the dementia itself
can cause death if the blood flow is significantly interrupted in the brain.
In terms of the epidemiology of vascular dementia, it was found to be the secondmost common form of dementia after Alzheimer’s disease. About 1.5% of the population
in the Western world tends to have it and it is slightly higher in Japan with about 2.2%. In
Japan, half of the patients who have dementia have vascular dementia. It also must be
noted that about one-fourth of the patients who suffer from stroke tend to develop
dementia within a year of their stroke (Jia et al., 2020). The prevalence of dementia in the
US in people over the age of 71 is about 2.5% (Kramarow & Tejada-Vera, 2019). Other
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than that, it has also been depicted that 80% of the patients of vascular dementia have
hypertension, which is something that shows a significant link between the two.
Dementia With Lewy Bodies (DLB). This type of dementia occurs when there
are microscopic deposits of a protein known as Lewy Bodies in the specific part of the
brain known as the cortex. Some of the symptoms include having trouble with memory;
not being able to make decisions, pay attention, or think clearly; having visual
hallucinations; sleeping during the day; blanking out; not being able to walk properly and
other motor problems. It is interesting to note that DLB is a type of Lewy body dementia,
with the other one being Parkinson’s disease dementia (PDD). In this regard, we find that
these two conditions tend to have many similarities with each other and many of the
researchers are of the opinion that both these types of dementias lie on the same spectrum
with each other. In this regard, there is a high chance of misdiagnosis as well when it
comes to these types of dementia (Sanford, 2018).
The exact cause of DLB remains unknown. However, researchers are aware that
the dementia is caused because abnormal clumps form in the brain that are because of the
proteins that are known as Lewy Bodies. These clumps tend to affect the central nervous
system as well as the autonomic nervous system. According to the DSM-5, DLB can be
depicted as a causative subtype of dementia with Lewy bodies while Parkinson’s disease
can be depicted as a causative subtype of Parkinson’s disease. The primary region where
the Lewy bodies present themselves in the body to cause DLB is in the cortical regions.
On the other hand, Parkinson’s disease dementia that occurs with Lewy bodies has the
presence of the Lewy bodies in the subcortical basal ganglia (Sanford, 2018). Since they
are similar in so many ways, there is enough evidence to suggest that there is a common
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pathophysiology mechanism between DLB and Parkinson’s disease dementia. However,
they tend to be present at the opposite end of the Lewy body disease spectrum. Moreover,
as noted herein, they also tend to share the component of the protein deposits that can be
found in the Lewy bodies as well as the Lewy neurites. It has been noted that the Lewy
bodies as well as the neurites tend to develop when there is an aggregation of the alphasynuclein protein that becomes misfolded. This type of protein is responsible for assisting
the neurotransmitter that releases the vesicle turnover and this is something that gets
negatively affected (Sanford, 2018). This is something that is more like speculation than
any confirmed theory because of how no link has been found between Lewy bodies and
the neurodegenerative effects that have been found. Even though these are very different
types of dementia, the autopsies of patients have shown that there are so many
similarities between the two conditions in terms of convergent neuropathology.
Since DLB is so similar to Parkinson’s disease dementia, it can be quite difficult
to diagnose it. This is because of how the neuropathological features are very similar but
at the same time, they are also highly variable. This is why pathological features alone
are not enough to distinguish it from Parkinson’s disease dementia. There tends to be a
very small timeframe in which the dementia symptoms appear compared to the symptoms
that occur in Parkinson’s disease dementia. The diagnosis is made with the diagnosis of
Parkinson’s disease, as those that have Parkinson’s disease would show the Parkinson’s
disease dementia rather than DLB. With regards to the epidemiology of the disease, it can
be said that anywhere between 5% and 25% of the dementias that are diagnosed are
because of one or the other type of Lewy body dementia. It is depicted that as many as
1.5 million people in the US are affected by DLB (Sanford, 2018). In most cases, DLB
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develops in patients after the age of 50 and men are much more susceptible to be
diagnosed compared to women. In terms of the prognosis of patients who have DLB, it
has been noted that life expectancy of patients who are diagnosed with DLB tend to be
reduced and it means that it is about five to eight years after being diagnosed.
One of the things to note about Lewy body dementias is that they are some of the
most misdiagnosed dementias than any other type of dementia. One of the reasons is that
many of those who are diagnosed with the illness are not aware of the disease and they
have not heard of the disease before their diagnosis. This shows that the general
awareness about DLB is something that is much less compared to the awareness that is
there in terms of Alzheimer’s disease or Parkinson’s disease dementia. This is something
that can be quite frustrating for the patients as well as their caregivers. This is because of
how it is not just the general public but many of the healthcare professionals are also not
aware of Lew Body Dementias, even though it is one of the more common forms of
dementia. This is something that can have many negative effects on the patients as well.
This is especially true if the healthcare professionals that are caring for the patients of
DLB do not themselves have much knowledge about the dementia. Other than that, if the
healthcare professionals are not aware of the DLB, it can mean various physical as well
as mental health issues. For example, patients of DLB tend to be extremely sensitive to
antipsychotics and if they are used in the treatment – which they are quite commonly – it
can have many adverse effects on the patients. Therefore over the years, many
organizations around the world are working to enhance the awareness about this kind of
dementia and to ensure that it is not only the general public but also the healthcare
professionals who are more aware of this type of dementia.
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Parkinson’s Disease Dementia. Parkinson’s disease dementia affects patients that
have Parkinson’s disease. It is depicted that about 50% to 80% of the patients who have
Parkinson’s disease develop this type of dementia and this starts to occur on an average of
10 years after the diagnosis of Parkinson’s disease. The signs and symptoms of
Parkinson’s disease dementia are very similar to those of DLB. As noted earlier, this type
of dementia, along with the DLB is one of the Lewy body dementias that is characterized
by the abnormal deposits of Lewy bodies in the brain.
Looking at Parkinson’s disease, it can be said that it starts as a movement
disorder, but it slowly progresses in many cases to include dementia. When this starts to
happen, there are changes that start to occur in the mood and behavior of the patients as
well. Parkinson’s disease is a big risk factor for Parkinson’s disease dementia, and it
speeds up decline in the cognition that leads to Parkinson’s disease dementia. Delusions
in Parkinson’s disease dementia are much less common compared to DLB (Jellinger &
Korczyn, 2018). Other than that, it is also noted that patients who have Parkinson’s
disease tend to be less caught up in terms of their visual hallucinations compared to those
who have DLB. Higher incidence of tremor at rest is also there with regards to
Parkinson’s disease compared to DLB. Moreover, the signs of parkinsonism in
Parkinson’s disease dementia tend to be not as symmetrical compared to DLB.
It has to be noted that the diagnosis of Parkinson’s disease dementia is made using
the various elimination methods. This is because the only way to confirm a diagnosis of
Parkinson’s disease dementia is after death when the autopsy of the brain is performed.
Diagnostic criteria have been set up for Parkinson’s disease dementia as well as for DLB
and this has been through the 2017 Fourth Consensus Report (Jellinger & Korczyn,
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2018). One of the ways in which Parkinson’s disease dementia is distinguished from DLB
is with regards to the time frame in which the dementia symptoms start to appear
compared to the symptoms that occur in Parkinson’s disease dementia. When cognitive
symptoms begin, DLB can be diagnosed. However, for Parkinson’s disease dementia, the
presence of Parkinson’s disease is confirmed several years before the dementia symptoms
begin. In most cases, it is about ten years, but it can be sometimes as soon as one year
after the diagnosis of Parkinson’s disease (Jellinger & Korczyn, 2018). There is no cure
for Parkinson’s disease dementia, but patients can find some relief using cognitive
behavioral therapy as well as take medications to reduce such related signs and symptoms
as insomnia, depression, as well as anxiety.
Frontotemporal Dementia (FTD). This type of dementia results from cell
damage in the areas of the brain that are responsible for judgment, planning, movement,
speech, and emotions. The signs and symptoms of this includes changes in the person’s
personality and behavior; lack of inhibitions; not being able to find the right words for
things when talking; having motor problems, such as shaking and muscle spasms. It is
interesting to note that frontotemporal dementia, or frontotemporal degeneration disease,
or frontotemporal neurocognitive disorder can include many different types of dementia
that are related to the frontal and temporal lobes. Frontotemporal dementias can be
depicted as being behavioral or language disorders. There are three main subtypes or
variants, and they include a behavioral variant, as well as two variants of primary
progressive aphasia, which include semantic variant and noneffluent variant.
Frontotemporal dementias tend to be early-onset syndromes and they are linked to
frontotemporal lobar degeneration (Olney, Spina & Miller, 2017). This is something that
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is characterized by a progressive neuronal loss that predominantly involves the frontal or
temporal lobes. In this regard, it is depicted that a loss of more than 70% of the spindle
neurons occurs with the other types of neurons remaining stable (Olney, Spina & Miller,
2017).
Frontotemporal dementia was first described in 1982 when Arnold Prick
conducted research on this type of dementia. At the time and for a long time, the disease
was called Pick’s disease. This term is still used but it is only used for the behavioral
variant frontotemporal dementia. This is because it is only this type of frontotemporal
dementia that shows the presence of Pick bodies and Pick cells. Frontotemporal dementia
accounts for about 20% of the degenerative dementia cases that are found in patients after
their deaths during autopsy. The signs and symptoms of frontotemporal dementia start to
appear in late adulthood, most commonly when the patient is between 45 and 65 years
old. The ailment affects men and women equally. Some of the common signs and
symptoms of frontotemporal dementia include the individual showing significant changes
with regards to their social and personal behaviors, as well as showing apathy to others
around them. The emotions also tend to become blunt and there can be deficits with
regards to the person’s receptive as well as expressive language. No cure for
frontotemporal dementia exists; however, healthcare professionals often provide
treatment to reduce the symptoms and to ensure that the patient has a better quality of life
(Olney, Spina & Miller, 2017).
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Symptoms
Symptoms of dementia in the early stages include not being able to cope well with
the change. The patient can have a difficult time in accepting changes in his or her
schedules as well as the environment. Patients can also have a difficult time in their shortterm memory. For example, the patient might remember what happened many years ago
but would not be able to remember what he or she had for breakfast. Patients can also
have difficulties in reaching for the right words, as dementia can affect their word
recollection. Some patients end up being repetitive, such as asking the same questions, or
doing the same tasks over and over again. Confusion is also another symptom of
dementia. Another common symptom is that the patient starts to lose interest in things
that he or she previously enjoyed. Moreover, there can also be increased anger and
frustration, as well as depression in the patients.
Even though dementia may result in cognitive decline, it is not the same thing as
cognitive impairment. Mild cognitive impairment (MCI) is when there is more decline in
a person’s cognition compared to normal aging and yet it is not as serious as dementia.
Cognitive decline can result in a person having various issues and problems, such as with
his or her memory, thinking, language, and judgment. Many people tend to complain of
having their memory being affected and family and close friends are the ones that tend to
notice the change first. Even though these symptoms might be there, they are not as
problematic to affect the normal functioning of a person’s life. It must be noted that even
though cognitive decline is something that does not post much of a threat to the person,
the patient is at a higher risk of developing dementia later on in life. For some people, the
cognitive decline does not get worse and might even get better in time.
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Some of the symptoms of cognitive decline include forgetting about things much
more often than before. This is because forgetting things is quite normal and this is
something that gets worse when a person gets older. However, if the person starts to
forget more than usual, it can be a symptom of cognitive decline. Another symptom is
forgetting appointments and other social engagement. People can also exhibit losing their
train of thought when reading books or watching movies. Some people can also feel like
they are lost, and they are not able to find their way even though they are in familiar
placed. Poor judgment is also another symptom of cognitive decline. Some patients can
also have various other mental issues, such as anxiety, depression, and irritability and
aggression.
Researchers have not been able to identify a single cause for cognitive decline.
The symptoms and outcomes for the patients also vary quite a lot. Some patients may
remain stable for years, while others might end up progressing to Alzheimer’s or any
other type of dementia. For many, the symptoms might improve over time. It has to be
noted that some of the same changes that occur in the brain during Alzheimer’s disease
and other forms of dementia are similar to what happens during a patient undergoing
cognitive decline, such as small strokes or the blood flow to the brain being reduced. The
risk factors that have been identified include normal aging, smoking, diabetes, elevated
cholesterol, high blood pressure, obesity, and lack of physical education and participation
in mentally stimulating activities (Kennedy et al., 2017).
There is no treatment that is there for cognitive decline; however, it has been
noted that some of the drug that are being used to treat other issues such as Alzheimer’s
can be effective in treating cognitive decline as well. Other than that, it has been noted
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that treating some of the risk factors, such as high blood pressure and depression, can also
result in the symptoms getting better. Lifestyle changes have also been depicted as being
useful to prevent or slow down cognitive decline (Kivipelto, Mangialasche & Ngandu,
2018). These include having a healthy diet, exercising regularly, and making other
lifestyle choices, such as quitting smoking, eating more fruits and vegetables and less fat,
as well as eating more Omega-3 fatty acids in the diet have all been found as being a
form of treatment for cognitive decline (Montero-Odasso, Ismail & Livingston, 2020;
Ngandu et al., 2015; Valls-Pedret et al., 2015). Studies have also shown that stimulating
the mind and intellectual stimulation, such as people reading books, playing video games,
and indulging in some kind of cognitive training can also help the patients in terms of
delaying their cognitive decline and helping to slow it down.
Stages
Dementia is mostly progressive and gets worse as time goes by. This process of
progression is different for different patients. Yet, the progression can be described as
having certain stages. The first stage is mild cognitive impairment. This is when the older
people start to feel that they might have some memory issues. In some cases, the
dementia does not progress beyond this stage. When the patient has mild dementia, it
means that he or she can start to have various symptoms, such as short-term memory
lapses, having changes in their personality, such as being angry, losing things and not
remembering where they put them, inability to complete simple tasks, and not being able
to express their ideas of emotions. The next stage is moderate dementia in which the
patient would need support from the loved ones or their care providers. The patients start
to exhibit poor judgment, can have increased confusion and frustration, memory loss that
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includes forgetting past evens, not being able to dress and bathe themselves, as well as
having personality changes that are quite significant. The final stage is severe dementia,
which is the late stage, and this is where the patient is unable to maintain his or her bodily
functions, such as swallowing, walking, and controlling the bladder. The person is not
able to communicate and requires full-time assistance. Eventually, this leads to the
person’s death (Livingston et al., 2020).
It can be said that the course of dementia can be described in four stages, and this
is something that is done because of how there is a pattern of progressive cognitive as
well as functional impairment that starts to occur. At the same time, there are also several
numeric sales that are also used, and they provide a much better description of the stages
of the illness. For example, some of the scales that are used to measure the stage include
the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS
or Reisberg Scale), the Functional Assessment Staging Test (FAST), and the Clinical
Dementia Rating (CDR). GDS can be depicted as one that can most accurately identify
each of the different stages of the disease progression. This is something that works to
provide the progression in seven stages (Livingston et al., 2020).
Pre-Dementia States. These include the pre-clinical and prodromal states. In the
pre-clinical state, the sensory dysfunction starts to appear. It has been noted that this is
where the first clinical signs of dementia start several years before the actual dementia
that takes place. This includes the loss of a sense of smell. People tend to lose their sense
of smell because of depression or loss of appetite that can be because of poor nutrition.
This is something that can lead to the nasal cavity being negatively affected and this can
lead to toxic elements to enter the brain and to damage the chemosensory networks. In
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the prodromal state, it is depicted that some mild cognitive impairment (MCI) can start to
occur. It can also result in mild behavioral impairment (MBI). The symptoms tend to be
extremely subtle, and people mostly tend to notice them in retrospect. It is interesting to
note that about 70% of the patients who have mild cognitive impairment tend to develop
dementia in their later lives. This is because of how the changes that have been occurring
in the brain have been happening for a long time. Yet, it is only much later than the
symptoms start to appear. In mild cognitive impairment, the symptoms are not very
severe, which means that the diagnosis of dementia cannot be made. People tend to have
some memory problems and they might have trouble finding words. However, the rest of
the daily routines continue normally (Livingston et al., 2020).
Early Stages. The early stage of dementia is when the symptoms start to become
noticeable to other people. This is when people in the household, as well as friends and
other family members start to notice that the person is having issues. Other than that, the
person also starts to notice that the symptoms can interfere with the daily activities (Davis
et al., 2018). Such symptoms also start to appear on the Mini-Mental State Examination
(MMSE). These scores show normal cognitive rating between 24 and 30; however, the
lower the scores, the more severe the symptoms become. The symptoms in this stage also
depend on the type of dementia. The more complicated chores as well as the tasks that
the person must perform in the house or work start to become exceedingly difficult.
People are still able to take care of themselves but they might start to forget things, such
as taking their medications on time or doing their daily grooming activities. Some of the
other symptoms of early dementia can also include difficulties in memory as well as
some issues with word-finding problems. The person’s executive functions of planning
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and organization can also be affected. The person can also find that it is difficult for him
or her to manage his or her finances in a proper manner. This can also lead to the person
repeating things, being lost in new places, as well as undergoing various types of
personality changes (Davis et al., 2018).
Middle Stages. The initial symptoms start to worsen in the middle stages when
the dementia starts to progress more. The rate of decline tends to be different for different
people as well as for people who have different types of dementia. When the MMSE
scores are between 6 and 17, it means that the dementia has progressed to the moderate
stage. For patients of Alzheimer’s disease, they start to lose almost all new information at
this stage. This is where there can be severe impairments with regards to problemsolving. Other than that, the social judgment is also something that tends to get impaired.
People are unable to function outside of their homes and therefore it is important to not
let them be alone. Such patients might be able to do some of the chores in the house but
not much else. They are also not able to keep up with their personal care and hygiene
(Davis et al., 2018).
Late Stages. This is where the patients start to turn increasingly inwards, and they
require assistance with almost all of their personal care needs. Such people tend to
require 24-hour supervision so that their personal safety can be ensured. It is also
important that they have constant supervision so that their basic needs can be met, such as
for their food and hygiene habits (Fereshtehnejad et al., 2018). If a person at this late
stage is left unsupervised, he or she can wander and/or fall. They are also not able to
recognize some of the more common dangers, such as not touching hot surfaces, or that
they can slip if they walk fast on wet surfaces. Incontinence is also rampant during this
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stage. Such patients also tend to want to stay in bed and they need assistance in getting
out in case they do. Such patients are also unable to recognize familiar faces and can have
significant issues with regards to their sleeping habits. They can also have widespread
insomnia and would not be able to sleep properly. Eating is also something that changes,
as the person is not able to swallow properly. This can lead to the patient choking on the
food, as well as refusing to eat outright (Davis et al., 2018).
Treatment
There is no cure for dementia, but they are treated with medications to alleviate
some of the symptoms as well as with non-drug therapies. Medications that are used to
treat dementia occurring because of Alzheimer’s disease include cholinesterase
inhibitors, which can help form memories as well as to improve judgment. The
medication can also delay the progression and worsening symptoms. Another drug that is
used is memantine, which is used to delay the onset of the cognitive as well as behavioral
symptoms in people who have moderate to several Alzheimer’s disease. Other than that,
there are several non-drug therapies that can also be used. These include modifying the
environment. If the patient is able to reduce the clutter, noise, as well as overstimulation
of his or her senses, it can lead to better focus. Tasks can also be modified so that it is
easier for the patient to perform. Occupational therapy can also work, such as learning
safer ways to walk, cook, and drive (Arvanitakis, Shah & Bennett, 2019).
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Care/Support
As noted earlier, patients with dementia can require constant care and support
depending on the stage of the dementia that they are in. In this regard, we find that it can
take a big toll on the caregivers, especially the family members. If the patient is unable to
perform his or her daily routine and tasks, the family members must spend a lot of time to
take care of the patient. This is something that can lead to a lot of stress on the caregivers
and can result in the caregiver ending up with mental health issues as well. The care can
include feeding the patient, helping the patient to get out of bed, go to the bathroom, and
perform other daily tasks as well.
Who Does Dementia Affect?
There are several risk factors for dementia, which means that it affects certain
people more. One of the biggest risk factors for dementia is age. The older the person
gets, the more at risk he or she becomes for Alzheimer’s disease, vascular dementia, as
well as other dementias. Genetics as well as having a family history of Alzheimer’s is
also another risk factor. If a person has a parent or a grandparent who had Alzheimer’s,
such a person’s risk of getting dementia increases. Other than that, researchers have also
been able to identify several gene markers that can contribute to a person developing
dementia in his or her life. For example, people who have Down’s syndrome are at a
much higher risk of developing dementia at a much younger age. People who smoke have
a higher risk of mental decline as well as dementia. Moreover, heavy drinkers of alcohol
are also at a higher risk. It has also been found that those that have higher levels of
cholesterol, especially low-density lipoprotein (LDL) tends to be at a much higher risk.
Diabetic patients are also at a higher risk of developing dementia, according to many
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studies. Such patients are at a higher risk for both Alzheimer’s disease as well as vascular
dementia. M…
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