Dealing with Dementia: When Thinking and Behavior Decline

Forgetfulness, confusion, or having trouble remembering a name or word can be a normal part of life. But when thinking problems or unusual behavior starts to interfere with everyday activities—such as working, preparing meals, or handling finances—it’s time to see a doctor. These could be signs of a condition known as dementia. 
Dementia is a brain disorder that most often affects the elderly. It’s caused by the failure or death of nerve cells in the brain. By some estimates, up to half of people ages 85 and older may have Alzheimer’s disease, the most common cause of dementia. Although age is the greatest risk factor for dementia, it isn’t a normal part of aging. Some people live into their 90s and beyond with no signs of dementia at all.  “Dementia really isn’t a disease itself. Instead, dementia is a group of symptoms that can be caused by many different diseases,” says Dr. Sanjay Asthana, who heads an NIH-supported Alzheimer’s disease center at the University of Wisconsin.
“Symptoms of dementia can include problems with memory, thinking, and language, along with impairments to social skills and some behavioral symptoms.”  Several factors can raise your risk for developing dementia. These include aging, smoking, uncontrolled diabetes, high blood pressure, and drinking too much alcohol. Risk also increases if your family members have had dementia.
The 2 most common causes of dementia in older people are Alzheimer’s disease and vascular dementia, a condition that involves changes to the brain’s blood supply. Vascular dementia often arises from stroke or arteriosclerosis (hardening of the arteries) in the brain. Other causes of dementia include Parkinson’s disease, HIV infection, head injury, and Lewy body disease. (Lewy bodies are abnormal protein clumps in brain cells.) 
Dementia in people under age 60 is often caused by a group of brain diseases called frontotemporal disorders. These conditions begin in the front or sides of the brain and gradually spread. A rare, inherited form of Alzheimer’s disease can also occur in people in their 30s, 40s, and 50s. 
“NIH has specialized centers across the country that have clinics that can diagnose and evaluate patients with Alzheimer’s disease and dementia,” Asthana says. (See NIH's Alzheimer's Disease Research Centers for more information.)  Different types of drugs are being used to treat Alzheimer’s disease, Parkinson’s dementia, and certain other forms of dementia. These medications may improve symptoms, but none can halt or reverse progressive damage to the brain. 
Chui notes that a healthy lifestyle can help protect the aging brain. “Regular exercise, a heart-healthy diet, and avoiding smoking can reduce your risk for heart disease as well as dementia,” she says. Engaging in social and intellectually stimulating activities might also help to protect brain function. “You can change your trajectory toward a healthier brain by making healthy choices,” Chui says. (Copied in part)                                                                                               
Source: National Institutes of Health, Jan 2014, http://nihnewsinhealth@od.nih.gov