Deterioration

Dr Cesar Rodriguez explains how dementia may change over time, or even from day to day, and why this happens.

Professor June Andrews comments…

The word “dementia” is used to describe the collection of warning signs that come about when your brain stops working as well as it used to. It is defined as dementia only if these problems continue to get worse and there is a permanent deterioration over time. The changes in the brain that give rise to dementia symptoms can be caused by a range of diseases. There are probably more than a hundred of these diseases, but three or four of them are very common. The commonest is Alzheimer’s disease.

What are the symptoms of dementia?

The key symptoms include:

  • Difficulty in remembering things
  • Difficulty in working things out
  • Difficulty in learning new things
  • Difficulty in coping with any physical or sensory impairments the person develops as a result of normal ageing or as a result of illness or accidents

These symptoms can be accompanied by other issues, depending on what the underlying disease process is, and different symptoms come to the fore at different times. People with dementia often have language problems and their  behaviour may change. The key problem is a reduction in the person’s capacity to manage normal day-to-day activities. Put together these symptoms cause phenomenal stress and a crushing fatigue. So it is really important to take the symptoms seriously, even in the very early stages.

All four of the symptoms outlined here (remembering, learning, working things out, and coping) give rise to dreadful strain. It is stress that explains some of the dementia related disturbing behaviour that other people find hard to understand. The more challenging the environment is for people with dementia, the more stress they will suffer. The main challenges have been identified by research. They include the behaviour of other people, challenges in the physical environment in terms of noise and light, and the design of spaces. Another challenge is presented when the person is required to go through rapid change and faces too many people and new systems and processes. The person may already be undermined physically by poor diet, lack of exercise, and even dehydration, on top of whatever cocktail of medicines they have to take for all their other bodily ailments. Any little intervention that can be made to reduce stress will certainly make life easier, both for the person with dementia and the carer.

Reviewed March 1, 2019

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